The Pharmaceutical Journal
Vol 269 No 7228 p863-866
14 December 2002

December Council meeting

Technician registration planned for 2007

The Royal Pharmaceutical Society's Council has decided that, subject to the appropriate legislation being in place, mandatory registration of pharmacy technicians by the Society should be introduced from 1 January 2007. It would be preceded by a two-year voluntary period. Registrants would have to meet the standards of the Scottish/ National Vocational Qualifications (S/NVQ) level 3 qualification in pharmacy services.

The Council made its decisions at its December meeting on the recommendation of the steering group on the regulation of support staff. Following its consultation earlier in the year (PJ, 22 June, p888), the steering group had put forward a document (PDF*, 60K) containing detailed proposals for taking forward the Council's policy of moving towards the regulation of support staff as part of the modernisation of the Society.

The Council agreed that, although the regulation of new professional groups is a matter for the devolved administrations, it is in the interest of both patients and the profession that there should be a single regulator for pharmacy support staff across Britain — the Society being the most appropriate body to undertake their regulation.

It also agreed that the regulatory framework for pharmacy technicians should be developed sequentially so that ultimately it would encompass all the functions of a modern health regulator, as outlined in the Kennedy report. A register of pharmacy technicians would be established separately from the Register of Pharmaceutical Chemists. Registrants would use the title "registered pharmacy technician".

On the required level of competence for pharmacy technicians, the Council agreed that the minimum standard would be that of the S/NVQ level 3 qualification in pharmacy services. This includes a programme of accredited underpinning knowledge that meets the requirements of the technical certificate (currently under development with input from the pharmacy sector committee of the Science, Mathematics and Technology National Training Organisation), plus a declaration, countersigned by the supervising pharmacist, of relevant work-based experience in a pharmacy for a minimum of two years, along with a health declaration, evidence of identity and a signed statement of good character.

The Council agreed that a grandparent clause and/or transitional arrangements would be introduced to allow registration by persons with the responsibilities, experience and training background of pharmacy technicians, even though this may have predated S/NVQs and/or been delivered through a company scheme. A flexible approach would be taken in relation to borderline qualifications. Consideration would also be given to developing top-up training programmes and/or competence assessment for those with a qualification not deemed acceptable for entry to the register (eg, the Boots one-year dispenser training programmes, the Buttercups dispensing assistant course and the National Pharmaceutical Association dispensary assistants course). This programme of work would be overseen by the pharmacy sector committee. Consideration would be given to whether to place a time limit on the completion of top-up training. A process would also be put in place for assessing those with non-UK qualifications, including overseas pharmacists working as technicians.

The Council also endorsed the steering group's view that similar standards, including regulation of dispensing staff, should apply in all non-pharmacy environments where medicines are dispensed and medicines other than general sale list products are supplied. It was agreed that this view should be promoted to relevant organisations and agencies, including the National Patient Safety Agency.

Finally, the Council approved proposed mechanisms for taking its decisions forward and agreed that the set-up expenses would be fully costed to ensure that, in the longer term, the regulation of pharmacy technicians would be self-financing.

Regulation of support staff

The Council approved for publication a consultation document on the regulation of pharmacy support staff working at Scottish/ National Vocational Qualifications level 2, ie, dispensary support staff other than pharmacy technicians and medicines counter assistants (see p868).

The document, produced by the Society's steering group on the regulation of support staff, does not propose registration of such support staff, given that they do not work unsupervised, but build on the Society's existing support staff policy to regulate the environment within which they work though professional requirements for training, competence assessment and written standard operating procedures.

Future of the Council

The Council made a number of further decisions on its proposals for the constitution of the reformed Council, including matters such as eligibility to serve as a Council member and the inclusion of reserved places for Scotland and Wales. One of the main changes from the current constitution is that members of the reformed Council will serve four-year terms and be limited to a maximum of three consecutive terms. Candidates for election will have to disclose certain information that might reflect on their ability to serve effectively on the Council. The current restrictions on canvassing by Council election candidates will be removed.

Most of the Council's decisions were made after considering a number of recommendations made by the modernisation steering group following its third consultation on the Council's constitution, which was concerned with elections and Council membership (PJ, 10 August, p197, and 12 October, p549). The decisions were as follows:

Residency

• The requirement for elected Council members and election candidates to be normally resident in Britain, the Isle of Man or the Channel Islands will be retained

Conflict of interest

• Council members and election candidates will have to register relevant interests and to declare such interests when appropriate

• Those appointing or electing members of Council to undertake specific roles will be required to bear in mind the need to minimise conflicts of interest

Fitness-to-practise decisions

• Council election candidates will have to declare any adverse decisions that might be relevant to membership of the Council, and this information will be included in the voting papers

• Guidance will be developed to help candidates determine the relevance of any adverse decisions, including decisions by the Society or other regulatory body on their fitness to practise and criminal convictions, and the level of detail that should be provided

• Further consideration will be given to whether any categories of adverse decision would render a pharmacist ineligible for election to the Council

• Further consideration will be given to any procedures that should follow if a Council member is the subject of investigation or proceedings concerning his or her professional conduct or performance, or a serious criminal offence

Active working within the profession

• Information will be provided to the electorate on the extent and type of work undertaken within and for the profession by candidates for election to the Council

Nominators

• Each election candidate must be nominated by 10 pharmacists, but there will no longer be a requirement that at least five should be from the candidate's own branch of the Society

Trusteeship

• Candidates will be required to declare that they are not disqualified from serving as charity trustees

Canvassing

• The current restrictions on canvassing will not apply to elections to the reformed Council

• Guidance will be provided to candidates on legal and professional requirements relating to publicity, the use of sponsorship and the Society's views on negative campaigning

• Further work will be undertaken to clarify the information or assistance that the Society can supply to candidates and the role of The Pharmaceutical Journal

• The Society will be able to issue a clarifying statement in any case where all or part of an election candidate's policy statement appears to be outside the functions, powers and duties of the Society

Upper age limit

• No upper age limit for Council members will be introduced

Term of office and frequency of elections

• Council members will serve four-year terms of office

• Council members will retire on a rolling basis, with about half the elected members and about half the lay members retiring every two years

Limit to consecutive years of service

• No Council member will be elected or appointed for more than three consecutive terms

• Any pharmacist candidate who is successful in the first election to the reformed Council who has served eight or more consecutive years on the Council immediately before that election will be eligible to serve only one further consecutive term of up to four years

• Members of the reformed Council who have completed their maximum term will be eligible for re-election or reappointment after a minimum of four years

Removal of members from Council

• Legislation will be sought to allow the Council to make rules providing for the removal from office or suspension of a Council member in specified circumstances

• More detailed proposals for the scope and limitation of such rules will be developed for consideration

The Council also agreed that the membership of the future Council should include one pharmacist from each of England, Scotland and Wales who would be elected only by members resident in that country.

The Council made this decision after considering a choice of options put forward by the modernisation steering group with the aim of ensuring that the reformed Council will include at least one pharmacist member and one lay member from each of England, Scotland and Wales. The options were set out in a paper produced after the steering group's consultation on getting the right balance of members on the Council (PJ, 22 June, p883, and 14 September, p375).

The option adopted by the Council is that the reformed Council will include reserved places for one pharmacist and one lay member from each of England, Scotland and Wales. For pharmacists, the "England" constituency will also cover the Isle of Man and the Channel Islands. The remaining elected places for pharmacists will be filled by Society-wide election.

Within the rolling schedule of two-yearly elections, all the reserved places for pharmacists will be filled in the same year. At the same time, about half the non-reserved places will be filled, and the remaining non-reserved places will be filled in the "interim" years.

Every four years, pharmacists will receive voting papers including two lists of candidates. One list will be for the reserved seat for the constituency in which a pharmacist's registered address lies; the other will be for all the non-reserved seats that fall vacant that year. Candidates will not be able to have their names included in both the reserved place list and the non-reserved list. A candidate will not be eligible to stand for a reserved place in a constituency other than the one in which he or she is normally resident.

Each voter will have one vote for the relevant reserved list and one vote for each vacancy to be filled from the non-reserved list. The vacancies for the reserved places will be filled by the highest placed candidate in each reserved list. The remaining vacancies will be filled by those candidates from the non-reserved list who receive the most votes from the membership as a whole.

The PRESIDENT said that a constitutional expert had advised the Society that as well as considering the principles of effectiveness, inclusiveness, accountability and transparency it should also consider the principle of equity, which required that England, Scotland and Wales be treated in the same way.

Professor BOB MICHELL suggested that the electoral scheme should be compatible with the development of constituencies within England if regional governments came to exist. In the interim, although there may be a rational and equitable reason for it, people might be disinclined to stand for the single reserved place for England when they could stand instead for one of several non-reserved places. A mechanism was needed for filling vacant reserved places from the general pool. He proposed that, in the event that there was no candidate for any of the reserved places, that place should be filled by the next highest scoring candidate after those elected to the non-reserved places who was normally resident in the relevant country. (Agreed)

The Council went on to agree that a recommendation should go to the reformed Council that the chairmen of the Society's Scottish and Welsh Executives should continue to serve as observers.

Professor MICHELL suggested that the Council might want to build in a future power to co-opt members. For example, in 10 to 15 years time it could be important to have a couple of members from European Union countries to guide the Council if far more legislation came from the EU rather than national governments.

The SECRETARY AND REGISTRAR suggested that the possibilities for co-option could be discussed with the drafters of the legislation. The drafting should be flexible enough to provide for the future but tight enough to ensure a robust Council.

ANDREW BURR said that co-option would also be useful if someone had to be removed from the Council.

Smoking ban

The Council agreed in principle that it should call for a ban on smoking in public buildings. The matter would be considered again during future consideration of policy on public health.

The Council's decision arose from a motion from HEMANT PATEL, who proposed that "This Council calls for a ban on tobacco smoking in public places, including pharmacies, and a new tax on tobacco companies to cut passive smoking deaths". Mr Patel said that the British Medical Association was calling for legislation to protect people from the effects of passive smoking. The Society should work with the BMA in protecting public health.

Second-hand smoke not only worsened existing health problems but also caused serious and fatal illnesses, leading to an estimated 1,000 deaths a year in the year in the United Kingdom. Scientific evidence indicated that passive smoking increased the risk of lung cancer by 20–30 per cent and the risk of coronary heart disease by 25–35 per cent.

Voluntary measures existed in many places, but the only way to protect people from second-hand smoke was legislation that worked. He supported the BMA call for a complete ban on smoking in public places. Surveys had shown that up to 86 per cent of the public favoured smoking restrictions in public places.

On his proposal for a new tax, Mr Patel said that the tobacco industry had spent a fortune on spin to obscure the evidence that tobacco caused harm. Along with other health care organisations, the Society should put pressure on the Government to do as the motion suggested.

In addition, there was a role for pharmacy in public health, where pharmacists' potential had yet to be fully activated. Programmes should be devised to help pharmacists develop the right mindset, and priority should be given to strengthening the necessary implementation skills.

The PRESIDENT reminded the Council that it already had a policy that smoking products should not be sold in pharmacies. It also had a policy to encourage smoking cessation, and community pharmacists were actively involved in this. He had enormous sympathy with the proposition and he was sure the Council would agree that the Society should play a bigger role in public health.

The President added that the new chairman of the Pharmacy Health Care scheme, Professor Sian Griffiths, was to give a presentation to the February 2003 Council meeting on pharmacy's role in developing public health. Smoking was an integral part of that, and rather than debate the issues piecemeal he suggested that the Council accept Mr Patel's motion in principle and incorporate Mr Patel's points into the debate after the presentation. The matter could then be brought back to a further meeting of Council for agreement as a policy.

Mr PATEL said that he would be happy with that but the Society needed to initiate discussion everywhere so as to develop a mindset in the profession that focused on preventive measures.

Mr CURPHEY seconded the motion. The Council was failing to debate big public health issues on which the profession did not have a stance. For example, it had no policy on cannabis other than in regard to its development for medicinal use. It should have a position on important issues tied to health in society.

Mr DOVE said that he was in favour of the overall principle but felt that the taxation issue had to be thought through carefully.

Professor MICHELL was also in favour of the motion but did not think it possible to ban smoking in public places such as street corners and parks. If that happened, it would probably increase passive smoking, because there would be more smoking in the home and in cars.

The PRESIDENT suggested that the Council should call for a ban on smoking in public buildings, including pharmacies. The Council agreed, but it rejected the idea of seeking a new tax on tobacco companies.

Branch grants

The Council has approved a new method of funding for the Society's branch network to encourage active branches to engage in more relevant, focused activities. Each branch will be given an annual basic grant to cover core activities but will be able to bid for additional funding to support the development of the profession locally.

Preference will be given to bids that: support continuing professional development; are for a priority topic; are made jointly with other branches; encourage multidisciplinary activity; encourage attendance by preregistration trainees and their tutors; encourage new attendance; or offer a forum for mediated discussion or debates.

The Council reached its decision after the proposed new funding method had been discussed in detail at the annual meeting of branch and regional secretaries in October. The Council was mindful that, under the existing system, some branches feel starved of funds to run their programmes while others struggle to use their allocation.

The Council agreed that the basic grant for 2003 will be based on the following formula: £4 a head up to the first 50 members, £3 for each of the next 200 members (ie, 51–250), £2 for each of the next 100 members (ie, 251–350), and £1 a head for each additional member in branches with more than 350 members. (In addition, an extra £100 is paid to branches with 100 or fewer members.)

The Society will also continue to cover the costs associated with travel and accommodation expenses for speakers from the Society's central list. Branches will be able to apply for up to two speakers to be funded in this way. Extra funds will only be available to branches that have existing balances of less then £1,000, except that all branches will be able to apply for additional funding of up to £250 to help send first-time attenders to the British Pharmaceutical Conference. Other extra funding will be available in amounts of £250 and £500. Branches will be able to make more than one application.

Pharmacy workforce

The Council agreed in principle the contents of the Society's response to the Department of Health discussion paper, "Pharmacy workforce in the New NHS: making the best use of staff to deliver the NHS pharmacy programme" (PJ, 28 September, p432 and p444, and 5 October, p469 and p480).

The Council had before it a draft response, which it examined paragraph by paragraph. It also considered a paper about developing a clinical governance framework that would ensure a safe pharmacy service in the event of changes to the definition of supervision. During a substantial discussion, Council members suggested a number of points for inclusion in the final response.

The Council was advised that the closing date for responses was the end of December. The draft response would be refined into a final submission, which would then be circulated to Council members before being delivered to the Department.

Nomination to international bodies

The Council approved a new procedure designed to strengthen the existing arrangements for nominations for service on international bodies such as the International Pharmaceutical Federation (FIP), the Pharmacy Group of the European Union, the Commonwealth Pharmaceutical Association and the Europharm Forum.

The procedure, proposed by the corporate governance working group, is designed to achieve the best outcome for the Society internally and externally, to ensure that the nominee has the requisite skills and experience, to be objective in assessing the potential contribution of nominated individuals, and to be transparent and demonstrate equity and fairness. Under the procedure, Council members would submit written nominations and/or expressions of interest, which would be considered by a panel comprising the Officers plus a Privy Council nominee as external assessor, together with the Secretary and Registrar and the Deputy Secretary. The selection process would aim to achieve the best outcomes for the Society internally and externally, to ensure the selection of a nominee with the requisite skills and experience, to be objective in assessing the nominee's potential contribution, and to be transparent, equitable and fair.

Audit Committee

The Council approved a proposal from the corporate governance working group that, in the interest of probity, an additional lay external expert should be appointed to the Audit Committee and the Treasurer, the Secretary and Registrar and the Director of Resources should no longer have an automatic right to attend its meetings.

Under its existing terms of reference, the committee consists of three members of Council and one member of the Society (not a Council member) with relevant knowledge and experience. One of the three Council members is a Privy Council nominee and the other two are pharmacist members who are not Officers of the Society or members of the Resource Management Committee. The Council agreed that the addition of a lay member with audit committee experience would strengthen the committee.

The Council also accepted that, because the Treasurer, the Secretary and Registrar and the Director of Resources are all members of the Resource Management Committee, their attendance at Audit Committee meetings could be seen as incompatible with the committee's monitoring role. It was agreed that in future they should attend by invitation only.