Heated debate on rebalancing board proposals

A heated debate is raging concerning the consultation by the Government’s rebalancing board on proposed changes to the legislation that deals with responsible pharmacists and superintendent pharmacists. Does this pave the way for remote supervision by the back door?

A consultation on changes to legislation regarding responsible pharmacists and superintendent pharmacists from the Government’s rebalancing board, which closed on September 11, has sparked a heated debate on social media. Some pharmacists believe changing the law would be a much-needed modernising influence on pharmacy practice, while others are convinced it could cause irrevocable harm to the sector.

The controversy centres on whether pharmacy regulators should have the power to make an exception to the general rule that a responsible pharmacist can only be in charge of one pharmacy at one time. Some fear that this could pave the way for remote supervision.

The Royal Pharmaceutical Society agreed with the rebalancing board’s proposal to allow exceptions to the ‘one pharmacist, one pharmacy’ rule, saying “this is the principle of rebalancing”.

“Being the responsible pharmacist in charge of one pharmacy at any one time should be the norm. We expect any regulator to make this clear but to allow exceptions for emergencies where patient care would be compromised, such as extreme weather or a pandemic situation,” the RPS said in its consultation response.

Unacceptable risk

The Pharmacists’ Defence Association, on the other hand, said the proposal “would create an unacceptable risk to patient safety and expose pharmacists unfairly to criminal and civil prosecution and regulatory sanctions, in working conditions that at present are poorly regulated and for activities that occur in pharmacies in which they are not even present”.

The RPS has come under fire from some pharmacists, with several claiming its stance looked like a tacit approval of remote supervision.

Former NPA board member Mike Hewitson tweeted: “Exceptional circumstances get diluted over time. Thin end of the wedge. I still do not understand the problem this is intended to solve.”

The RPS was quick to clarify its position, president Ash Soni tweeting: “This is absolutely not about remote supervision.” This would fall under separate legislation, he said.

An official RPS statement read: “The RPS has always been clear that every pharmacy should have a responsible pharmacist. We will be challenging the General Pharmaceutical Council to make sure there is a defined and specific description of the ‘exceptional’ circumstances where pharmacists, not employers, would use their judgement to make sure patients have access to essential medicines.”

New powers

The rebalancing board proposes giving the pharmacy regulator new powers with respect to responsible pharmacists and superintendent pharmacists, and removing certain ministerial powers in this area.

The RPS broadly agrees with the aim of moving from legislation to regulation to better keep pace with changes in pharmacy practice, said Ash Soni. “This will, however, place greater responsibility on the GPhC to ensure their regulatory standards and systems are robust enough to identify areas of risk, while still offering sufficient flexibility to empower pharmacists in their daily practice.

“Superintendents must have authority and autonomy over the professional aspects of the pharmacy business and this should be enshrined in legislation,” he stressed.

The Company Chemists’ Association said that while it supported the ‘one pharmacy, one pharmacist’ principle, it viewed the consultation “as an opportunity to start to unlock the potential provided by the whole pharmacy team to deliver timely and cost-effective services for patients and the NHS and move away from outdated legislation.”

Clarity needed

More clarity is needed around the proposed roles and responsibilities for superintendent and responsible pharmacists, the CCA added, particularly with regard to the ‘senior manager’ definition of superintendent pharmacists.

Again, the PDA took up a robust position. “We do not believe the regulator is ready to undertake the formidable task that has been outlined for it by the Government… nor do we believe that it will be ready any time soon”

The Department of Health and Social Care says it is currently analysing feedback to the consultation and will publish an outcome “soon”.

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