The Royal Pharmaceutical Society's branch representatives' meeting this year will have an emphasis on the composition of the Society's Council and the election of Council members and officers. Several of the motions submitted for debate are concerned with this topic, which will also be the theme of a discussion session in the afternoon.
One of the motions calls on the Society to investigate whether a proportion of Council members should be elected on a regional basis. Another wants the Council to consider devolving some of its power to a body in England similar to the Society's Welsh and Scottish Executives. A further motion calls for the President and Vice-President to be chosen by an electoral college of the Society's branches. And another wants the Council to reconsider the restrictions on election canvassing.
Several of the other motions relate to the Society's branches. One calls for a review of their structure, role and functions, and another seeks a re-examination of the branch boundaries. One motion suggests that branches may in future need professional or commercial assistance to run their affairs efficiently. Another seeks recognition for members who have given long and dedicated service to their branches. Other motions concern the British Pharmaceutical Conference's relationship with the local branch and the branches' relationship with preregistration trainees.
Two motions concern the Society's public relations unit. One wants an outside consultant body to assess public relations performance. The other asks the Society to assign a press officer to monitor developing political, sociological, moral and scientific issues and bring them to the attention of the Council so that the Society might comment authoritatively on appropriate matters.
Other motions cover a broad range of topics, including the promotion of seamless pharmaceutical care, recognition of the advice and care given by community pharmacists, the provision of emergency oral contraception, the design of patient packs, dispensing in whole packs, disciplinary procedures, the Society's memberships database, a clearing house scheme for preregistration training posts, publication of registration examination successes, the registration fee paid by newly qualified pharmacists, encouraging the provision of more preregistration training places, office accommodation for the British Pharmaceutical Students Association, and the Council's response to BRM motions.
This year there are 25 motions in all - four more than in 1999. They will be debated during the morning session and the first part of the afternoon. All motions carried by the meeting will be referred to the Council for its consideration.
The final part of the afternoon will be devoted to a discussion on the Council election process, followed by a discussion on issues that are currently under consideration by the Council, introduced by the head of the Society's policy support unit (Ms Eileen Neilson).
The branch representatives' meeting takes place at the Society's London headquarters on May 11. Set out below is the text of the motions for debate. Each is followed by an explanatory paragraph from the branch or branches concerned.
Seamless care between hospital and community pharmacists has been discussed for many years. The reality is that very little progress has been made. Guidelines and best practice should be vigorously promoted nationally. The Royal Pharmaceutical Society, the British Medical Association, the National Pharmaceutical Association, the Pharmaceutical Services Negotiating Committee and the Department of Health must agree on the principle of seamless care. There must be a will to make this a reality. In each area the local branch, local pharmaceutical committee, primary care groups, health authority and each community and hospital pharmacist will need to work towards this concept.
The "added value" to the public cannot be measured. This should be a new initiative with funding similar to NHS Direct. Effective national public relations should be initiated concurrently on a cost effective basis.
Community pharmacists are ideally placed to provide patients with increased access to emergency hormonal contraception while also providing counselling and advice for the protection and benefit of the woman concerned. As the roles for health professionals develop, this is one area where pharmacists who wish to do so are well positioned to provide this professional service. Community pharmacists are generally open longer hours than the traditional access points for emergency hormonal contraception (general medical practices and family planning clinics) and do not require an appointment to seek professional assistance. In addition, private counselling areas can be provided in most pharmacies to ensure patient confidentiality. The training a pharmacist already receives means minimal additional resources and training are required to utilise this widespread expertise, particularly if an appropriate protocol is put in place. Such a shared care protocol will be a joint agreement between involved health professionals and the health authority (or other body as appropriate) and include agreed management pathways and clear responsibilities for the individuals counselling the patient.
Concordance is most likely when the user can easily identify the medicine and read the instructions for taking or using it. Thus, different products need contrasting colours for ease of identification. Clear product identification is needed (name and strength), particularly to assist the visually handicapped. The bar code and manufacturer's logo can overwhelm this. Standard British National Formulary cautionary and advisory labelling could be on the box itself, leaving more space on the standard dispensing label for a larger type face for specific instructions. Foil strips - which themselves can be difficult to open for patients with arthritis, etc - should have the printing in legible type. There should be sufficient spacing on the foil to enable odd quantities to be cut out and dispensed (and to retain the batch number and expiry date on such part strips). The current position is unsatisfactory and presents a poor image to the general public.
In support of this motion we wish to point out the reasons why patient packs should not be cut, eg, when a prescriber issues a prescription for 30 tablets of a product packed in 28s. Pharmacists should be able to supply whole packs giving a total quantity nearest to that specified by the prescriber. Supplying cut packs is both unprofessional and potentially hazardous to patients because: it may be almost impossible to identify tablets, expiry date or strength; there is an increased chance of dispensing errors; sharp edges occur as a result of cutting the strips; no leaflet is available, and therefore there is a disregard for the European Community directive; and there are possible severe consequences in the event of overdose.
This has been based on some recently reported deaths following prescribing or dispensing errors for which medical practitioners were responsible and similar errors by pharmacists.
At present it is not mandatory to complete the section on the reverse of the retention fee form which relates to the member's area of employment. If paying by direct debit, which is recommended in order to reduce administrative costs, there is no need to return the form at all. The employment data is therefore incomplete and can only be updated annually. There is a legitimate need for up-to-date and accurate information on pharmacists employed in the various sectors of the profession for the purpose of targeting relevant correspondence. For example, the continuing education centres or schools of pharmacy may wish selectively to distribute information on direct or distance learning courses. Such information is also of value for statistical records, manpower planning and monitoring changing trends within the profession.
Concern has been expressed about the level of support the branch receives with respect to information on pharmaceutical matters currently in the news media spotlight. The branch endorses a constructive approach to the Society and suggests due consideration be given to establishing an independent review to ensure the profession is getting an optimum public relations service. The potential of gaining an independent view of the quality and quantity of public relations services currently offered, in comparison to that which is possible, should help to judge whether the current facilities can reasonable be improved. A better level of public relations should enable an improved understanding of the benefits the profession can offer the public and help ensure we are regarded as a significant force in improving the health care and welfare of the population. The branch hopes this helps the Council's deliberations by trying to indicate that there was a level of dissatisfaction at branch level on PR matters without just being critical. We are sure our public relations officers will be able to provide more detailed comment if required. Sadly, PR assumes ever greater importance these days and we have to continue to provide a first rate service just to keep up.
Our press department is now more proactive in informing the public of the profession's position on pharmaceutical matters. However, pharmacy will not be recognised as a major health player until its uniquely informed input to debate on matters with wider or less obvious health implications is expressed and (hopefully) subsequently routinely sought.
The burden of work required to run the local branches means that by and large the committees are composed of older, part-time or retired pharmacists. If we are to attract the younger members we need to rethink the way in which branches are structured.
In every branch there are members who have given long service on branch committees. They may not fulfil the criteria for fellowship, yet their service to the profession has been very significant. In some cases the efforts of these members have been crucial in the survival of their local branch and it would be good if some form of recognition could be given by the Society for their contribution. Since the Society is interested in marking millennium year in special ways, what better way than to give some recognition to those who have formed the backbone of the Society, across the country, over many years. Most branches would be able to identify recent and present branch committee members and validate the service they have given.
There have been a number of recent changes in headquarters and committee structures. The branches have not changed for many years. Changes to provision of postgraduate education and increasing commitments for meetings and team working in the National Health Service have put pressure on members' time. Devolution has added a new dimension and locality working another. An effective branch support network is required for communications within the profession and for communications with other professions locally. However, some members in our branch have to travel for up to two hours each way to attend meetings and they are not well served by current arrangements. The internet offers tremendous potential to help them. There is a need to review the current arrangements and identify existing good practice, identify new roles, update others and develop a strategy that takes a renewed branch structure into the future. If no action is taken then a rapid decline is likely.
The objective is to facilitate, encourage and revitalise branch members' attendance at branch meetings with concomitant cost savings and effectiveness of human resources.
Bearing in mind the fact that the Society no longer arranges excursions for conference participants and accompanying persons, we feel that it would maximise the enjoyment of these visitors if local information could be made available at the reception area and provided by members of the local branch.
This information would be in addition to the current policy where branches are informed of the names of preregistration graduates, their tutor and the business or hospital address within the branch boundaries where training is taking place. Tutor and preregistration graduates have an obligation to attend branch meetings as part of their training commitments. The branches, under their model rules, are expected to arrange lectures upon scientific and other subjects appertaining to pharmacy for members and "students" and encourage social intercourse between members. Our branch members work very hard to make the young people attending feel a valued part of the pharmacy profession and welcome at meetings. However, we feel our efforts would be enhanced and more young pharmacists encouraged to maintain branch attendance after registering if we had the information to include those preregistration students or tutors within the branch boundaries as well as those working in our area.
This is to try to standardise the dates on which applications have to be submitted. Under the present system many posts are filled before other establishments consider applications.
Pharmacists should be recognised by the public and other health care professionals as well trained medicines experts. Any move to publicly recognise the mark of achievement in passing this examination and to improve the perception of the pharmacy profession should be welcomed.
All preregistration trainees have to pay a fee to sit the examination and this should be sufficient to incorporate the registration fee until December of that year.
The Society has previously identified manpower shortage as a potential threat to the provision of a satisfactory pharmaceutical service. The number of preregistration places will reduce in the "fallow year". This could be perpetuated and lead to a long-term problem as some tutors may not continue in this role, particularly in the light of increasing demands being placed on them to deliver quality training. It is likely that hospital places will fall as trusts enlarge and amalgamate. In subsequent years increasing graduation rates will compound the problem. The training year, which is regulated by the Society, should not become the rate-limiting step to pharmacist registration. Action is required to maintain and possibly increase the number of tutors.
The BPSA aims to provide the best possible service to its members. A permanent base would provide a foundation for improved efficiency of the association and continuity throughout the years. The proposed renovations planned for Lambeth make this a good time for this ideal to be realised. This can only lead to an enhanced service for the future of the profession.
There is a weakness in the present system of communication between the Society and those branches which have had motions accepted at the BRM. It is recognised that the rate of progress may be subject to all sorts of issues and have ramifications which are not necessarily foreseeable, but that is not a good reason for failing to keep branches informed of progress (or lack of it). This proposal would introduce a mechanism for ensuring that the Council's (interim) response to BRM motions in the five months between the two meetings can be discussed with branch secretaries, and providing feedback over a longer period, in particular, to the branches which sponsored the original motions.
We believe that with the current restrictions on canvassing it is difficult for the electorate to differentiate between candidates. Removing the restrictions would provide candidates with a greater opportunity to express their opinions and policies, on which the electorate could base their voting decisions.
Members are concerned that they have little or no knowledge of those who stand for the Council and this is reflected in the low numbers who vote at Council elections. Electing some Council members on a regional basis could go some way towards overcoming this problem. It would still allow the rest of the seats to be decided on a national basis and could provide a more balanced and representative Council than at present. The details of the process, such as the relative numbers of the two types of seats, their distribution and period of Council membership, as well as the principle of this proposal, would be the subject of the investigation and consultation.
It is considered that, in view of the absence of an "English Executive", devolution of some powers to a similar structure in England to the Welsh and Scottish Executives should be considered, with the intention of ensuring that all regions and branches of the profession are democratically represented, thus devolving some of the Council's powers down to a more regional level in England.
The President and Vice-President are currently elected by a secret ballot of Council. This is not a transparent process and the outcome in the past two years has left pharmacists feeling surprised, confused and without influence in the appointment of a key representative. As now, candidates must be elected members of the Council, and they must be nominated by other Council members. Elections for the President and Vice-President could be held after the outcome of the Council election is known in May, and the new President could take office at the British Pharmaceutical Conference in September. We would look to the Society to draw up procedures for branches to follow to ensure a fair process. It is hoped that if pharmacists feel empowered to affect the leadership of their Society more directly, they might become move involved in branch affairs.
Motion 21 at the Royal Pharmaceutical Society's branch representatives' meeting on May 11 is a joint motion of the Hull and Birmingham branches and not just a Hull motion. We apologise for the error.