The Pharmaceutical Journal
Vol 269 No 7216 p420-423
21 September 2002

Society summary

Branch representatives' meeting: Council's response to resolutions

Improving outcome of medicines usage That in the light of recent reports by the Audit Commission, "A spoonful of sugar" and the Scottish Executive Health Department, "The right medicine: a strategy for pharmaceutical care in Scotland", the Royal Pharmaceutical Society must be the body spearheading a pharmacist-led programme to reduce preventable drug related morbidity and increase concordance to improve the outcome of medicines usage by patients. Such an initiative must be clearly evident to the general public. [Edinburgh and Lothians]

Much of the work of the Society has the aim of supporting the safe and effective use of medicines. This includes work on clinical governance; standards and practice guidance; practice research and audit; and the publication of scientific and clinical reference works.

In England and Wales the Society will be working with the National Patient Safety Agency, which has been established by the Government to set up a national error reporting system. The agency has started a pilot project on errors in primary care, in which pharmacy and medicines will be a major focus. In Scotland the Society will work closely with the Quality Standards Board, which will strive among other things to improve the outcomes of medicines usage.

The Society's ground-breaking work on concordance seeks to create partnerships in medicines-taking with patients, with the objective of helping patients get the best from their medicines. This work has been recognised by the Department of Health, which is now funding a national project on partnership in medicines-taking, based at the Society.

The Society will be conducting work on "A spoonful of sugar" to identify how pharmacists can maximise the impact of the recommendations in the report. In addition, the Society will be working closely with the Audit Commission and the National Patient Safety Agency to ensure that the patient safety aspects of "A spoonful of sugar" are implemented by the NHS.

Promoting pharmacy That the RPSGB should promote pharmacy as a health profession which specialises in medicines — the dispensing of prescriptions, the recommendation of medicines, the use and misuse of medicines, the interactions between them and the management of medicines. All should be overseen by the profession with the training to do this. Pharmacists are the only health professionals with four years university training and a further year of practical training in medicines. [Dudley and Stourbridge]

The Council endorses the spirit of this motion, although it is not clear what is of concern in the explanatory paragraph (PJ, 20 April, p549).

As the regulatory and professional body for pharmacists, the Society works in a number of ways to support and promote the role of pharmacy as described in the motion.

Through its role in approving the content of pharmacy undergraduate degree courses, the Society helps ensure that pharmacists have the knowledge and skills that they need to fulfil their role. The requirement and support for continuing professional development helps pharmacists maintain their level of knowledge throughout their careers.

The Society works with the Government, the National Health Service, patients and other stakeholders to achieve the best use of pharmacists' unique understanding of medicines and their use. Much progress has been made in recent years: national strategies for the modernisation of health care delivery now recognise the contribution that pharmacists can make and include a much more defined and integrated role for pharmacists across a range of services. The common denominator in all these developments for pharmacy is the support of the safe and effective choice, use and management of medicines. Increasingly, this involves pharmacists supporting other health professionals in their practice, as well as working directly with people taking medicines.

The Society works to provide a framework of standards of best practice for new service developments and to support pharmacists through the provision of quality information and other services.

Standards for technician registration That the Society should establish standards for registration of technicians as a matter of urgency. These standards should reflect the requirements of employers, allow for additional specialist skills and meet the needs of the different British health care systems. [Glasgow and West of Scotland]

In December 2001 the Council agreed to move towards the mandatory regulation of pharmacy support staff. Proposals are to be developed on how to progress the regulation of support staff as part of the regulatory reform of the Society as a whole. The Council is committed to consultation throughout the profession on the approach being taken and also ultimately on the proposals themselves. This work will be ongoing throughout 2002.

At present, a number of different training courses lead to qualifications as technicians. Some of these (such as the Business and Technical Education Council national certificate in applied science, pharmaceutical) are purely academic (knowledge-based) programmes with no requirement for practical employment-based training or competence assessment. The question is whether this is acceptable in the current climate with its focus on professionals being required to demonstrate competence.

It is the Council's view that all training programmes for pharmacy support staff should combine an underpinning knowledge component with sufficient relevant practical work-based experience and has recently agreed a statement to this effect. Scottish/National Vocational Qualifications are made up of knowledge-based programmes combined with the demonstration of competence against national occupational standards. There are questions about the quality of the underpinning knowledge-based programmes and these will be addressed as part of the regulatory modernisation process.

S/NVQ standards are intended to be applicable across the United Kingdom. Representatives from all home countries were invited to participate in working groups as part of the review of the pharmacy services S/NVQ Level 3 or equivalent and pharmacists across the UK were consulted as part of the consultation phase.

There are also a number of older qualifications that have now been superseded, and the question of overseas qualifications will also need to be addressed.

Other issues include the range of staff to be regulated, illustrated by the wide variety of job titles in use, such as dispensers, dispensary assistants, pharmacy assistants, assistant technical officers and medicines counter assistants.

A steering group is being set up to develop proposals on how to progress the regulation of support staff. The steering group is to be chaired by Helen Remington (member of Council) and the secretariat provided by Janet Flint (practice pharmacist in the Society's practice division).

The formulation of standards for registration of technicians will be addressed as part of this work. A consultation paper outlining some of the implications of moving towards mandatory regulation of pharmacy support staff was published in The Journal of 22 June (p888). Further consultation papers will be published as work progresses.

Payment for professional development That the Society should support the principle that pharmacists should be paid for one session a week of professional development/continuing education. [Glasgow and West of Scotland]

There is an obligation upon all pharmacists to keep up to date in their knowledge and skills, and properly to prepare themselves for developments in their practice. Pharmacists' main means of fulfilling their obligation is structured continuing professional development, including, but by no means limited to, participation in continuing education courses.

The Society, of course, supports, within available resources, measures and approaches that help pharmacists undertaking continuing professional development. The Council supports the principle of the motion but recognises that it is the responsibility of other bodies to negotiate remuneration.

Statutory Committee decisions That the Royal Pharmaceutical Society of Great Britain should ensure that the judgement of Statutory Committee decisions are published on the official RPSGB website in a timely manner thus making them freely available to the public and profession. [Birmingham]

This matter has been raised with the Chairman of the Statutory Committee and further consideration has been given to this matter at the committee's July meeting. The committee agreed that the notice of inquiry and the transcript of the chairman's approved decision should be published on the Society's website soon after the hearing. It is expected that these will remain on the website for six months from the date of posting by which time the transcript of proceedings will be available for private study or personal information in the Society's library.

It is expected that these new procedures will commence following the September sitting of the committee.

'Medicines, ethics and practice' That the profession (still) requires that the 'Medicines, ethics and practice' guide should be written in simple and clear English with a more comprehensive index than in the current document. [Hull]

A complete review of the Code of Ethics was undertaken between 1998 and 2001 and the new document adopted at the annual general meeting in 2001. The membership was consulted during the review process and a large number of comments were received, including some relating to the change in style and language. The response from the membership to the revised code has been overwhelmingly positive. No other comments have been received suggesting that the code is in any way difficult to read or to understand. Indeed, a number of correspondents have welcomed the change in style and language and commented that the revised document is much easier to read in comparison to earlier versions.

The Professional Standards Directorate continues to work with the editor of 'Medicines, ethics and practice' to revise and improve the publication. Part 1, concerning general legal requirements, is being rewritten and the index is continually updated. The comments of the Hull branch will be taken on board throughout this work.

Inspectorate's supporting role That the Society's inspectorate should publicise its supporting role as well as a regulatory one in order to maintain and improve the standards of pharmacy. [Brighton]

Over several years, the work of the inspectorate has developed so that, while the enforcement role is still an important part, there is much more emphasis on the role of inspectors as supporters and advisers to the profession. This started in the late 1980s with the pre-notification scheme, which allows pharmacists to prepare for a visit by the inspector so that matters can be raised constructively. This also demonstrates that the inspectors' main purpose in routine visits is to inform the profession rather than "catch them out".

In more recent times, the inspectors have given the same message in talks to preregistration trainees. Inspectors have shared their telephone numbers and e-mail addresses so that pharmacists can contact them for advice and on many occasions pharmacists who have made errors or who need advice have sought immediate guidance from the inspectors, who have largely been able to give that advice informally.

The inspectors have also given support in some health cases, including providing advice on sources of assistance. In some cases, the inspector has liaised with the support networks and the pharmacist to help secure appropriate treatment.

To prepare the inspectorate for the future, inspectors' meetings have included presentations on audit and clinical governance. Inspectors give advice to pharmacists about those measures that need to be implemented on error and near-miss logging, interventions logs, dispensing standard operating procedures, training of support staff and continuing professional development.

Because pharmacists are increasingly busy during visits, the inspectors are mindful of the intrusion and try to minimise the interruptions. Some out-of-hours meetings have also taken place.

The Professional Standards Directorate is exploring with the Society's website editor the possibility of setting up an inspectorate presence. The site would include the guidance notes and forms which inspectors provide during visits. A number of inspectors are also experimenting with meeting pharmacists outside the pharmacy to discuss in more depth issues which the pharmacist or inspector have identified.

Inspectors' involvement with branches That the Society encourage its inspectors to be actively involved in the activities of a branch local to their place of residence. [Bolton]

Branch meetings are a useful forum for exchanging views but the workload of inspectors means that sometimes meetings cannot be attended. It would not be appropriate or practicable to place an obligation on an inspector to attend branch meetings.

The inspectors generally do participate in local branch meetings, but expecting them to attend each meeting of their own branch would remove their ability to visit and participate in other branches.

The head of the inspectorate and some inspectors serve as committee members in local branches but other inspectors will not have the time or desire to take on such roles. Some inspectors have also given the membership team their details for publication in the list of speakers for branch meetings.

The inspectors welcome the invitation expressed in the motion to participate more, and they will attend branch meetings where time and circumstances permit.

Representing the membership That the Royal Pharmaceutical Society of Great Britain must maintain or improve its existing role of representing the membership. [Birmingham]

The Society's Charter contains the objective: "to maintain the honour and promote the interests of the members in their exercise of the profession of pharmacy." In this context, it is not within the remit of the Society to "represent" commercial or pecuniary interests of the profession or of one section of the profession over another. The Society does, however, legitimately act as an advocate for the profession with the aim of influencing public policy on matters within its professional and regulatory remit.

The Society has invested heavily in building influence with Government, Parliament and devolved administrations, the National Health Service and other stakeholders. The Society regularly — and successfully — makes representations on behalf of the profession to deliver a safe, high quality service. This might be on a range of technical or practical issues that affect pharmacists. The Society has recently made representations to ministers about its concerns on workload and workforce shortages. The Society is currently lobbying over concerns that a proposed European directive on the movement of professionals might compromise public safety.

The Society is active in supporting the work of the All-Party Pharmacy Group in Parliament, which highlights pharmacy issues among Parliamentarians and ministers.

The Society intends to continue to lobby and campaign as now to ensure that the profession's voice is heard where policy is made and implemented.

Date of 2003 BRM That the decision of the Council to hold the 2003 branch representatives' meeting at the British Pharmaceutical Conference should be withdrawn and the BRM should continue to be held at Lambeth on the day after the AGM. [Moray and Banff; South Cheshire; Shropshire]

The Conference Committee considered this motion and agreed to recommend to the Council that the branch representatives' meeting 2003 should not be held at BPC but should be reinstated into its traditional timing of Thursday 15 May 2003, the day after the annual general meeting. The Council agreed with this recommendation at its August meeting.

Branch representatives at BPC That the decision of Council to withdraw central funding for branch and regional representatives attending the British Pharmaceutical Conference is not in the best interests of the membership and should be rescinded. [South Cheshire; Bolton]

The Council considered strategies from its Conference Committee to deliver the 2002 conference within the budget and proposals of a review group established to look at the future direction of the conference.

The Council agreed that the conference should continue to include scientific, professional and political elements and that the conference programme should be designed to meet the continuing professional development needs of practising pharmacists. To succeed, it was agreed that BPC needs to operate on a robust business basis, with its costs identified and separated from those of the Society, its expenditure kept within a budget, sponsorship and exhibition income increased and a programme designed to maximise attendance.

The conference continues to be heavily subsidised by the Society, both in terms of direct costs and staff time. A number of measures and cost savings have been identified in order to ensure that the conference can be managed within its allocated budget. In future, the BPC will only bear the costs of staff and Council members directly involved in conference organisation or the programme.

The Council also agreed that branches and regions should be encouraged to continue to send delegates to the conference but that, in future, such delegates should have their costs met from the general branch and regional grant allocations rather than from a central allocation within the conference budget.

The conference will continue to be held in the autumn each year and will take place over three days. Day programmes will be developed as integrated packages, with day tickets for members in 2002 costing £125. This is certainly not out of line with the cost of similar events.

The Conference Committee has reconsidered this motion and its recommendation to Council was not to reinstate the branch support in the previous format but for consideration to be given to how first time attenders could be attracted to the BPC.

At its August meeting the Council agreed that branch delegates would not be funded to attend BPC 2002 but that options would be considered to encourage future attendance for first time attenders. It was agreed that any such costs would be subject to overall budget considerations and that that they would not be met from the BPC budget.

Museum funding That the Council should realise the importance of the museum and historical collection and rescind the decision to greatly reduce the monies allocated to this activity and the museum used better as a public relations tool. [Cheltenham and Gloucester]

The Council decided to reduce expenditure on museum activity because of the need to focus resources on priority areas of work. The principal change in focus is that the museum is no longer open to the general public but remains a resource for pharmacists and researchers. It is expected that the museum will continue to qualify for registration which will underpin the standards and levels of collection care and enable the existing Byelaw to be honoured. It will also enable the museum to stay as part of the various museum networks and to qualify for grant funding.

The museum's acquisitions and disposals policy has to provide an accurate description of current collecting policy. For many years now, the museum's mandate has not sought to collect from abroad.

The policy regards the Council as the governing body, which means it continues to be responsible for the museum's constitution and to make decisions about the disposal of any items.

The policy contains a statement about the museum's current collecting policy which says that "acquisitions outside the current stated policy will only be made in very exceptional circumstances and only after proper consideration by the governing body." This would allow for the museum to accept exceptional gifts bequeathed to it, if the Council wished. The same clause would also cover "significant" items from earlier periods.

Society's accounts That members require a more transparent set of accounts which should be provided to members no less than 20 days before the AGM and for the honorary auditors to monitor income and expenditure with an enhanced and more public role. [Hull]

The current financial statements provide in summary format the income and expenditure of the Society as well as a summary review of the main areas of Society activity for the year. The format of the financial statements has been developed over a number of years to provide consistent and comparable data that complies with the major disclosure requirements of company reporting, which is considered best practice for the Society to adopt. A more detailed analysis of income and expenditure has been incorporated in the Society's full financial statements to enhance transparency and help with interpretation of the financial information. This is further supplemented by a commentary in the main Society annual report, and by the Treasurer's speech at the annual general meeting.

The Society's income and expenditure is monitored by a committee of the Council, the Resource Management Committee, which meets on a quarterly basis. The committee receives the proposed financial budget for future periods and a departmental and directorate analysis of financial performance to date. The committee is able to question the finance team on any issues arising from the data presented and makes recommendations to the Council in terms of budgetary control and compliance with financial policy.

Additionally, the Council established an Audit Committee during 2000, which is charged with, among other issues, the establishment of a sound internal audit function, monitoring both financial and non-financial internal controls. In this way, transparency and accountability are constantly monitored within the Society.

The Society operates a number of other key controls to ensure accountability. To provide additional financial detail in the public domain would compromise the Society's commercial activities and would involve additional cost to the Society. As part of the budgetary control proposed for 2002, the Society will again publish the financial statements on the Society's website before the AGM. The actual date of publication depends on the internal timetable for committee approval.

The honorary auditors currently approve the financial statements prior to the AGM. At the honorary auditors' meeting, they are able to raise any issues or concerns with the Society's external auditors, Treasurer, President, Secretary and Registrar and Director of Resources. The future of this role is currently under consideration by the Audit Committee.

It is planned to now meet with the honorary auditors at least twice a year and at the first of those meetings, in the late summer/ early autumn of 2002, there will be a discussion about what additional information could be supplied to help with their role.

Election canvassing That Council should review the "rules on canvassing" applied to candidates for election to Council. [Moray and Banff; Slough]

The Modernisation Steering Group is reviewing all aspects of the electoral scheme used for election to the Society's Council. Pharmacists' views are being sought as part of the review (PJ, 10 August, p197).

Replacing STV That the decision of Council to refer a decision on replacing the single transferable vote for the election of Council members to the committee on modernisation of Council is to be deplored. [Slough]

The Society's Modernisation Steering Group published a discussion paper in June 2002 asking for views on how to achieve the right balance on the Society's Council in the light of its decision that the Society should retain both its regulatory and professional roles within a reformed structure (PJ, 22 June, p883). The voting system used for Council elections was addressed in this paper and the Council will take a decision on this issue in due course.

Pharmacy awareness campaign That the Society should undertake an active pharmacy awareness campaign to educate members of the public about the pharmacy profession. [British Pharmaceutical Students Association]

The Society works across a number of areas to influence the policies and developments that affect the pharmacy profession. Not all this work can or should take place in the media spotlight: although, where appropriate, the Society has shown that it is adept at supporting its policy work with media campaigning.

In 1998, the Council decided to create a Directorate of Public Affairs, to manage political external relations. Since then, a programme of work has been developed to ensure that the profession's concerns are known and understood by a wide range of opinion formers.

Staff across the range of directorates involved in policy at the Society have developed good working relationships with key government officials, people working in the National Health Service, Westminster Parliamentarians, health professionals and their organisations, patient bodies and the public. The Society also works closely with the Scottish Executive and Parliament and the National Assembly for Wales. The Society works on a number of fronts within the European Union.

If there is greater public awareness of the British Medical Association and the Royal College of Nursing, this may be because these organisations have a different role from that of the Society. As trade unions, their role in negotiating NHS pay and conditions for their members brings them often into public conflict with government policy on these matters. In recent years, the General Medical Council has received a considerable amount of adverse media coverage following high profile cases against doctors.

Where there are opportunities for the Society to maximise pharmacy's profile in the media then these are taken. Evidence of this can be seen in the media coverage that resulted from issues relating to the provision of emergency hormonal contraception through community pharmacies, the use of cannabis as a medicine and the reclassification of medicines. On all of these issues the Society, through its communications work, ensured that the pharmacy message was given centre stage in the media spotlight.

ADR reports That there should be encouragement of pharmacists to use the formal reporting scheme for ADRs to drugs which are unlicensed or being used outside their licence. [British Pharmaceutical Students Association]

The Pharmaceutical Journal has published editorials and articles on the use of the yellow card scheme by pharmacists (PJ, 6 July, p2, p14 and p25; 25 July, p86 and p109), and these goes a long way to encouraging pharmacists to use the scheme.

In addition, the Society is requesting the Neonatal and Paediatric Pharmacists Group to remind its members to use the yellow card scheme whenever it is applicable — for example, through its newsletter.

The Science Committee is also setting up a meeting of interested and enthusiastic paediatric pharmacists to identify the best way of reporting ADRs, to identify 30 or so of the most commonly used and important drugs, to create a project outline to accumulate the data on their usage, to identify possible sources of funding for the project and to identify someone who could create a network of interested parties. This meeting will also involve other professions.