Main points
|
At its meeting in London on August 1 and 2, the Council of the Royal Pharmaceutical Society examined the National Health Service plan for England (PJ, August 5, p182) and agreed that the Society's staff should immediately begin developing the relevant contacts and having the discussions to set out current Society policy in the key areas of the plan, to ensure that the Society's views were heard from the start.
The PRESIDENT said that, given the nature of the document and its potentially far reaching implications, a considerable amount of analysis and thought was needed before submitting responses or proposals to the Government. Even from a preliminary analysis, it was clear that the document had some positive implications for pharmacy and for the Society's policies in a number of key areas.
On the morning of the plan's launch, the President had received a call from Lord Hunt (Parliamentary Under-Secretary of State, Department of Health) that made it plain that a lot of detail for pharmacy would be fleshed out in a further announcement - probably at the British Pharmaceutical Conference. As a holding position, the Society's media response had flagged up to the Government that the Society was keen to be involved in shaping and implementing developments. At a stakeholders' briefing meeting later that day, the President had had the opportunity to make that point to the Secretary of State for Health (Mr Alan Milburn).
As soon as the Society had become aware of the proposed launch date for the plan, it had undertaken to provide the Council with a rapid response overview. But the national plan was long and complex. There were potential issues that might not be highlighted in the paper but would be teased out in due course. And there were issues that were highlighted but which had implications that would not come to light until further developments had taken place. The Society needed to be in on some of those developments from the start. There were hugely positive opportunities and challenges both in explicit proposals and between the lines of others.
What the plan did give the Society was a clear steer on what the Government wanted out of health and health professionals. No one could say that pharmacy had been marginalised in the proposals. Even at the present stage there were clear implications for the way that pharmacists delivered services to the public. Much of what was in the plan reflected the profession's ambitions and its far-sighted desire to make a greater contribution. The President was proud at how pharmacists had been aligning themselves with the need to move with the times in all their areas of activity and influence.
The President said that three areas stood out which the Council might wish to consider or express some ideas on. The first was new plans for professional regulation. That brought great potential opportunities to realise some of the Council's own regulatory modernisation agenda. It did, however, come with a pointed message to health professions about getting their houses in order - or else! But the Council was well on track with the work in hand through its Health Act working party.
The second area was new ideas on education, training and accreditation of health professionals and support staff. At present, there was no detailed picture of how that would be developed for pharmacy, but there were clear markers for the kinds of shared training and accreditation that would shift some of the rigid boundaries that the Government wanted to dismantle. Again, much of what was in the plan echoed the finding of the forum on team-working in primary care, sponsored by the Society and the British Medical Association, which would report in October.
The third area was new roles for pharmacists. The proposals to invite bids for personal pharmaceutical services pilots signalled a new shape to remuneration for pharmacy services that would underpin the service of the future. The signal that dispensing would no longer be the sole key to funding opened doors, but it would need to be carefully explored. The targets on medicines management and repeat medication were very exciting indeed.
The President saw the Council's discussion on the NHS plan as the start of a process. With the benefit of the points raised by the Council and input from the Policy Support Unit, the Society would be evolving a considered draft response for the Council. In parallel with that was a lot of work to be done quickly. The Council would need to agree a way forward now if it was to get in on discussions that were already taking place. Some key structures were being established which the Council would need to work with if the opportunities were to be fully realised.
Over the coming weeks the staff would need to analyse the plan further to identify what work needed doing right away. Clearly, there would be a need for early contact with those bodies and organisations that were tasked with shaping and implementing the plan.
Any new policy areas that needed to be dealt with would, of course, come back to the Council. At the same time, the standing committees would need to map the work needed in their areas. The President was sure that much of it would involve working across committees and directorates. There was so much in the national plan that they had to be involved in. The standing committees would need to review their workload priorities so that they did not miss the boat.
The President hoped that the Council's discussions would reflect the need for positive and forward thinking messages to come out of the building to the members, to the Government and to the other stakeholders in the process. She recognised that not all Council members might have had time to digest the national plan yet, and she did not expect them to come up with immediate solutions.
After a free-ranging discussion of issues arising from the NHS plan, the SECRETARY AND REGISTRAR said that the staff would consider the plan and carry out a mapping exercise. This would identify all the issues, and take points made in the Council discussion and look at what needed to be done. The Society had already been in contact with the Department and had pencilled in a date towards the end of the month to talk to officials.
The staff had to work very fast and they would have to drop other things in order to carry out this exercise. They would bring in some Council members when they had completed the initial analysis and mapping.
The VICE-PRESIDENT said that he wanted to espouse some key principles not from the Society's position but from the position of the Government. In truth, that was what the Council had to satisfy.
The Government wanted to change patients' experience when they involved themselves in the NHS - when they went to a GP's surgery, when they visited an accident and emergency department, when they were referred to hospital. The actual experience would be different, so they would be able to see it, recognise it and feel it. That was what the Society had to play a part in.
The Government was not looking at improving the efficiency of the existing organisations. It was looking for radical change, moving the NHS from its existing plane up to a new level. The Government was not particularly interested in pharmacists or pharmacy per se. It was looking at pharmacy and pharmacists to contribute to improving the lot of the patient to ensure that the patient experienced something new and different. Therein was the threat and the opportunity for pharmacy.
The Secretary and Registrar had referred to mapping. It was the responsibility of the Society's directors and staff to go through the national plan with a fine-toothed comb to identify what it meant for the Society, both explicitly and implicitly. Then there would be a basis to develop models and plans. Equally they had to get that done very quickly.
The SECRETARY AND REGISTRAR said that important points in the document had been identified and the shorthand writer's transcript of the Council's discussion would be circulated. People would be invited to add anything they wished, but it was important to get the Society's input urgently.
The Council approved a proposal to set up a task force on pharmacist prescribing. Its aims would be: to establish clear policies on the roles pharmacists could play in medication therapy in the context of the National Health Service plan in England, and to identify desired goals and set out and propose tactics to achieve them.
As well as Council members and representatives of pharmacy in Scotland and Wales, the task force membership would include a general medical practitioner, a National Health Service trust medical director, a health authority of primary care group finance director, a health authority pharmaceutical adviser (or similar) and, if possible, a high profile, non-pharmacist advocate of pharmacist prescribing.
The Council also agreed to set up a small group to look immediately at opportunities for pharmacists in the supply of medicines within patient group directives in the light of the NHS national plan.
The Council agreed that comments should be sought on canvassing by candidates in Council elections, including the use of the internet, to assist a reconsideration of the rules on canvassing in the Council election procedure.
The SECRETARY AND REGISTRAR reminded the Council that the branch representatives' meeting had carried a motion from the Bristol branch that the Council should reconsider its restrictions on canvassing (PJ, May 27, p800). The officers proposed that comments should be invited into the office from Council members and from others, including comments via the internet. In the light of the comments, a brief paper would be prepared, with recommendations, and the matter taken further if necessary. Many issues needed to be drawn together and considered in the light of the introduction of electronic media.
Dr GRAY said that the internet was just one aspect of the media that the Council should consider. The Council always seemed to think that canvassing was bad, but it was good for the members. As a recent Council candidate, she appreciated the opportunities that she had had through internet forums, but that had to be seen in a totality of all possible canvassing procedures.
The PRESIDENT pointed out that the Council wished to make the whole thing equitable for everybody.
Mrs STONE said that, in making it equitable, the Council should ensure that the burden on candidates was not so onerous that they would not be able to respond properly.
The SECRETARY AND REGISTRAR reported to the Council that four persons nominated by the Council for honorary membership of the Society had all confirmed their acceptance of the honour.
The four were Dr J. Ron Davidson (senior director, pharmaceutical research and development, Pfizer Ltd central research), Mr Nils-Olof Strandqvist (a former president of the International Pharmaceutical Federation), Mr Gary Flather (chairman of the Society's Statutory Committee 1990-2000) and Dr Terence Maguire (director, Northern Ireland Centre for Postgraduate Pharmaceutical Education and Training, and a past president of the Pharmaceutical Society of Northern Ireland).
Ron Davidson |
Nils-Olof Strandqvist |
Gary Flather |
Terence Maguire |
Assurances were given to the Council that the Treasurer and the Resource Management Committee had every intention of producing a balanced budget for 2001, after the state of the Society's finances had been raised by Dr EVANS during the Council's consideration of matters in open business.
Dr Evans said that some important matters were to come before the Council in the minutes of the Resource Management Committee and also, in confidential business, in agenda item 18 [which later in the debate was disclosed as concerning expenditure on the defence of resale price maintenance]. There were issues that made him think that the Society's financial affairs were not in as good order as they ought to be. He thought the Society was verging on quite serious financial disarray, and there were important issues that should be aired in public. The details might well require confidential discussion, but there were matters that members should know about.
Dr APPELBE said that he, too, was perturbed at the financial matters in Council papers. The Council seemed hell-bent on doing things that it could not afford. He would not, of course, mention figures in open business, but he was amazed that the meeting was to consider matters involving large sums of money.
Dr Appelbe said the Council had gone through some trauma the previous year, when he had been Treasurer, regarding the question of probity and transparency. He wanted the President or the Council to consider whether some items should be taken in public business. The finances were of concern to the members, who were paying ultimately for what was being done.
Dr EVANS said he did not wish to speak about the whole of the Resource Management Committee business in public, but he thought that the financial rectitude of the budgetary affairs had to be exposed in public business. The fact that the Council was currently running a budget deficit, was expecting a much bigger budget deficit next year, and was planning considerable expenditure over and above that, had to be spoken about in public.
Professor DAWSON said that the Resource Management Committee papers before the Council were interim papers. They had been discussed at the committee and they would be taken forward. He would be uncomfortable if there were not a general belief that there was probity within the committee, that it would try to come up with an appropriate budget, and that it would not be careless with its financial management when it brought those papers back to the Council. The issue was one of timing. The principles raised were appropriate, but it was not appropriate to comment on interim papers while they were still in discussion.
Answering a question from the PRESIDENT, Dr EVANS said that he believed that the issue of item 18, and the thinking behind it, should be in public business. He believed it was of interest to everybody. But it was important to consider it in the context of the other budgetary problems.
The SECRETARY AND REGISTRAR said that, as Professor Dawson had explained, the budget for 2001 was at an interim stage because the Council had expressed a wish to do many things. There was a need to plan how to do as much as possible. The Treasurer had every intention to produce a balanced budget. There had been a long discussion at the committee meeting, and a further paper would be presented in October. The Treasurer and the committee intended to follow that process.
While the issue of item 18 was in a way separate, she could understand an anxiety that the whole of the finances should be taken into account. It would be for the Council to decide whether it wished to take that item separately and in public business, but it would be difficult to have a discussion in total isolation.
Bearing in mind that the Council was in public business, she wanted to stress that the matter of the budget for next year was under strict scrutiny. The Resource Management Committee had considered matters in depth. It was trying to plan a budget for the next year which it was hoped that the Council would accept.
Mrs BANKS said that her memory of the "ways of working" recommendations was not that the Resource Management Committee would take the matter away, solve problems and say, "Here is your budget. Please endorse it". In her recollection, the intention was always that the Council should receive a paper on the big choices for the year ahead. She would expect the paper to set out matters that had to be done, matters that the committee did not think needed to be done, and matters where there were difficult choices to be made. That would be where the Council needed to focus its attention. Such a paper had not appeared before the Council since the new ways of working had been agreed.
Mrs Banks's view was that the Council had expected such a paper to come up as a policy paper in the first instance and then, after informal discussion, it would be formally blessed in open session with any points that anybody wanted on the record at a second stage. The Council needed the freedom to talk about the policy on finances in an informal way before going public. Mrs Banks agreed that the debate and the choices made, and why, should be on the public record.
Dr EVANS said that the Council, not the Resource Management Committee, should come up with a budget. The committee should then decide how it should be allocated between budgetary heads. The Council had to set the framework. Lord Peston [a former Privy Council nominee member of Council] had said that the Council should live within its means and that the Society's assets - the money that previous generations had put on one side - should not only be protected but should be enhanced as necessary to retain their real value. Those points had been put forward as matters of financial policy and had been accepted by the Council. So far as Dr Evans knew, that had never been changed. But that was not the picture from the papers before him.
Mr BURR expressed anxiety that the Council should discuss an interim report in open business. If a public limited company had two board members starting to talk about the finances in open business, the share price might be affected. If the Council did not work through the process before debating the finances, the danger was that it would send out the wrong message. At the end of the process the position might be totally different, but by their conduct only half way through the process Council members had potentially misrepresented the final position.
The Council should deal with the issues in confidential business. There were matters in the Resource Management Committee report that he would not dream of discussing in open business. Council members had to take on what corporate governance actually meant in their process.
Mr CURPHEY congratulated Mr Burr on his statesmanlike comment. He suggested to Dr Evans that he might reconsider the words "financial disarray" being used in public business.
Dr EVANS replied that he would gladly reconsider them - and he said that he would reaffirm them.
Mr NATHAN said that he shared Mr Burr's view that there were matters that were not suitable for being discussed in open business and being freely reported. He also took exception to the implication that the Society's financial arrangements were in disarray. If nothing else, that reflected badly on the former Treasurer.
The process the Council was going through was the process that most organisations went through as they tried to balance their budgets. The Council had three issues before it. One was that income had fallen slightly behind what was expected at the current stage in the year, for reasons that had been fully explained and were reasonable, and measures were being taken to correct that.
The second issue was the budget for 2001. The wish list of things the Council would like to do could not all be achieved because the Society did not have the necessary resources. The Council had to consider what it could and could not afford to do.
The third issue was resale price maintenance, which for strategic reasons should be discussed only in private.
Professor MACKIE agreed strongly with what had been said in terms of it being time to raise the issue in open business. Comments had appeared in the press regarding the Council's ability properly to ensure financial probity and management of the resources on behalf of the membership.
She was not confident that a clear process was in place. Mrs Banks had pointed out that the Council was not following the new ways of working. Council members had not had the opportunity to prioritise the key issues that they wished to support. They needed a radical rethink of what they were doing. That would need to be done in confidential business. In open business the Council should recognise that there were problems in terms of financial management, that the budget forecast for next year was for a deficit and that it would take steps to deal with that unacceptable position.
Professor Mackie agreed that the Society's finances were in disarray. She felt it was the Council's duty to inform the profession of that and that it wanted to take steps to deal with it.
The SECRETARY AND REGISTRAR replied that Mr Burr had put the matter absolutely accurately. Any organisation had a wish list of things that it wanted to do and a process by which it decided what it could afford. That was the process the Council was currently going through. The decisions for the Council would come in October when the Resource Management Committee had honed the wish list. Most organisations did that exercise first. That was what Council members were talking about. If they were talking about the full Council starting at the beginning of the process, that had not been envisaged in the new ways of working.
Dr APPELBE said that, while he accepted that the budget would still be worked on, he did not believe it would be brought into balance. His concern particularly was that the Council agenda included eight items where money was being asked for now. That would decimate the Society's liquid assets reserves if granted. All he was saying was that, as they went through the agenda, Council members should bear in mind - particularly when dealing with item 18 - that two of the items would probably have to come out of capital reserves, and capital reserves could not stand that.
The capital reserves were quite low in relation to the Society's turnover. Dr Evans had made a point that they should not only be protecting the capital reserves but they should be increasing them. Dr Appelbe did not want them decimated by a decision of the Council without considering what the implications would be.
The PRESIDENT said that the point had been made and that it would be considered carefully and thoughtfully by the Council.
Mrs BANKS stressed that she wanted to make a distinction between two different things that had been said. One was about where they were in the process and the other was about the finances being in disarray. She saw no reason to say that the finances were in disarray. They might be in disarray if the Council took a whole series of careless decisions. But it would not do that.
On the process, Mrs Banks said that she agreed entirely with Mr Burr that the Council had not yet quite reached the point of having the policy paper come to it to have the discussion before it went public on what it was going to do. It had nearly managed to do that the previous year. Mrs Banks wanted to put right any idea that the matter was delegated to the Resource Management Committee.
Mrs STONE said she was disturbed at some of the things she had heard during the debate. The Council over the years had behaved as properly as any other public body was able to do in the circumstances. It had recognised the need to move forward and to update its processes. It had done that by and large in a timely fashion. The Treasurers who had served the Council had behaved entirely appropriately in that way.
The Council was going through the budgetary process. It had to discuss and take on board what the Resource Management Committee might present in its minutes. That had to be taken properly and in private. Any suggestion that the finances were in disarray and that the Society was not behaving properly as a professional body was wrong. The Council had behaved properly and the Treasurers had behaved properly.
When the Council took decisions on the budget it would take them properly and, it was to be hoped, in a way that allowed the resources to be used to the best effect. She hoped that Council members would not go away thinking that they had behaved other than properly.
The TREASURER felt that the discussion had been slightly surreal. He intended to be extremely transparent about the budget process. The intention was to produce a balanced budget - if not a surplus budget. The Council was in the middle of the budgetary process. It had made no decisions. It would have the paper that Mrs Banks had referred to for its October meeting, when all Council members could participate in the discussion.
To say that the Society's financial affairs were in disarray or that their reserves were being decimated was absolute nonsense. There were problems that would be discussed in private, and steps were being taken to ensure that the problems were rectified. When it was right and proper to bring the matter forward in public, he would be happy to do so. However, the Council would be foolish to go any further with the debate at present.
The PRESIDENT said that the point that Dr Evans wanted to make had been made. There was a lesson to be learnt. The President reminded Council members that they were always learning how to manage their affairs better. The whole way that they budgeted was fairly new to them; but they were getting better at it. She supported what Mrs Stone and Mr Burr had said.
The Council was told that the Officers were to set up a small task force to examine the post of editor of The Pharmaceutical Journal before the Society appointed a successor to the current editor, who was to retire on September 1. The position would not be advertised until after a report had been made to the October Council meeting.
The PRESIDENT said that the present Council meeting would be the last one attended by Mr Douglas Simpson, the esteemed editor of The Pharmaceutical Journal. Mr Simpson had studied pharmacy in Sunderland, where he had edited the college's newspaper and discovered a latent interest in journalism. The President felt that to become editor of The Pharmaceutical Journal was the ultimate position.
Mr Simpson had worked in community pharmacy for Boots in various locations and had been a member of the Society's staff since 1965, being appointed assistant editor in 1973 and designated senior assistant editor in 1981.
On behalf of the Council the President wished Mr Simpson well and a very happy and healthy retirement. [Acclamation]
Mr BURR felt it had been a great privilege to have had Mr Simpson working for the Society for so long. One thing he would remember Mr Simpson for was that he had stood firm on the independence of The Pharmaceutical Journal. That was the sort of thing that the profession held highly, and it was important to the membership.
It was also important to recognise that there should be assurance that the things that Mr Simpson had striven for, in terms of keeping the position of the editor of The Journal independent and at the level to which they had been accustomed for so many years, would be maintained.
The PRESIDENT replied that a group was looking at the whole position.
Mr DAJANI also sought assurance that the good work that Mr Simpson had fought for would continue. He also asked that, if the editor's job description was to change in the future, then it was in the interests of the profession - and he stressed that Council members were all elected to represent the profession - that the Council would be able to ratify any such changes as well as ratify any new position before any contracts were signed. That would not only ensure the continued success of The Journal but it was also in the interests of the profession for editorial freedom to continue.
The SECRETARY AND REGISTRAR reassured the Council that no changes would be made to which the Council did not agree.
The VICE-PRESIDENT commented that, as Council members knew, he chaired the working group looking at corporate governance. Mr Simpson had written to him to say that he would like to prepare a paper for consideration by the corporate governance group. The Vice-President awaited the paper. Everything that was looked at and examined in the group would come before the Council in due course.
Mr SIMPSON responded that he had been glad to have been editor of The Pharmaceutical Journal. Few had had that opportunity, and he felt extremely lucky to have been editor. He expressed his thanks to the people who had appointed him, one of whom, Mr Darling, was currently sitting at the Council table.
Mr Simpson added that he had had the benefit of a committed and hard-working staff. He had received a great deal of help and support from throughout the building over the years. He had also found support and help from around the Council table. He was sure that such support and help would continue in the future. One or two members of Council had just made remarks that made him feel confident that that would be the case.
Mr Simpson concluded by saying that he had felt privileged to have had the chance to have been the editor of The Pharmaceutical Journal. [Acclamation]
Mr HEMANT PATEL said that the Society had been well served by a good editor. The whole Council knew that Mr Patel was interested in the issue of the job description of the editor. He had written to the President some time previously asking for confirmation that the editor's job description would remain the same after Mr Simpson retired. It gave him cause for concern that he had not had that confirmation.
The PRESIDENT said that the officers had agreed that a small task force would be put together to look at the whole question of what the objectives were and what they were trying to do regarding The Pharmaceutical Journal. Mr Patel was part of the group. The President was aware of Mr Patel's anxieties.
Mr PATEL pointed out that he wanted his concerns now to be more widely known because he did not think that any officers or Council members other than the President were aware of his anxieties. Therefore he wanted to take the opportunity to put his concerns on the record.
Having said that, he would make a prediction: he thought that what would be seen would be a demotion so far as the job description of a new editor was concerned. He predicted that the editor would be made accountable to the publisher, as in the plans that the Council had had previously. He did not want to create tensions, but if the editor's job description was changed and that reduced his influence and independence, then Mr Patel would oppose it as fiercely as he could.
Mr KIRIT PATEL said that he had intended to speak in closed business, but as the debate had already started he too would speak in open business. There had been various rumours regarding Mr Simpson's resignation, which he did not want to go into, but what was important was that The Journal should not be perceived as the mouthpiece of the Society. The Journal had a responsibility to the membership, and it was important to maintain its editorial integrity.
With regard to Mr Simpson's replacement, the final decision had to be made by the Council so that the person who replaced him would be answerable to the Council. Mr Patel felt strongly that Mr Simpson's replacement had to be finally vetted by the Council and his appointment made by the Council and hence the responsibility had to be with the Council, and he so moved.
Mr DAJANI seconded the motion.
The SECRETARY REGISTRAR said that there was no decision that would not be taken by the Council.
Mrs BANKS said that a brainstorming group would look at the post, as one would do on any major and important post, and report to the Council, while the corporate governance group would consider a paper by the present editor and bring that back to Council. She suggested that the Council should debate the issue in substance when it had the two things in front of it rather than off the cuff without an item on the agenda.
The PRESIDENT felt that that course of action would be much more useful because she did not feel prepared for the current debate. She asked whether the Council was prepared to move on, on the understanding that they would return to the item when the paperwork was properly documented so that they knew what they were talking about. She felt unprepared for the situation she found herself in.
Mr KIRIT PATEL asked what was the time period of the matter being brought back.
The VICE-PRESIDENT said that, under standing orders, a motion had to be submitted to the Secretary and Registrar in advance of a Council meeting. The Council was discussing an issue on the hoof, and therefore it was not possible to have rational consideration of what was being proposed simply because people were reacting to what was being said.
Putting that on one side, Mr Simpson's paper on the role and responsibilities of the editor of The Pharmaceutical Journal had been pencilled into the agendas of the corporate governance steering group, which had meetings in the diary for August and early September. The paper would be considered then.
As a consequence of that, various recommendations and other issues relating to corporate governance, including the position of the editor, would come to the Council's October meeting. At that time, the Council would have the benefit of a paper, various considerations and perhaps recommendations. He therefore urged the Council not to have a discussion at present but to wait and hear what Mr Simpson recommended, consider it and look at it on the basis of a calm debate armed with the facts.
To talk just about issues meant that there would be a danger that the whole thing would run away. Frankly, that was not the best way for the Society to manage its affairs. The Council was the body that would determine who would fill the new position and the parameters of the position.
Dr APPELBE accepted what the Vice-President had said. But it seemed that The Journal would be without an editor for six or eight months. Following discussion of the paper in October the position would have to be advertised and somebody would have to give three months' notice and therefore it would be well into the spring before The Journal had an editor.
The SECRETARY AND REGISTRAR replied that arrangements would be made for an acting editor in the interim. The time period did not need to be as long as six or eight months.
Mr BURR said he had asked for reassurance and he understood the process. He presumed that the acting editor appointment would have full independence.
The SECRETARY AND REGISTRAR replied that the acting editor would be in the same position that Mr Simpson was in at present.
The PRESIDENT said that she had hoped that Mr Kirit Patel had been reassured regarding how matters were to be managed. She suggested that he should withdraw his motion, since she would rather have a motion when there was something substantial to discuss, with papers in front of the Council.
Mr PATEL said that he would withdraw the motion on the understanding that in the interim period the job description would not change and independence would be maintained.
The PRESIDENT replied that in the interim period that was exactly how it would be.
The Council approved a document laying down standards of good professional practice for the dispensing of extemporaneous preparations (see p233). The document would be added to the Appendix to the Code of Ethics, where it would join the 19 existing standards covering various aspects of professional practice.
The Council approved a number of proposals designed to improve the quality assurance of preregistration training schemes that involved a period in the pharmaceutical industry.
The Council recognised that, while it would prefer the bulk of the preregistration period to be in a patient-focused setting, it was not currently practical to move away from the existing arrangement in which six months was spent in industry and six months in hospital or community practice. The Council therefore agreed that, to help ensure the development of patient-centred skills, quality assurance measures should be introduced for joint schemes that began in 2001 or later.
The first quality assurance measure was that preregistration programmes should be well planned and integrated, with tutors having discussed and agreed which aspects of training would be covered in each placement. As much time as possible would be made available for the development of patient-centred performance standards in the hospital or community sector by covering other performance standards in the industry placement. Trainees would also be permitted to attend hospital or community study days while working in industry, and vice versa.
A second quality assurance measure was that trainees would be signed on to the register jointly by all the tutors involved in their training and not just by the tutor at the trainee's final placement. A trainee would only be "signed off" if his or her hospital or community tutors were satisfied that he or she would be a safe and professional pharmacist in the patient care environment. Where this was not the case, discussions would take place with the Society's education division to help develop an action plan for the trainee's further development, which might involve a further period in a particular sector.
A further measure was that the Society would assess and accredit preregistration programmes before they started. One purpose of this was to confirm that proper planning and integration existed. Another was to ensure that all tutors involved in the trainee's training had undertaken to determine jointly the trainee's readiness to register and to sign off the trainee only if all tutors believed that the trainee was competent to practise. In addition, a trainee's entry to the registration examination would be determined by joint decision of all tutors.
The Council further agreed that joint programmes operating to these standards would be evaluated by the Society at the end of the 2001-02 preregistration year.
The Council approved a scale of statutory fees for 2001, which would represent an overall increase of about 3 per cent for members' and premises fees (see panel below).
The retention fee for members in full-time employment would rise from £138 to £142, the members' part-time fee from £78 to £80 and the premises retention fee from £90 to £93.
For the increases in members' fees, the Society would seek the approval of the Privy Council for an alteration to the Society's Byelaws. For premises fees, the Society would make a submission to the Secretary of State for Health for the proposed new fees to be fixed by Statutory Order.
Council announcement - Statutory fees for 2001
The Royal Pharmaceutical Society's Council decided at its August meeting to seek approval for increases in the statutory fees, to take effect from January 1, 2001.
|
|
|
On the recommendation of the Infringements Committee, the Council agreed that complaints should be made to the Statutory Committee about several pharmacists.
Failure to supervise trainee The Council decided to make a complaint to the Statutory Committee about a pharmacist whose alleged failure to supervise fully a trainee dispensing technician had led to a child being supplied with a phenobarbitone solution at a strength several times that prescribed.
The Infringements Committee heard that the pharmacy had received a prescription ordering 500ml of phenobarbitone 30mg/5ml (ie, 0.6 per cent) for a young child but had allegedly supplied a liquid containing phenobarbitone 4.75 per cent, without a preservative. The child had been hospitalised after taking the equivalent of more than 600mg of phenobarbitone a day for two-and-a-half days. It was alleged that the pharmacist had delegated the dispensing of the prescription to the trainee and had not checked the trainee's calculations or weighings.
Fraudulent locum claim The Council agreed to refer to the Statutory Committee the case of a pharmacist who had allegedly made a fraudulent claim for £127 in locum fees in relation to his or her spouse.
The Infringements Committee heard that the pharmacist had at the time been an employee of a multiple pharmacy company. The pharmacist had worked on a Sunday, for which the company paid double time, and had also allegedly submitted a locum payment form falsely claiming that the spouse had worked that day.
Returns to wholesaler The Council agreed to refer to the Statutory Committee the case of a pharmacist who had allegedly ordered stock from a wholesaler and then returned the same product but as short-dated packs from existing pharmacy stock, claiming that the orders had been placed in error.
The Infringements Committee was told that the wholesaler had monitored all stock returned from the pharmacist's two pharmacies for one week, during which time the pharmacist allegedly returned 18 lines with expiry dates earlier than the stock supplied by the wholesaler.
Drink problem On the recommendation of Infringements Committee, the Council agreed to make a complaint to the Statutory Committee about a locum pharmacist who allegedly had a drink problem. The Council also agreed that the pharmacist should be recommended to cease practice. The case had arisen from a complaint by an employer that the pharmacist had reported for locum duties after having consumed an excessive amount of alcohol, with the result that he had been incapable of discharging his professional duties.
Dispensing error The Council agreed to refer to the Statutory Committee the case of a pharmacist who had allegedly dispensed glibenclamide against a prescription for frusemide.
The Infringements Committee heard that there had been two pharmacists and one dispensing technician on duty in the pharmacy at the time, and that it was a company procedure that, if possible, a different member of staff checked dispensing. However, the pharmacist concerned had allegedly both dispensed the tablets and carried out the check. The committee noted that the frusemide and glibenclamide in stock at the time had been marketed by the same generic manufacturer and were in similar packaging.
Rodney Ledward The Council agreed that a complaint should be made to the Statutory Committee about Rodney Spencer Ledward, formerly employed as a consultant obstetrician and gynaecologist and also registered as a pharmacist. Mr Ledward's name had been removed from the medical register on the order of the professional conduct committee of the General Medical Council after it had found proved an allegation of serious professional misconduct. The Council also agreed that its decision should be made public and that the Statutory Committee should be advised of the Council's view that the case should be heard at the earliest opportunity.
The case had been considered by the Infringements Committee, which found that, although the inquiry by the GMC was relevant to Mr Ledward's practice of another profession, some of the inquiry's findings were also relevant to his status as a pharmacist.
The Secretary and Registrar reported to the Council that a high court judge had found in the Society's favour in a judicial review of the Society's rule that applicants for membership should have no more than three attempts at its registration examination (PJ, August 5, 185). The Society would now consider the role and the remit of the board of examiners in the light of any considerations in the course of the review. That would be brought back to Council in due course.
The Council approved a recommendation of its Education Committee that the Society should refrain from reaccrediting the pharmacy degree course of Liverpool John Moores university. It was agreed that the following statement should be published, under the heading "Status with the Royal Pharmaceutical Society of Great Britain of the master of pharmacy honours (MPharm) degree course of the Liverpool John Moores university":
"As an important element of its quality assurance of pharmacy education and training, for patient safety and in the wider public interest, the Society has responsibility for approving United Kingdom pharmacy degrees. For each degree course, the Society normally reviews approval by a system of accreditation every five years. As part of the accreditation process it considers the curriculum and the resources available for its delivery.
"Reaccreditation of the MPharm degree course of the Liverpool John Moores university fell due in the academic year 1999-2000. The review was centred on a two-day visit of Society expert representatives. As is not unusual, concerns arose about aspects of the degree course and those were communicated to the university following the visit. They have since been the subject of discussion and correspondence but have not yet been resolved.
"Consequently, the Society has urged the university to share with all potential new students the information that they will be joining a degree course that is presently not accredited. The Society further urged that the possible consequences of this situation should be made known to potential new students. These are that, in addition to passing their degree they may have to perform satisfactorily in examination(s) or other assessment(s) set by the Society before they are allowed to commence preregistration training. A fee or fees may be levied by the Society for entry to any or all such assessments.
"The Society would emphasise that existing students on the Liverpool John Moores university MPharm degree course - second, third and fourth years - joined an accredited programme. They will therefore be allowed normal progress to registration, ie, they are not directly affected by the current situation."
(See also news item, p218)
The Council agreed that the Society should provide additional funding to help the Community Pharmacy Action Group meet the legal costs of the campaign to retain resale price maintenance on medicines in the public interest. The Council noted that other major contributors to the CPAG had already pledged additional financial contributions to support the high costs of fighting the case, which was to reach the courts on October 2.
|
Attendance Those present at the meeting, which was held on August 1 and 2, 2000, at 1 Lambeth High Street, London SE1, were the President (Mrs Christine Glover), the Vice-President (Mr Marshall Davies), the Treasurer (Mr David Allen), Dr Gordon Appelbe, Mrs Terri Banks, Mr Andrew Burr, Mr Peter Curphey, Mr Sultan Dajani, Mr William Darling, Professor William Dawson, Mr Digby Emson, Dr John Evans, Miss Alison Ewing, Dr Nicola Gray, Dr Gillian Hawksworth, Mrs Patricia Hoare, Professor Clare Mackie, Mr Alan Nathan, Mr Hemant Patel, Mr Kirit Patel, Mrs Helen Remington, Mrs Linda Stone, and the Secretary and Registrar (Miss Ann Lewis). Also present were the chairman of the Society's Scottish Executive (Miss Alison Strath) and the chairman of the Welsh Executive (Mr Colin Ranshaw).
Apologies for absence had been received from Mr Hassan Argomandkhah and Professor Michael Schofield. Present by invitation were Ms Janice Buckley (representative of the Society's Epsom branch), Mr Stephen Curtis (chairman of the Society's Harrow and Hillingdon branch), Mr Edward Mallinson (secretary of the Society's Lanarkshire branch), Mr Andrew Karvot (vice-chairman of the Society's Sherwood region) and Mrs Susan Wills (acting secretary and treasurer of the Society's South Lincolnshire branch). |
Council briefsCouncil expenses The Council approved a proposed alteration to the Byelaws to provide for the limits for all Council expenses, including reimbursement of locum expenses if agreed by the Privy Council, to be determined annually by resolution of the Council and reported to the annual general meeting. Alterations to the Byelaws The Council agreed to accept a request from the Privy Council that all future proposed changes to the Byelaws should include the qualification "subject to such amendments as the Lords of the Privy Council may require". The Council was told that the qualification would speed up the process of amending the Byelaws by allowing the Clerk to the Privy Council to make minor amendments to clarify understanding. |
