The Pharmaceutical Journal
Vol 269 No 7218 p499
5 October 2002

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UniChem convention 2002 summary

Comfort zone of the dispensary has to be challenged, says Society

Professionals are increasingly having to make choices that restrict the use of their specialist knowledge to those circumstances where it is really needed, Helen Darracott, head of professional standards, Royal Pharmaceutical Society, told conference participants. "And yes, that means challenging the existing comfort zone of the dispensary."

She explained that the Government has clearly indicated that patients' interests and safety must be at the heart of all professional practice. And that politicians, health service managers, and even the public are starting to question the role of the pharmacist as the guardian of the nation's medicines.

Mrs Darracott asked why pharmacists felt the need to remain hands-on in the supply functions of pharmacy. "Why do pharmacists leave lesser qualified staff to undertake what might be seen as inherently more risky activities? Those same activities are arguably more professionally rewarding, like giving advice about medicines, health care and lifestyle to people who are both well and ill," she said.

She explained that, contrary to popular belief, the Code of Ethics has not required a final check for many years. Furthermore, the code leaves it up to pharmacists to determine the precise systems and procedures that meet their individual needs and circumstances. She added that there is now common ground across the pharmacy bodies that the only element of the dispensing process that cannot be delegated is the pharmaceutical assessment of prescriptions.

"In this accountability-based approach, quality is assured through the training and competence of staff and by having robust systems and procedures in place that are then regularly monitored and evaluated," she said.

So if fewer than 100 per cent of all transactions are to be directly overseen by a pharmacist, there must be arrangements in place that ensure the safety objective is met in some other way.

As a minimum, there must be:

• Clear systems to identify cases where a pharmacist's intervention would be of assistance, and to provide for that intervention

• An identifiable pharmacist who is professionally accountable in order to provide the assurance of safety

• Systems that incorporate, as a quality assurance measure, a means by which the pharmacist assuming responsibility for sales or supplies can verify compliance with those systems

"In my view it is unlikely that arrangements which utilise trained and competent staff and which can demonstrably provide a satisfactory means of addressing these three elements would be considered by a court to breach the Medicines Act supervision requirement."

She went on to say that quality, like justice, has to be seen to be done. "Any argument that smacks of even the slightest hint of professional self-interest only makes things worse."

After a debate, 85 per cent of conference participants indicated that they would feel comfortable delegating some of the pharmacist's role to support staff. However, 42 per cent saw provision of staff training as the main barrier to greater pharmacist delegation.

The development of new roles and greater patient contact were viewed by most participants as the most important potential benefits from increased delegation.