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Supervision changes: let’s keep it simple

In this blog written exclusively for Pharmacy Magazine, Community Pharmacy Scotland outlines its response to the Government’s supervision consultation and asks – do the proposed changes fall short of achieving what modern pharmacy practice really needs?

Isn’t it frustrating as a pharmacy team member when you can’t hand out a prescription to a patient when the pharmacist has nipped out on their lunch break, even though the prescription has already been checked and bagged?

It can also be frustrating when, as a pharmacist, you are trying to juggle providing clinical services to your community with being tied to overseeing the technical aspect of dispensing within your pharmacy.

Luckily, we may soon be able to work differently. The Department of Health and Social Care has launched a consultation focusing on changing the primary legislation which currently governs the supervision of activities in pharmacy practice.

Community Pharmacy Scotland is fully supportive of its goal of modernising supervision. However, we feel that the proposed Government changes may fall short of achieving this aim.

We have therefore submitted an alternative response to the consultation, which advocates for positive change that can see utilisation of a pharmacy teams’ experience and knowledge, whilst freeing up registered pharmacy professionals to deliver clinical services.

One pharmacist per pharmacy

Community Pharmacy Scotland is backing the safe and effective optimisation of community pharmacy practices. We strongly support retaining the core principle of one responsible pharmacist per pharmacy premises.

We also believe that the assembly of prescriptions should not require direct supervision by a registered pharmacy professional, but should instead rely on authorised safe systems to allow experienced, qualified and competent members of the dispensing team to undertake the technical aspect of preparation, assembly and dispensing, up to the point where an accuracy and clinical check needs to be undertaken.

Of course, the pharmacy superintendent would be responsible for making sure that these safe systems and well-trained team members are in place so that this could all happen. This would allow the profession to test new ways of working whilst still having the (more flexible) safeguards of regulation, set by the regulator (GPhC) and professional body (RPS), in place.

The environment, technology, training, conditions and SOPs in the community pharmacy setting have a far bigger effect on safety of preparation and assembly than supervision by an individual. Shifting the reliance from one individual (a responsible pharmacist) to another (a registered pharmacy technician) as is proposed in the consultation simply leaves new ways of working open to the same vulnerabilities, such as absence, as before.

Our pharmacy technician colleagues are more than up for the task of taking on supervision, but we believe their future also lies in using their training to deliver clinical services. By focusing on safe systems, you not only have a more sustainable model to work with, but you decouple both pharmacist and pharmacy technician from the technical aspect of dispensing allowing them to harness their clinical skills in delivering clinical services and patient care.

Use this opportunity

We do agree that sale and supply of medicines should still require the supervision (but not necessarily presence) of a registered professional, and support the proposals as written for these elements of practice. With an ever-evolving healthcare landscape and the need for greater access to health advice than ever before, it is important that we use this opportunity to ensure the proposals help to support the requirements of an already strained NHS.

Looking at proposal two, we fully support the handout of prescriptions by any member of the team, when authorised by the responsible pharmacist, and that it should involve a signed-in responsible pharmacist, even if not physically present.

This will deliver a significant operational benefit whilst maintaining safety controls around the point of transfer by enabling the responsible pharmacist to decide on a case-by-case (and potentially a prescription-by-prescription) basis how prescriptions may be handed out.

These changes are designed to provide a more flexible approach to community pharmacy operations, creating new opportunities for pharmacy teams while maintaining the key factor of patient safety. Additionally, it will free up valuable time for everyone in the pharmacy and improve access of healthcare services and prescriptions to patients.

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