News

Statutory committee
• Pharmacist struck off after over-claiming conviction
• Disqualified surgeon ordered off pharmacists' register

British Pharmaceutical conference
• Stephen Denyer to be science chairman in 2002

• Society publishes resource pack on patient group directions
• APS chooses a new name and a logo
• Society opposes proposed extension of general sale for NRT

Pharmacist struck off after over-claiming conviction

A pharmacist who over-claimed payments on prescription forms to the value of £1,500 has been struck off the register by the Statutory Committee.

At its meeting on August 15, 2000, the committee inquired into the case of Mr Ritesh Maganlal Shah, of 73 Howberry Road, Canons Park, Edgware, Middlesex. Information had been received that on October 21, 1999, at Watford magistrates' court, Mr Shah had pleaded guilty to the offence of falsifying prescription forms for risperidone, contrary to the Theft Act 1968. Eleven similar offences had been taken into consideration. For those offences, he had been sentenced on December 20, 1999, at St Albans crown court to three months' imprisonment.

Mr G. R. F. Hudson, of Penningtons (solicitors), appeared in order to present the facts of the case to the committee.

Mr Shah, who was present at the inquiry, was represented by Mr W. J. Jones, of counsel.

The committee heard that the offences had arisen while Mr Shah was operating his pharmacy at Leavesden Road, Watford, Hertfordshire.

In 1996, a local doctor was prescribing medication for patients in a nursing home. One of them was prescribed the antipyschotic risperidone in a dose of two 4mg tablets twice daily, ie, 120 tablets each month. The cost was £154.44 per 60-tablet pack. Then, in August, 1997, the dose had been reduced to one 4mg tablet twice daily (60 tablets per month). Mr Shah supplied the lower quantity, having been informed by the nursing home that the doctor had reduced the patient's dose. However, for some time repeat prescriptions signed by the doctor continued to indicate 120 tablets per month. Mr Shah submitted claims and was paid for that quantity. This continued until in May, 1998, the doctor realised her error and reported the matter to the local health authority.

When interviewed by the police, Mr Shah had immediately admitted his guilt. He said he had made a foolish mistake for which he was deeply sorry. The money over-claimed, amounting in total to £1,500, had been repaid.

The judge at the crown court, sentencing Mr Shah, had said that he had deliberately and fraudulently overcharged the public authorities until the prescribing doctor realised her mistake. Mr Shah had been in a position of trust but had "set out to cheat the system".

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that, over a number of months, Mr Shah had taken advantage of an error in prescribing made by a doctor. When the offences came to light, he had admitted his guilt and had not tried to exploit the confusion that might have followed the undoubted error in prescribing made by the general practitioner.

The references presented on Mr Shah's behalf reflected well on him; nevertheless, given the facts of the case, the committee was bound to direct that his name should be removed from the register.

Mr Shah had three months to appeal against the decision.

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Disqualified surgeon ordered off pharmacists' register

The name of Mr Rodney Spencer Ledward was ordered to be struck off the Register of Pharmaceutical Chemists by the Statutory Committee at its meeting on October, 11, 2000 (PJ, October 14, 2000, p540). Mr Ledward, who was living in the Republic of Ireland, has since died (PJ, January 13, p50). He was formerly a consultant obstetrician and gynaecologist whose name had been erased from the medical register by the General Medical Council for serious professional misconduct (PJ, June 10, 2000, p866).

Complaint

A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Ledward had (i) conducted himself in such a way as to damage or destroy public confidence in him as a professional giver of health care, (ii) failed, by misrepresenting information concerning patients to their general practitioners, to demonstrate the appropriate care and consideration of a health professional towards the care of his patients, (iii) practised in such a way as to demonstrate a lack of professional judgment in failing to appreciate the need for referral to other professionals, (iv) failed critically to review his level of competence and failed to act within his proper competence, (v) brought into disrepute the branch of public health care in which he practised as a physician and surgeon, namely obstetrics and gynaecology, and (vi) shown himself by his professional conduct to be unfit to be on the medical register under the Medical Act 1983.

It was contended that those matters were evidence of his unfitness to be registered as a member of a health care profession and demonstrated that he was unfit to have his name on the Register of Pharmaceutical Chemists, and that his continued registration as a pharmacist was likely to bring the Society into disrepute.

Mr N. Pleming, QC, and Miss A. Foster, of counsel, instructed by Penningtons (solicitors), appeared in order to place the facts of the case before the committee.

Mr Ledward did not attend the inquiry and was not represented.

The committee heard that Mr Ledward had qualified both as a pharmacist and as a physician and surgeon. He had been registered as a pharmacist on September 7, 1960. He had retired from the register on June 19, 1967, and been restored to it on October 7, 1982. He had for some years practised as an obstetrician and gynaecologist but his name had been removed from the medical register by the General Medical Council on September 30, 1998. The professional conduct committee of the GMC had found that the standard of care provided by Mr Ledward to his patients had fallen "lamentably below" that which the public required and which the medical profession expected. Mr Ledward had been found guilty of giving misleading information on a patient to her general practitioner, giving misleading information to a patient about her treatment under the NHS, and, on two occasions, failing to refer to another professional when appropriate. He had also been found guilty of inappropriately delegating his professional duties to a locum registrar, of operating to remove a patient's ovaries without her prior consent, of failing to provide or make arrangements for the care of patients pre- and post-operatively and of not reading patients' clinical notes before embarking on treatment.

Public protection

The GMC had decided at the conclusion of Mr Ledward's case that it was necessary for the protection of the public that his registration should be suspended immediately. Mr Ledward had not appealed against that decision. Subsequently, he had applied for, and been granted, registration by the Pharmaceutical Society of Ireland.

Although there was no evidence to suggest that Mr Ledward had done anything wrong in his career as a pharmacist, it was argued that the evidence on which the GMC had decided to strike Mr Ledward off the medical register demonstrated also that he was unfit to remain on the register of pharmacists. The profession of pharmacy, it was submitted, relied on the same qualities of trust, judgment and skill that had been impugned in the GMC proceedings against Mr Ledward.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that the committee accepted the evidence presented to the GMC. Mr Ledward had been given the opportunity to challenge anything established against him by the GMC but had not taken that opportunity.

The findings of professional misconduct against Mr Ledward had been in a health care profession related to pharmacy, said the chairman. The first principle of the pharmacists' Code of Ethics said that "a pharmacist's prime concern must be for the welfare of both the patient and other members of the public".

Mr Ledward, as an obstetrician and gynaecologist, had failed in having as his prime concern the welfare of his patients, and the committee was "more than entitled" to take note of that in determining whether or not he had met his obligations as a pharmacist.

Relevance

Among other relevant provisions in the Code of Ethics were the requirements that "pharmacists must ensure that they behave with integrity and probity, adhere to accepted standards of personal and professional conduct and do not engage in any behaviour or activity likely to bring the profession into disrepute or undermine public confidence in the profession", and that "a pharmacist must at all times endeavour to co-operate with professional colleagues and members of other health care professions so that patients and the public may benefit". That was another comparable respect in which Mr Ledward had not discharged his duties as an obstetrician and gynaecologist.

The committee agreed that the fact that Mr Ledward's name had been removed from the medical register for serious professional misconduct showed that he was unfit to be on the Register of Pharmaceutical Chemists and that he was guilty of misconduct in the context of his registration as a pharmacist.

The committee directed that his name should be struck from the register.

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Stephen Denyer to be science chairman in 2002

The Academy of Pharmaceutical Scientists has announced that the Conference Science Chairman for the 2002 British Pharmaceutical Conference is to be Professor Stephen Denyer, FRPharmS, head of the school of pharmacy and biomolecular sciences and professor of pharmaceutical and applied microbiology at the University of Brighton.

Professor Denyer is a graduate and PhD of Nottingham university. He has over 200 publications in areas of pharmaceutical and medical microbiology and biomedical technologies and is joint editor of five postgraduate microbiology textbooks. He currently serves on the editorial board for the Journal of Pharmacy and Pharmacology. His research is supported by research councils, charities, the European Union and industry. He has received awards for scientific innovation leading to the development of patents and products. He is a director of two university spin-out biotechnology companies.

Professor Denyer currently serves on the Department of Health's Microbiology Advisory Committee and Standing Pharmaceutical Advisory Committee. He is an expert assessor on active implantable medical devices for the Medical Devices Agency. He is a member of the Engineering and Physical Sciences Research Council life sciences college, and serves on the Committee on Safety of Medicines subcommittee on chemistry, pharmacy and standards. He is a past member of the Veterinary Products Committee.

Professor Denyer takes an active interest in education, and serves on the Education Committee of the Royal Pharmaceutical Society's Council, is a past subject assessor for pharmacy and pharmacology for the Quality Assurance Agency for Higher Education, and is alternate member on the EU advisory committee on pharmacy training. He is a member of the NHS steering committee on pharmacy postgraduate education. He has been vice-chairman (1994-96) and chairman (1996-98) of the UK committee of heads of schools of pharmacy.

Professor Denyer was designated a fellow of the Royal Pharmaceutical Society in 2000.

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Society publishes resource pack on patient group directions

The Royal Pharmaceutical Society has published a 32-page resource pack designed to help pharmacists involved with patient group directions. It includes tools to help both those who supply or administer medicines under PGDs and those who are responsible for drawing up and signing them.

The pack contains:

1. A seven-page fact sheet outlining the legal requirements and NHS guidance
2. The professional standard for PGDs from the Society's Code of Ethics
3. A five-page document addressing the questions about PGDs that are most frequently asked of the Society's Professional Standards Directorate
4. A template PGD showing how all the legal requirements may be incorporated in a standardised form
5. A sample PGD showing how the template may be used
6. Audit tools for assessing whether a PGD service is being delivered to a suitable standard and whether it could be improved
7. A flow chart for pharmacists devising PGDs to help with the decision making process as to whether a PGD is justified or appropriate (provided by Mrs Beth Taylor, pharmacy manager, Community Health South London NHS trust)
8. A four-page document giving tips for community pharmacists wanting to be involved with PGDs (provided by the National Pharmaceutical Association)

Pharmacists should note that parts of the resource pack are based on guidance issued in Health Service Circular HSC 2000/016, which relates only to England. Pharmacists in Wales are advised to refer to Welsh Health Circular WHC (2000) 116; those in Scotland should consult Health Department Letter HDL (2001) 7.

The resource pack can be downloaded as a PDF file from the Society's internet website (www.rpsgb.org.uk/pdfs/pgdpack.pdf). Pharmacists without access to the internet can obtain copies by sending a C4-size, self-addressed envelope bearing stamps to the value of 72p to Mrs Jo Raffaitin, Pharmacist Adviser, Professional Standards Directorate, Royal Pharmaceutical Society, 1 Lambeth High Street, London SE1 7JN.

Mrs Taylor's flowchart can also be accessed at the Approved Group Protocols website (www.groupprotocols.org.uk). Pharmacists wishing to receive a laminated copy should send an e-mail to Mr Stephen Curtis at stephencurtis@curtisbuckley.co.uk. Mrs Taylor says that she would welcome e-mailed comments on the flowchart (Beth.Taylor@chsltr.sthames.nhs.uk).

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APS chooses a new name and a logo

The Academy of Pharmaceutical Scientists of Great Britain has changed its name and acquired a logo.


The academy was formed just over a year ago through a merger of the Royal Pharmaceutical Society's Pharmaceutical Sciences Group and the UK Association of Pharmaceutical Scientists. At a recent meeting, the academy's committee decided that the word "Scientists" should be changed to "Sciences". The change brings the name into line with European associations such as the European Federation for Pharmaceutical Sciences and the Swedish Academy of Pharmaceutical Sciences.

The new logo has been chosen through a competition among the academy's members. Nine members submitted a total of 26 designs for consideration by the selection panel.

The winning entry is by Dr Karl Malcolm (school of pharmacy, Queen's University of Belfast).

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Society opposes proposed extension of general sale for NRT

The Royal Pharmaceutical Society has objected to a Medicines Control Agency proposal to reclassify nicotine patches, lozenges and higher strength chewing gum as general sale list medicines (PJ, January 6, p6).

In a letter dated February 6, the Society says that the proposed amendment to the GSL Order is not in the public interest because those wishing to stop smoking need the advice and support of a health professional.

The letter refers to the Society's support for the Government's commitment to a comprehensive smoking cessation service, as set out in the National Health Service plan. It points out that pharmacists' role in smoking cessation has been highlighted by their successful participation in health action zones and in the recent update to the Thorax guidelines on smoking cessation (PJ, December 2, 2000, p809).

The advice and support of a health professional is particularly important when a smoker receives a first-time supply of NRT, or makes an inquiry about NRT at the beginning of an attempt to quit, the letter says. It points out that many pharmacists already carry out immediate interventions in smoking cessation for individuals and refer them to a specialist clinic or to a GP where appropriate. Pharmacists are in a good position to advise and supply smokers with an appropriate product directly and to follow up at a later date, it suggests. Under the current arrangements, therefore, smokers have easy access both to nicotine replacement therapy and to expert advice and information — including advice on the selection of a product and how to use it.

The Thorax guidelines, says the letter, state that smokers must be given accurate and balanced information on the effectiveness and safety of products used in smoking cessation. The Society's view is that patients and the public health are best served by having all the relevant advice and information available at the point of sale.

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