Opinion: Self-selection or self-destruction?

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Calls to allow the self-selection of Pharmacy (P) medicines are once more gaining traction with the decision of the RPS to reverse its policy position on the matter – but this is an ill-judged misstep in the wrong direction, one that threatens patient safety and undermines pharmacists’ professional role.

Supporters claim it improves access to OTC medicines, empowers patients to read packs and make informed choices about their own care, and could even boost sales to offset income losses in other areas. 

Sorry, but I just don’t buy it. 

Self-selection weakens pharmacist oversight and creates inconsistency between pharmacies, sowing confusion for the public. It blurs professional boundaries, putting commercial priorities above clinical ones. Most pharmacists, perhaps concerned about potential conflict if sales are refused away from the medicines counter, simply think it’s a very bad idea.

The P classification acts as a clinical checkpoint that facilitates real-time conversations about appropriate OTC medicines use, stops harmful purchases and helps guide patients to safer alternatives where necessary.

Supervised sales provide a critical window of opportunity to intervene, advise and, where necessary, say no – there and then, with the patient in front of you, not 20 minutes later at a distant checkout lane.

Community pharmacy has worked tirelessly to be recognised as a vital healthcare service, not merely a shop selling stuff. Eroding this distinction by allowing the public to grab P medicines off the shelf in the name of convenience risks commoditising pharmacy’s unique offer and serves no one – least of all the patients that the profession strives to protect. 

Yes, access matters. But safety and trust matter more. Self-selection of P medicines, “facilitated” or otherwise, is just not a risk worth taking.