The Pharmaceutical Journal Vol 267 No 7169 p527-532
13 October 2001

Main points

CPD The Society is to work up a new continuing professional development system to run on a voluntary basis until it is possible to make the transition to a mandatory scheme [more]

Council meetings The Council has made a number of changes to the structure and format of its meetings to make them smoother and more focused [more]

Repeat dispensing The Society is to make the case for a repeat dispensing system using electronic links between surgeries and pharmacies [more]

Election system No changes are to be made to the Council election voting system before a review of the Council under its modernisation programme. [more]

Self-checking Self-checking of dispensing for accuracy is to be recommended only in exceptional circumstances [more]

Attendance

Society moves nearer to mandatory continuing professional development

The Council of the Royal Pharmaceutical Society has approved a proposal for progressing to a new continuing professional development system that will run on a voluntary basis until legislation allows the transition to a mandatory scheme.

Making its decision at its meeting in London on 2 and 3 October 2001, the Council approved a proposal that involved the establishment of a Continuing Professional Development Implementation Committee as soon as possible.

The Council agreed that the new committee would make proposals for the framework and nature of regulations for CPD requirements for pharmacists’ continued eligibility to practise, including a draft definition of a “practising pharmacist”. It would also oversee the design, development and testing of a large-scale system for the voluntary participation of pharmacists in CPD. The system would be capable of being quickly adapted for the mandatory participation of pharmacists. The committee would also monitor the operation of this voluntary system.

The committee’s membership would include one of the Privy Council nominee members of Council and two elected members of Council, plus the directors of pharmacy postgraduate education for England, Scotland and Wales, along with pharmacists from the main spheres of pharmacy practice, three lay members (a human resources development expert, an expert in implementing a professional CPD system and an advocate for patients and consumers). The committee would be able to co-opt other members from time to time for their expertise or experience.

The Council made its decision on the recommendation of its CPD advisory group in the light of information that it could now be some time before mandatory CPD can be introduced through an Order under the Health Act 1999. Progress towards achieving this Order has been delayed by the Government’s decision to consult on an overarching body to oversee professional regulation in the National Health Service.

Council’s workings

On the motion of the President, the Council approved a number of changes to the structure and format of its meetings with the aim of improving the effectiveness and efficiency of the Council’s workings by making meetings smoother and more focused.

The Council agreed that in future the business and development parts of the agenda will be more clearly differentiated. The business section will take place on the Tuesday afternoon in the Council chamber. The development section will take place on the Wednesday morning in the hall, with senior staff joining Council members at the table and able to contribute to the development of policy or particular issues under debate.

Observers will be present for the business and development sessions in their entirety, other than for debates relating to the Society’s staff, such as employment or remuneration issues. The observers will be asked to sign a confidentiality agreement before the Council meeting and to agree not to divulge any sections of debate or discussion that are not to be put into the public domain at that time.

Another change will be a relaxation of formality within the Council chamber. Those present will no longer be required to stand when addressing the meeting, and they will be allowed to use forenames rather than formal titles when referring to others. They will also be permitted to remove jackets or coats if they so wish.

A further change is that Council members who wish to draw attention to inaccuracies in the minutes of the previous meeting, to raise matters arising from the minutes or to raise matters under Any Other Business will in future be required to notify the Secretary and Registrar in writing before the meeting. If time does not permit such notification, then the item could be drawn to the attention of the Secretary and Registrar or the President verbally before the meeting. Matters not so raised before the meeting will be deferred to a future agenda.

The Council’s decisions were made in response to a letter in The Pharmaceutical Journal of 8 September (p323) from the observers at the August Council meeting, who expressed dissatisfaction with their experience and criticised the Council and the way in which it operates. The decisions were made on the recommendation of the Officers, which had been set out in a letter from the President circulated to Council members before the Council meeting. The Council also took into consideration a motion put by Ashwin Tanna in response to the observers’ letter.

The Council began its consideration of the matter by debating Mr Tanna’s motion, which was: “That the Society’s Officers decide what action they intend to take in response to a letter published on p323 of The Pharmaceutical Journal of 8 September, from the observers that attended the August Council meeting.”

Presenting his motion, Mr TANNA commended the President for his letter but said that he wished to clarify certain things that had transpired since the August Council meeting. The observers had said that there was too much secrecy, no openness and no transparency within the Society. They were worried about the issue of accountability and felt that two-thirds of the Council’s business was discussed behind closed doors. One of the observers was Sandra Gidley, a pharmacist and a Member of Parliament. She had said at a National Pharmaceutical Association conference that she received more guidance from the NPA than from the Society and could not see why the issues raised could not be covered in the press. Moreover, she also felt that there was no clear direction.

There was no openness and transparency among the Council members, Mr Tanna said. Only the Officers and the chairmen of the standing committees were allowed to attend the Resource Management Committee. Other Council members were not allowed to attend as observers. Why were they so secretive? Mr Tanna believed that as an elected member of Council he had a right to attend and observe Resource Management Committee meetings. He believed he had the trust of the membership, so why not the trust of the Council and the officers?

Commenting on the letter in the PJ, Mr Tanna said that he understood that it had been toned down considerably before submission to the editor so as not to embarrass the Council. The observers had been excluded from the August meeting’s discussion of the retention fee. Had they been allowed to listen to the discussion, they would perhaps have been in a better position to explain to the membership the rationale behind the matter. Was the Council embarrassed about being observed?

The observers also felt that items of strategic importance were missing from on the agenda. They felt that the published report of the meeting conveyed a different impression to what they had observed.

Mr Tanna hoped that in future most items would be discussed in public business unless there was a compelling and overriding factor that required them to be taken in private business.

The PRESIDENT replied that the arrangements for attendance at committee meetings were highlighted in the governance documents that had been approved by the Council and published on the Society’s website. Therefore the matter in that respect was in the public domain.

HELEN REMINGTON proposed that the motion be put immediately. That would allow Council to move on to the consideration of the President’s letter. Mrs Remington endorsed the last paragraph of the President’s letter, which referred to supporting both the spirit and the content of the changes that would take place.

The motion was seconded by KIRIT PATEL and was carried.

The PRESIDENT then referred to his letter, which had been circulated to Council members earlier in the day. After setting out the Officers’ proposal, the letter concluded: “It is emphasised that the purpose of these changes is to improve the effectiveness and efficiency of the workings of Council. I, as your President, have an open door policy and as a matter of routine will always be in my office for at least one hour prior to all Council meetings, should you wish to discuss any topic with me. I do hope that you will support both the spirit and the content of the changes that will take place, and by so doing we shall prevent such comments as we have heard and read in recent weeks.”

SULTAN DAJANI expressed anxiety that matters not raised ahead of the Council meeting would be deferred, which could mean a delay of two months. Some matters might need to be debated as and when they developed. He felt that the Council should decide what was referred to the next meeting and there should be flexibility to avoid things becoming out of date.

The PRESIDENT replied that raising a matter of concern in writing before the Council meeting allowed things to be thought through. Matters taken on the hoof, or in haste, could result in poor decisions. Matters emerging at the last minute should be brought to him before the meeting.

Regarding the meetings to be held in the hall, Mr DAJANI welcomed the team approach but said that the roles of Council members and staff members had to be clear. Council members were elected members of the profession and were there to set strategy and policy. The staff were not elected by the membership but helped in formulating the strategy rather than the policy behind the strategy.

The PRESIDENT said that the meetings in the hall would be for policy development, which could take place at one meeting or over several. It was not a decision-making process but would lead to a formal proposition in which the Council would make a decision in open business.

WALLY DOVE said that the Council needed sharpening up. It needed decent, well-structured debates chaired in a strong way. It had to cut out the rubbish and focus on the important things that faced pharmacy. He hoped that the items in the President’s letter would be seen only as the first steps. Other essential steps also had to take quickly.

The PRESIDENT replied that he would be happy to consider any proposition the Council put forward. His letter did not attempt to think through all eventualities, permutations and combinations.

LINDA STONE asked what would happen if debates at the developmental meetings in the hall needed to be ratified by the Council. Would the Council move back into a more structured approach? Otherwise, things would be delayed again by two months.

The PRESIDENT replied that the meeting in the hall would be for consultation and discussion. If, as a consequence, an immediate formal decision was needed, then the Council would sit in the Council chamber and take the decision.

Mrs STONE asked whether matters would be reported.

The SECRETARY AND REGISTRAR responded that it was normal for policy development to be taken in closed business because such matters were at a formative stage. If it was appropriate for the matter to be reported, then the Council report would show the information.

PETER CURPHEY felt that it was time that the profession grew up and understood that the development of policy and strategy needed to involve the wider profession. There was criticism that people did not know what was going on until matters had been decided, and consultation documents were sent out with such short timetables that it was difficult to convince the membership that it was real consultation.

The Council needed a communication strategy. It had no strategy over how to get the members involved. It was no good Council members expressing fine words about involving people. They had to do it. If they did not have a communication strategy about how they involved the membership, they would get more and more letters.

Answering a question from ALAN NATHAN, the SECRETARY AND REGISTRAR said that that debate on the budget could include issues that affected individual members of staff. If observers were present, it would be important that confidentiality was respected.

The PRESIDENT envisaged that observers would be present but they would have to recognise the sensitivity as it related to particular staff. The difficulty with the budget was that it covered the whole spectrum of activity, one aspect of which might be particularly sensitive.

ALISON STRATH said she echoed Mr Curphey’s views on communication strategy.

HEMANT PATEL agreed with Mr Dove’s remarks and added that policies agreed by the Council should be implemented within a reasonable period. It often appeared that after a decision was made the matter went into a black hole, and neither the membership nor the Council knew what was happening.

Mr Patel also said that the President’s letter did not deal with the issue of placing strategic items on the agenda. The letter from the observers had said that items of strategic importance should be on the agenda as soon as possible. And Council members should have sight of original papers at the earliest opportunity when dealing with strategic issues. An example, was the recent National Health Service paper on shifting the balance of power, which he said should have been sent to every Council member. The President’s letter did not deal with that point, which should have been highlighted.

ANDREW BURR welcomed the presence of observers during confidential proceedings. He did not want the observers to think that that was a weak link because that was not the case. In his experience, it was not the observers who leaked stories.

Mr Burr said he had intended to raise an issue on pharmacy prescribing. He gave notice that he would be doing that. He felt the Council should protect Any Other Business. Saying that points had to be raised in advance meant that there was no point in having Any Other Business.

The PRESIDENT responded that that was not the intention. He was making it clear that Council members needed to know about topics in advance. If a point about prescribing was raised under Any Other Business, that would be perfectly reasonable. But a member might raise a question that no one was in a position to answer. Knowing in advance what the points were would lead to a better and fuller debate. If Mr Burr raised a point without advance notification he might not get as full and as adequate a response as he would if the points had been raised in advance.

The SECRETARY AND REGISTRAR pointed out that over a one-and-a-half-day meeting, people could raise matters in such a way as to enable more informed responses to be given. Nobody benefited when a point was raised off the cuff. The observers had been concerned about the element of time wasting that they felt took place at the August Council meeting.

KIRIT PATEL felt that a lot of decisions were pre-made and brought to the Council for rubber-stamping. Debate was stifled. He also felt that some Council members were privy to more information than others were. That point needed to be addressed.

Professor MICHAEL SCHOFIELD said that he was trying to avoid contributing to the discussion because it was about processes rather than outcomes. If he had observed any weakness in the Council it was a tendency to focus on processes rather than outcomes. He had been chairman of two NHS trusts. They had dealt with business that was much more sensitive than anything that came before Council. Both trusts followed a policy of being open. It was unusual to take debates in private. He could recall only one occasion in five years in each of the two trusts. So it was very, very rare.

The Council should approach the issues in that spirit. There was little business from which they needed to exclude the observers. They should approach matters in that way otherwise they would continue to have the present debate, which was wasting time.

The PRESIDENT expressed thanks for the helpful comments that had been made. He then formally asked for the acceptance of his letter, which was agreed.

Pharmacy-based repeat dispensing

The Council ratified the recommendations to be made to the Department of Health in two documents on the professional issues surrounding the implementation of pharmacy-based repeat dispensing. The first document makes recommendations based on guidance from the Department that, initially at least, pharmacy-based repeat dispensing would have to be paper-based. The second document makes the case for establishing electronic links between general practice surgeries and community pharmacies, and between primary and secondary care, at the earliest opportunity.

The two documents have been drafted by the Society’s working group on professional issues in repeat dispensing. Subject to minor amendment, they were endorsed by the Practice Committee at its meeting on 18 September. The recommendations in the first paper are based on a model of repeat dispensing designed to achieve the Government’s objective of making the supply of long-term medication more convenient for patients. In addition, this model would enhance patient care by introducing simple questioning at the point at which repeat supplies are requested. The second paper goes on to show how a repeat dispensing system based on electronic links could help the Government to meet a range of policy objectives that the paper-based system could meet only partly, if at all.

Presenting the documents to the Council for ratification, the PRESIDENT said that they had been revised to incorporate comments made by those to whom they had been circulated. The documents had been sent to the National Pharmaceutical Association for comment and a response was awaited.

CHRISTINE GLOVER said that although the document about electronic systems was intended to support the main repeat dispensing paper it was sufficiently useful to be taken away for use in other forums. It would become the hymn sheet for why there was a need for fuller integration into the information technology arena. Mrs Glover added that recent correspondence with her Member of Parliament showed that the document was badly needed.

Common values in health care

The Council agreed to ratify the text of a statement drafted on behalf of all the health regulatory bodies to set out common values of health care professionals.

The statement says that all health care workers are bound by a common duty to safeguard and promote the interests of their patient and clients. It goes on to summarise their responsibilities in five areas: respect for the dignity, individuality, privacy and rights of patients and clients; maintenance of public trust and confidence; protection from risk of harm; standards of practice and care; and co-operation with other health professionals.

The Council heard that the statement had been prepared by a joint working party of the eight health regulatory bodies, which had established the common principles of each body’s code of practice and standards of ethics.

The PRESIDENT said that the regulatory bodies had been seeking to produce a commonly agreed document as a response to, and in anticipation of, government requirements and other demands. The document did not go as far as the individual professions went in certain aspects, but it set out five key points that were commonly acceptable. If it was going to sign up to the principles, the Council needed to support the document.

Professor MICHAEL SCHOFIELD said that the paper was an entirely well intended initiative and perfectly sensible. The Council should not make heavy weather of it.

SULTAN DAJANI asked what the next step would be. Would there be more meetings? Would matters be reviewed in the light of NHS changes?

The SECRETARY AND REGISTRAR replied that one clear outcome of the inquiry into the baby deaths at Bristol Royal infirmary was that there should be consistency across the health regulatory bodies. A starting point was what was consistent about the common values on which they based their codes. It was a basis on which they could build. It was about building consistency.

ALAN NATHAN asked what would be the future of the document. Would it be quietly filed away or would it be incorporated into the Code of Ethics?

The SECRETARY AND REGISTRAR replied that it was already incorporated in the Code of Ethics.

The PRESIDENT said that the health professions needed to address how they would deal with the issues that had emerged from Bristol and other places. The regulatory bodies had produced the document to demonstrate that they had common purposes and acted in a proper way in the interests of the patients. It was not a mechanism to bring about change. It was a response to the reasonable anxieties expressed by the public relating to how self-governing professional bodies dealt with issues.

CHRISTINE GLOVER said that one reason for the meetings was a lack of understanding of what the regulatory bodies had in common. The document was the first effort to show what it was that they were all doing for the benefit of the patients. It was important that they could demonstrate that commonality to the Government.

In fact, different bodies had progressed further with different bits of work. They were endeavouring to move in the same direction together in an effort to ensure that they were able to go on regulating themselves without being leant on because they had missed something.

LINDA STONE said the exercise had been a useful one for all the bodies. It was healthy to see where there were gaps.

Modernisation programme

The Council approved a document setting out arrangements for dealing with the Society’s programme to bring forward proposals for modernisation of the Society’s regulatory function and to capitalise on the Society’s dual role in professional regulation and professional leadership. The programme, already agreed by the Council, will address what the preferred model of regulation of the pharmaceutical profession should be and what reforms are needed to the Council itself to support that model and to discharge its other responsibilities.

It was agreed that the modernisation programme would incorporate work formerly undertaken by the Health Act working party and would be taken forward by a steering group led by the President. The group’s membership would include four other Council members, the Secretary and Registrar, a project director, a lay member, an expert in governance, an expert in law relating to charter and statutory bodies, an expert in NHS and pharmacy policy and research, and one nominee each from the Scottish and Welsh Executives.

The steering group would be supported by a project manager and a project co-ordinator (who would also act as secretary to the group), and an external facilitator when necessary. The project director, manager and co-ordinator would all be pharmacists on the Society’s staff.

A cross-directorate group, led by the project director, would be established to identify issues for consideration by the steering group as a basis for developing a work plan. Working groups, including other Council members, could then be brought together to deal with individual strands. Small task groups involving both Council members and staff would deliver the work.

Council election procedure

The Council re-examined the Council election voting system and agreed that any changes should be deferred pending the outcome of a review of the Council planned under the modernisation programme.

A document before the Council reminded it that the single transferable vote (STV) system had been used for the election of Council members and auditors since 1976, following the adoption of the report of a Council working party. In 1990, following a review of the procedures by a further working party, the Council had agreed not to change the system. The 1999 branch representatives’ meeting had carried a motion from the Slough branch calling on the Council to reconsider the use of STV. The Council had considered the motion at its August 1999 meeting and, after consultation with the branch, had agreed that the 2000 BRM should debate the voting system. The debate had concluded with a vote in favour of returning to the system of seven equal votes. At the 2001 BRM, a motion from the Slough branch deploring the Council’s lack of action was carried without opposition.

It was suggested to the Council that there were four possible courses of action: (a) to discontinue the STV system and reinstate the previous system; (b) to continue with STV for the time being; (c) to defer any changes pending the outcome of the review planned under the Council’s modernisation programme; or (d) to canvass further opinion and consider the matter again at the Council’s December meeting.

After debate, the Council carried a motion in favour of option (c).

Self-checking of dispensed items for accuracy

The Council agreed that its policy on the self-checking of dispensed items for accuracy would be that a check by a second person should be the norm. Self-checking for accuracy should be recommended only in exceptional circumstances, such as when a pharmacist was the only person working in the dispensary. (Council members were in agreement that a pharmacist should always carry out the professional assessment of the prescription.)

The Council had before it a draft policy statement prepared after consultation with the membership. The document referred to self-checking in exceptional circumstances by phrase “by those who are trained and competent to do so”.

WALLY DOVE said that he had a problem with the phrase “by those who are trained and competent to do so”. It left the door open for technicians to self-check, and he was totally against self-checking by technicians.

PETER CURPHEY said that the training of technicians would have to change before they could be considered competent to self-check in exceptional circumstances. For pharmacists, accuracy self-checking was included in the postgraduate training.

HELEN REMINGTON suggested that the policy statement should make clear the distinction between the pharmaceutical assessment and the accuracy check.

ALAN NATHAN suggested that the statement should explain more clearly what “those who are trained and competent to do so” meant.

DIGBY EMSON said that until the Council had a solution to the “trained and competent” point, he could not agree to that element of the statement.

Mr CURPHEY said that it had always been Council policy that pharmacy technicians were competent, and it had defined “competent” as National Vocational Qualification level three. Now they were saying that self-checking would need extra training because it was not covered in the current NVQ level three.

ANDREW BURR said that there might be a situation where a hospital technician trained in accuracy checking moved into community practice. That did not make them less competent. Competence was about the individual and should not be tied to the location. The Council had fudged the issues of technician training and accreditation and now had to show leadership. It had to move forward, look at skill mix and allow competent, trained non-pharmacists to do things that pharmacists used to do that they should not have been doing.

ALISON EWING said they were trying to make a policy only for exceptional circumstances in the patient’s interest. She sincerely hoped that it did not become the norm. The rule was double-checking. The absolute exception to that was self-checking with proper procedures.

Mr CURPHEY replied that the norm was a professional check by a pharmacist and a check by a second person for accuracy.

The PRESIDENT said that what the debate had highlighted was that the norm was as Mr Curphey had stated and the policy statement only covered exceptional circumstances in the patient’s interests.

On a vote, the Council agreed to accept the draft policy statement subject to some rewording to reflect the views expressed during the debate. The policy would then be incorporated into the draft guidance on developing and implementing standard operating procedures for dispensing before it was sent out for consultation.

Pharmacist prescribing

The Council agreed that the President should write a letter to the Secretary for State for Health setting out the arguments for a prescribing role for pharmacists, and using nicotine replacement therapy (NRT) as an example of a service.

The matter was raised by ANDREW BURR, who said that he had become increasingly concerned that nurse prescribers were being trained by pharmacists to prescribe products that traditionally had been counter prescribed by community pharmacists. Nicotine replacement therapy was an example. By moving NRT on to prescription the Government had created a major problem for community pharmacists. Community pharmacists had the expertise to work with NRT and to counter prescribe products if the patient paid but now they could not necessarily offer that service if the patient expected to receive it free. The network of community pharmacists, who had tremendous access to the public, was not being fully used. What was currently going on disenfranchised the most accessible health care professionals. It made it even more difficult for them to offer services and it did nothing to address the key issue of smoking.

Mr Burr believed that NRT should be free on prescription, but it was outrageous that patients could not be offered continuity of service. He had funded NRT for patients himself on principle.

If at the end of the day it was all about outcome and targets, then the Government should use the community pharmacists to their best ability. Government local policies seemed to be running counter to the goals.

The PRESIDENT said that Mr Burr had presented a very powerful argument.

CHRISTINE GLOVER suggested that the President should write a robust letter laying out the arguments. It should be sent as soon as possible to the Secretary of State. The case could be strengthened by consulting the Pharmaceutical Services Negotiating Committee and National Pharmaceutical Association, so that the letter could come from all three bodies.

PETER CURPHEY said that he supported the sentiments and felt that would be sensible to write a letter. But it had to include a reality check. It would have to be carefully balanced, acknowledging what was going on with patient group directions and the prescribing agenda.

The PRESIDENT said that the letter should emphasise the basis of public interest, because it was a public interest issue.

The Council agreed that such a letter should be sent. (See also Committee proceedings)

Direct-to-consumer advertising

The Council agreed that the Society should develop a policy on the direct-to-consumer (DTC) advertising of prescription medicines. Council members were opposed to DTC advertising but accepted that it might well be inevitable. If it did happen, consumers would need access to accurate, unbiased and balanced information on prescription medicines, which would provide opportunities for an increased contribution by pharmacists.

The Council considered a draft position statement on DTC advertising and after debate agreed that Council members should submit comments in time for a further statement to be prepared for consideration at the December meeting.

Summing up the debate, the PRESIDENT said that the Society had to be positive and constructive. It had to have patient interest at the forefront at the end of the day. Any statement made could only be an interim statement.

Generic medicines

The Council agreed to prepare a paper setting out its views on the Government’s proposed choice of options for the future National Health Service procurement of generic medicines and reimbursement for their supply.

The Council was told that the Society was not being formally consulted on interim arrangements for reimbursement. The consultation document had been sent only to organisation that had a commercial interest and contractor representatives. However, the Government had produced a second document, which it called a discussion document, and the Society had had a clear indication from the chief pharmacist’s office at the Department of Health that the Department would welcome a response from the Society as one of a number of interested parties. The Society’s Policy Support Unit had therefore produced a briefing paper and a draft position statement. The draft position paper drew attention to the way in which both options would affect the viability of pharmacies and thus risk damaging the profession’s ability to deliver on the Government’s wider modernisation agenda, with possible effects that would be against the public interest.

After a substantial debate, the PRESIDENT asked Council members to submit their comments for inclusion in a revised position paper, Summarising the debate, he said that the paper should welcome the way in which the existing arrangements had worked well for a long time and they should welcome that. It should also highlight that the Society’s view came from the public interest and patient care perspective. The Society was seeking to achieve the objectives of the NHS plan, which required continuity of service and sustainable supply. There had to be the provision of an adequate network of pharmacy to produce services and deliver the plan.

Infringements

On the recommendation of the Infringements Committee, the Council agreed that action should be taken against several pharmacists for alleged legal or ethical infringements.

Unlawful purchase of POMs The Council agreed that the Society should prosecute a pharmacist who had purchased two prescription only medicines on behalf of an acquaintance who was a diabetes patient.

The Infringements Committee heard that the purchase had been reported to the Society by the pharmacist’s employer. When interviewed by a professional standards inspector, the pharmacist had confirmed that he had ordered 48 Viagra 50mg tablets and 224 Glucophage 850mg tablets from a wholesaler, purchased them himself, openly making the payment through a pharmacy assistant, and then handed them to the acquaintance, who lived abroad.

The committee noted that the patient had been treated for many years with Glucophage and there was no evidence to suggest that he could not have obtained a prescription from a medical practitioner.

Inadequate repeat medication service The Council agreed to refer to the Statutory Committee the case of a pharmacist whose system for providing repeat medication services was allegedly inadequate and who was also alleged to have stolen Equagesic tablets.

The Infringements Committee heard that the pharmacist was employed at one of two pharmacies owned by another pharmacist. The employing pharmacist had contacted the Society’s inspector, alleging that the employee had issued weekly Dosette boxes containing prescription only medicines to several patients without covering prescriptions. In addition, it was alleged that for three patients the dosage on the cards in the Dosette boxes did not match the current prescriptions held for the patients.

Interviewed by an inspector, the pharmacist had admitted supplying Dosette boxes in the absence of prescriptions for periods of up to three weeks. He said that the prescription forms were at his home, to which he had taken them in order to complete the instalment form for dispensing fees and to fill out repeat request forms. He admitted that no patient medication records were kept for those patients who received Dosette boxes.

The pharmacist also admitted to ordering and purchasing 1,000 Equagesic tablets for his personal use, only 100 of which were covered by a doctor’s private prescription.

Supply of wrong product The Council agreed that an alleged dispensing error by a pharmacist should be added to a complaint of professional misconduct already made to the Statutory Committee. The new complaint concerned the alleged supply of a 150ml bottle of promazine 25mg/5ml syrup for the balance of a prescription requesting 150ml of amantadine 50mg/5ml syrup. The bottle had been labelled as amantadine 50mg/5ml and had been administered to the patient by nursing home staff for four days before the error had been noticed.

Tenfold strength error The Council agreed to refer to the Statutory Committee the case of a pharmacist who had allegedly supplied Percutol (glyceryl trinitrate) 2 per cent, a treatment for angina, against a prescription calling for Percutol 0.2 per cent for unlicensed use in the treatment of anal fissure. It was reported that the patient, having received no advice from the pharmacist on how to use the product, had applied it for two weeks in accordance with the directions given in the patient information leaflet, suffering a range of severe side effects as a result.

The Council also agreed that the complaint should include an allegation that the pharmacist had made a supply of 535ml of Antepsin suspension, a prescription only medicine, without prescription. The Infringements Committee heard that the pharmacist had received a private veterinary prescription for 25ml Antepsin suspension, available only in 560ml bottles. He had dispensed 25ml but made a charge based on the cost of a full bottle. When the customer queried the charge with another pharmacy and returned to complain that she had been overcharged, the pharmacist had allegedly met the complaint by supplying her with the remaining 535ml of Antepsin without the authority of a further prescription and without labelling it.

Consistent poor performance The Council agreed to make a complaint to the Statutory Committee about a pharmacist who was allegedly responsible for a prolonged series of dispensing errors and customer complaints that he had handled poorly.

The Infringements Committee heard that, following a complaint by a patient alleging a sequence of dispensing errors, an investigation by one of the Society’s inspectors had revealed a number of other errors involving the pharmacist. The investigation allegedly indicated that he would often not admit that he had made an error and often failed to comply with the error-reporting procedures laid down by the company for which he worked as a pharmacy manager.

In considering the list of alleged errors and complaints, the committee noted that, despite a number of warnings, the pharmacist appeared to have failed to comply with the company’s requirements for dispensing and checking procedures. Furthermore, he did not seem to realise that his conduct represented a potential risk to the public.

On the committee’s recommendation, the Council agreed to refer the case to the Statutory Committee on the grounds that the number and frequency of the pharmacist’s alleged dispensing errors suggested that his competence to practise safely might be impaired and/or that his alleged failure to deal with complaints in a constructive and diplomatic manner was such as to bring the profession into disrepute and undermine confidence in it.

OFT review of pharmacy

The Council agreed to seek clarification from the Office of Fair Trading on its plans to review the market for pharmacy services, announced on 3 October (PJ, 6 October, p451).

The President referred to an OFT press release headed “New look OFT announces three new studies”, and said that it struck him as a strange document. When one looked at the pharmacy element of it, the words written were inaccurate, incomplete or certainly imprecise. By way of example, it did not acknowledge that since 1987 new pharmacies have had to prove that they are necessary or desirable before they could have a National Health Service contract.

Clarification was needed. The matter was at an early stage. The Society would seek clarification and study the proposals and would be in a position to respond more fully in due course. In the interim, a statement had been prepared stating that the Society was concerned to see the provision of an appropriate network of pharmacies and the availability of the full range of medicines and pharmacy services to the public.

That was the current position. Other bodies in pharmacy, such as the Pharmaceutical Services Negotiating Committee, would be particularly concerned.

Mr CURPHEY suggested that the Council’s position paper on control of entry, which had been produced four or five years ago, could be reconsidered and used as the basis of talking with other bodies.

The PRESIDENT said that the world had moved on in the past five years and therefore the document was a bit dated. However, he was sure the Council would agree that the document should be shared with the other relevant bodies.

Attendance Those present at the meeting, which was held on 2 and 3 October 2001, at 1 Lambeth High Street, London SE1, were the President (Marshall Davies), the Vice-President (Dr Gillian Hawksworth), Andrew Burr, Peter Curphey, Sultan Dajani, Wally Dove, Digby Emson, Dr John Evans, Alison Ewing, Christine Glover, Sally Greensmith, Patricia Hoare, Alan Nathan, Hemant Patel, Kirit Patel, Helen Remington, Professor Michael Schofield, Linda Stone, Ashwin Tanna and the Secretary and Registrar (Ann Lewis). Also present was the chairman of the Society’s Scottish Executive (Alison Strath).

Apologies for absence were received from the Treasurer (David Allen), Dr Gordon Appelbe, Hassan Argomandkhah and Dr Nicola Gray.

Guests Present by invitation were Anthony Cox (representative of the Birmingham branch), Richard King (secretary of the East Kent branch), David Morgan (secretary of the Clwyd branch), Pat Murray (representative of the Scottish Executive) and Maria Scott (secretary of the Derby branch).

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