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Final word: Charting a course for pharmacy

In the last article in this series, Harry McQuillan turns the final key in unlocking community pharmacy’s full potential by examining what needs to change regarding the sector’s outdated supervision and responsible pharmacist regulations

So far in this series, I have explored how community pharmacy might move towards ensuring not just the accuracy, but the safety of every supply of medicine.

We have looked at how most of these prescriptions will continue to be generated by other prescribers in the healthcare system – but increasingly we will see community pharmacists themselves issuing more scripts after either a consultation for an acute condition or a review of chronic disease pharmacotherapy. Either way, our focus has to be on making the most of each and every interaction we have to improve the nation’s health.

We know broadly what future services will look like, and have thought long and hard about how we educate and train our people to be confident and competent in delivering those services. Last month’s discussion was all about how we support pharmacy professionals to spend more time with patients and the public by developing IT and teams that can take the technical aspects of delivery into the background – but these measures alone won’t be enough. 

Restrictive, outdated

Let us now examine what needs to change about our profession’s outdated and restrictive supervision and responsible pharmacist regulations.

As part of the Rebalancing Medicines Legislation and Pharmacy Regulation programme, the GPhC now has much more control to set the terms of clinical governance that we must all abide by. 

This is a fantastic development, as the regulator can be responsive to an ever-changing profession, adapting, if not necessarily in step, then certainly in a much more timely manner than is possible when everything we are held to is effectively set in stone in restrictive detail within regulations.


I am acutely aware that the topics of supervision and  responsible pharmacist can be polarising for the profession to say the least – and that is why the Community Pharmacy Scotland executive, council and board have been carefully considering the issues and developing our position on the matter for nearly a year now, listening to both hopes and fears in the process.

Firstly, let’s acknowledge the elephant in the room – and then show it the door. Community Pharmacy Scotland is absolutely clear that a 1:1 pharmacist-to- pharmacy ratio must remain a key principle going forward. We know (and have research to prove it) that what makes a successful pharmacy is the team that keeps it running.

There are some things, however, that we are equally clear do need to change. The current arrangements stifle the potential of pharmacy teams and, at a more basic level, actually impede the efficient running of a modern community pharmacy.

“Where people have to use workarounds to safely fulfil a basic function, your system is flawed”

The main, urgent changes needed are that prescription assembly can proceed without a responsible pharmacist being signed in. Also that the handout of prescriptions which have already been reviewed clinically should be possible when a responsible pharmacist is signed in, but not necessarily present. 

When it comes to handout, technology in the form of ‘locker boxes’ is already making a mockery of the current regulations – allowing collection of assembled and checked prescriptions at all hours, while pharmacies without this equipment have to sheepishly refuse to make a supply if the responsible pharmacist is not on the premises.

We even have pharmacies in rural areas deregistering small parts of their pharmacy to allow handout to occur, ensuring continuity of care to communities where a pharmacist is working across two sites in the day. Where people have to use workarounds to safely fulfil a basic function, your system is flawed.


I’m certain there will be alternative views on these matters. In recognition of that, our position is to seek the flexibility that enables owners, superintendents and responsible pharmacists together to agree new, safe ways of working where the conditions and environment allow it. 

We all know that no two pharmacies are alike and, indeed, no two days in one pharmacy are alike either. All it takes is an unexpected absence to throw a spanner in the works.

Responsible pharmacists are used to making decisions about how a pharmacy is run each day. These new ways of working we are asking for will be no different. We need to be able to adapt to deliver new models of care, but also to ensure the safety of every supply when covering the basics gets tricky.

Final thought

I hope that through this series you can see that we have a clear and bright vision of what the future holds for community pharmacy. So I will leave you with this final thought: the changes we need to see are ultimately ones that empower, not enforce. For those who cannot yet see how they could work safely in these ways – they won’t have to. For those who can, a whole new world awaits.

Harry McQuillan is the chief executive of Community Pharmacy Scotland

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