New look at supervision
To the world outside, pharmacy may seem a quiet place. Stories about the Society and the Charter have not, as yet, spread beyond its shores. Ask the man and woman on the Clapham Omnibus what they know about pharmacy and pharmacists, and they are unlikely to appreciate the depth and breadth of what members of the profession know about medicines and the contribution pharmacists can make to better health.
Inside pharmacy, of course, things are not so serene and one professional
issue that has caused as much dissent as any other — supervision — is
on the point of causing further ripples.
On 9 April 1989, almost 15 years ago to the day, a special general meeting
was held at the National Theatre, in London, to discuss whether or not
a pharmacist always needed to be the final checker in the dispensing
process. The upshot of the debate and an abbreviated interpretation of
the arguments was that pharmacists — against the recommendation
of the then Council — should remain the final checkers.
For some sections of the profession this was a decision that put the
cause of pharmacy back decades. It immediately curtailed the individual
pharmacist’s freedom to ensure responsible and accountable dispensing
and supply in ways to suit his or her practice. In short, this confirmed
the policy that pharmacists should never leave their premises for long.
Remote supervision was not going to happen.
Many things have changed since then. Professionally, the greater emphasis
on clinical pharmacy and the opportunities for services that pharmacists
may provide in locations other than their primary workplace, were not
on the pharmacy agenda 15 years ago. More significantly, the developments
in electronic communications over the past 15 years were barely glimmers
on the horizons of the most forward-looking pharmacist. Who, in 1989,
could have envisaged the benefits brought by desktop computers, let alone
anticipated the impact of mobile phones, e-mail and the internet?
But all this has come to pass, and as this week’s cover story reveals
(p377), the use of this technology has made remote supervision a reality.
To date, the system has only been piloted and will require legal guidance
from the Department of Health and the Royal Pharmaceutical Society to
become a permanent feature. However, even the most sceptical pharmacist,
who fundamentally thinks it is wrong to leave the pharmacy in the hands
of another professional, must accept that remote supervision can work,
is safe and effective, and, arguably, in the instance described, provides
as good a level of service as is offered in many more traditional pharmacies.
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