Danger time for new pharmacists

In Opinion

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In the next few days and weeks, a new generation of pharmacists will join the GPhC register, complete with prescribing qualifications. This is the point of maximum danger for them personally — and for members of the public. 

I am sure the vast majority will be fine, upstanding members of the pharmacy community, but I am concerned about the risks of some of these individuals cutting loose and maybe being swallowed up by online providers, who have shown little or no regard for patients beyond taking their payments.

Rough start

So let’s start by acknowledging that this cohort has had it rough. Their education was badly affected by Covid, their foundation training felt as though it was made up as they went along, and some had to cope with multi-sector placements that have not always been easy.

Expectations for them were also sky high. Experienced pharmacists were expecting super-whizzy trainees, but the reality has been more sobering. Some have not been ready for the transition and, dare I say it, if they didn’t pass their assessment, there will be more than a few relieved supervisors out there.

Pressure’s on

For those who do get through, a whole load of pressure could be coming their way. Their skills will be in high demand across all sectors of pharmacy, but the systems that should support them are not yet ready.

There is a pilot Pharmacist Enhanced Practice Pathway (PEPP), with 1,200 places open to newly qualified pharmacists to provide education and training for their early career journey. This sounds helpful, but 900 places are for those with “employer-provided educational support”, which
I read as mainly NHS organisations.

The remaining 300 places will allocate a CPPE tutor to learners who cannot access educational support from their employers, which means most community pharmacies. I’ve read what the course entails, but to be perfectly honest, I’m still none the wiser.

Governance concerns

The challenge in community pharmacy is that this new cohort will largely be supervised or managed by non-IP pharmacists. In my experience, these pharmacists don’t necessarily know what they don’t know about prescribing governance.

I’ve talked to a few superintendent pharmacists, and most stare blankly at me when I ask what their prescribing governance looks like. We are going to get pharmacy owners who think this is all on the prescriber, but it isn’t. The right processes and systems need to be in place to identify prescribing problems and intervene where necessary.

For private services, some pharmacies don’t even have a digital system for recording consultations. Some will rely on paper prescriptions, creating a massive headache when they need to work out what went wrong. I can cope with people who don’t know what they’re doing if they hold their hands up and say they need more help to make prescribing safe within their organisation. But then there is a whole world of people who just don’t seem to care.

Just today, I spoke to a young lad in his late teens who came in to ask about symptoms. As I ran through the conversation with him, he told me about the supplements he had been using after completing an online quiz. It turned out these ‘supplements’ were minoxidil and dutasteride.

He had no idea what he was taking, or even that they were POMs. If he didn’t know that, how could he consent to treatment? What side-effect information had he been given? My worry is that some newly qualified pharmacist IPs could be dragged into situations like this.

Not convinced

We all know NHS pharmacist prescribing is coming in England, but I’m not convinced pharmacy owners are ready to host prescribers, or fully understand the work they need to do to keep patients safe. The NHS service definitely won’t cover the cost of this additional workload, and there are not enough experienced pharmacist IPs to mentor colleagues and show them what to do to get ready.

Who will stop inappropriate pressure being put on these new pharmacists?