The Pharmaceutical Journal
Vol 272 No 7295 p487-489
17 April 2004

Society summary

Motions for branch representatives' meeting

The Royal Pharmaceutical Society’s 2004 branch representatives’ meeting takes place at its London headquarters on Thursday 13 May. Set out below are the 12 motions submitted for debate, each followed by an explanatory paragraph from the branch or branches concerned and background information provided by the Society’s Council. All motions carried by the meeting will be referred to the Council for consideration.

1. Birmingham That the agencies responsible for the safety, quality and efficacy of authorised medicinal products, which are the Medicines and Healthcare products Regulatory Agency and the Veterinary Medicines Directorate, should be supported in their action to help the public to recognise and benefit from being more able to distinguish medicinal products which are authorised from products which are not.

The branch says: At present authorised medicinal products are identifiable by the discreet small print of a unique marketing authorisation number on their labels, but the significance is unlikely to be understood by many members of the public. At best the number, if seen, may be thought to be just part of the batch record.

The Society is concerned that the authorisation of medicines, which is intended to ensure their quality, safety and efficacy, whether for human or animal use, and their consequent benefit, is less well understood than it should be by the public and by medicine users. The need for anyone to be easily able to distinguish products that are not authorised from those that are authorised deserves reappraisal. We would wish to encourage and support the government agencies responsible for authorised medicinal products in their endeavours to make marketing authorisation details on medicinal products more self-evident in such a way as to better reflect the benefit of the authorisation to and for the patient and user.

The Veterinary Medicines Directorate has already decided to take action to address these issues and it has been indicated that they would welcome support from professional bodies. It is hoped that the recently restructured Medicines and Healthcare products Regulatory Agency (formerly the Medicines Control Agency) will soon consider taking joint action to meet this need.

We are all aware of the way in which many unauthorised products are promoted to give the impression that they will effectively help restore or improve health but have not been subject to proper testing in order to justify the claims. At present, the situation is aggravated by the fact that many claims made on the internet are apparently outside the control of the Advertising Standards Agency.

The Council says: The Society recognises that it is important for the public to be able to clearly identify medicinal products that have been licensed by the Medicines and Healthcare Products Regulatory Agency or the European Agency for the Evaluation of Medicinal products or the Veterinary Medicines Directorate.

The Society regularly runs news items and public campaigns that are designed to emphasise the importance of the public taking care with their medicines and pointing out that “natural” does not necessarily mean “safe” when it comes to herbal products and food supplements. Legislation on standard herbal medicines is in the pipeline and this will provide a platform for further public information work.

The MHRA has no plans at present to run any campaign highlighting the issue of unlicensed medicines and are not likely to have in the immediate future.

2. British Pharmaceutical Students’ Association That the RPSGB should consult the BPSA with regard to student issues within the profession for an official student opinion.

The association says: Recently there have been a number of matters that directly affect students, and which students feel that they should be consulted on. The BPSA believes that the Society should be more proactive in approaching and consulting the BPSA on issues that affect students; this is particularly relevant regarding current subjects such as tuition fees and the impact they will have on the study of pharmacy in the UK. The BPSA could also be asked to provide input for articles relating to students in The Pharmaceutical Journal.

The BPSA has access to student opinion, and should be invited to voice this, in view of its status as the official student branch of the RPSGB.

The Council says: The BPSA is invited each year to nominate a student member of the Society’s Education Committee. It is chiefly within the Education Committee that the kinds of student issue referred to in the motion are considered. In the recent past, the Education Committee considered the White Paper on “The future of higher education”, which carried the proposal for variable tuition fees. At the time, the committee made points on behalf of the Society, that this measure could further engender a “what do I need to pass” mentality among students; that schools of pharmacy may polarise into “have” and “have not” institutions, depending on their marketability, with the latter in danger of losing their accreditation by the Society; and that increased tuition fees might discourage students from studying longer courses such as the master of pharmacy programme.

The input of the BPSA into the life of the Society is further supported by its right to submit motions to this branch representatives’ meeting and to send delegates to the British Pharmaceutical Conference. Regular liaison meetings are held, attended by Officers and staff.

Journalists on The Pharmaceutical Journal are happy to seek a comment from the BPSA when a story is of relevance to students. This has been done in the past. Whether or not the BPSA’s opinion would be sought on these or other issues would be up to the discretion of the editor and news editor.

However, a difficulty for The Pharmaceutical Journal has been knowing whom to contact. It should be the BPSA’s responsibility to provide the name of a press contact who can respond authoritatively within the short timescales involved in preparing stories.

Some indication of other issues relevant to the whole profession about which the BPSA would like to comment, if asked, would also be helpful, provided it is updated regularly.

3. Brighton That all prescriptions for oral medicines should carry complete dosage instructions.

The branch says: Many patients are unable to remember verbal instructions for longer than a few seconds, do not always understand their medication and cannot recall the advice received from the prescriber to tell the pharmacist, in order that this can be written on the label and re-enforced by the pharmacist’s counselling.

Additionally the recent government report published by the Department of Health “Building a safer NHS: improving medication safety” states that the instruction “as directed” should never be used on a prescription. Also that all prescriptions should be “clear, unambiguous and leave no doubt as to the prescriber’s intentions”.

The Council says: The issue has been raised with the Department of Health on a number of occasions. We will attempt to ensure that it is built into the specifications for the electronic transmission of prescriptions in the NHS IT programme. The Society will also ask the Department of Health to follow its own advice and build this concept into legislation.

4. Cheltenham and Gloucester That the Council should issue specific guidance to the owners of pharmacies to ensure that provision is made for appropriate breaks to be taken by staff when working long shifts.”

The branch says: The Code of Ethics, Part 2, Paragraph A2, refers to the responsibility of pharmacist owners to ensure that they do not impose conditions on pharmacists that may affect their ability to comply with their professional and legal duties. Despite this there are owners, both individuals and multiples, who do expect employees and locums to work excessive hours without a break. Paragraphs A1(a) and (d) advise pharmacists that they should not accept employment where they are not fit for the required tasks or where the conditions do not allow them to comply with their responsibilities, and this is interpreted as covering meal breaks. However, complying with this can pose a particular problem for a locum working in a pharmacy for a short period to assert his or her professional authority when the normal full-time pharmacist has acquiesced with a lower standard than should apply. It would be helpful in order to secure compliance with the code if owners of pharmacies were reminded in a no uncertain manner of their professional obligations.

The Council says: A similar motion submitted by the Brighton branch was carried in 2001. A Law and Ethics Bulletin item was published in The Pharmaceutical Journal (PJ, 16 June 2001, p811) by the Society concerning pharmacists’ working hours. For ease of reference it is repeated below:

Pharmacists are reminded that they should ensure that they do not work for extended periods without taking appropriate rest breaks. Not taking appropriate breaks could adversely affect a pharmacist’s ability to practise safely. The new Code of Ethics supports this requirement by stating that pharmacists should ensure that they “do not work in conditions that do not enable them to comply with the key responsibilities of a pharmacist”.

Similarly, pharmacy owners, superintendent pharmacists and managers have a personal professional responsibility to ensure that they do not seek to impose conditions on pharmacists that may adversely affect their legal and professional duties. Requiring employee pharmacists to work extended periods without adequate provision for rest breaks could constitute a breach of this requirement of the Code of Ethics.

The Society has no authority to prescribe what hours pharmacists may work. As responsible professionals, pharmacists must make individual judgements about their working hours and their capacity to undertake the tasks they are asked to perform.

5. Hull That it is the opinion of this meeting that the Society support the members by reinstating the funding of special interest group magazines.

The branch says: In an effort to move funding from membership support to pay for enhanced registration activities and to save costs, the Society has reduced monies available for services to the special interest groups and stopped funding the newsletters for the Industrial Pharmacists Group and the Veterinary Pharmacists Group.

This reinforces the impression of many that the Society is not interested in the support of the non-community pharmacist members.

The Industrial Pharmacists Group has temporarily kept its newsletter by sponsorship from individual committee member’s companies; however, this support is now coming to an end. The Industrial Pharmacist magazine is the only tangible benefit that most industrial pharmacists get from the Society. As most industrial pharmacists do not have to be registered to be able to do their work, the loss of the magazine is likely to increase the numbers of those who decide not to renew their membership.

Industrial pharmacists are committed to the Society and contribute to the knowledge base of the profession. However if they are cast adrift by the Society then we believe that the loss will be everybody’s.

The Council says: The Industrial Pharmacists Group newsletter was published by the Society from 1996 to the end of 2000. In 2000 the Council set a priority budget to enable it to meet the challenges of the future, which led to changes in the level of funding in many areas of activity, including subsidy of the newsletter. However, the Society arranged for the newsletter to be published by an independent publisher, Euromed, for three years with sponsorship from a number of pharmaceutical companies.

This agreement came to an end in December 2003 and Euromed decided that the publication was not commercially viable. As an interim measure, the Industrial Pharmacists Group was offered pages in The Pharmaceutical Journal every other month. The Society decided to approach other publishers to publish the newsletter and discussions with an alternative publisher are now ongoing.

6. Oxfordshire That the Society sets up and maintains an electronic register of its members with e-mail addresses for Branch mailing purposes using the annual subscription form to collect data.

The branch says: Branch secretaries currently request addressed adhesive mailing labels from IT services which are used to inform branch members of meetings via the postal system.

An electronic register of members’ e-mail addresses would facilitate the distribution of newsletters to branch members, save branch secretaries’ time and valuable branch funds.

Some branches are already using electronic mailing organised at branch level, however it would be useful if this facility was organised centrally from headquarters.

The Council says: The Society recognises that e-mail addresses are a useful means of communication with members but it should be borne in mind that some people do not have access to e-mail.

It is not a statutory requirement for the Society to collect members’ e-mail addresses. The main reason for currently not doing so is because the administration and maintenance of the data would require additional resources. If the Society did collect and maintain e-mail addresses for members, in order to ensure that the data was useful and timely it would be necessary to have a process in place to ensure that the e-mail addresses were current. Evidence suggests that people frequently change their e-mail address or have several e-mail addresses. The Society currently has to deal with over 250 changes of postal addresses per week, which consumes considerable resources. The maintenance of e-mail addresses would have similar resource implications.

Branch secretaries who collect and use their members’ e-mail addresses must ensure that they comply with data protection legislation. They must ask for their members’ permission to use their e-mail addresses for bona fide branch purposes and should send information out by blind copy to avoid e-mail addresses being misused. Branch members should be asked to give explicit consent for such use and assurances that their details will only be used for branch purposes and not be passed to third parties. This ensures that e-mail addresses of other recipients are not transmitted, thereby complying with the requirements of the Data Protection Act.

It might be envisaged that to hold this centrally would create less work for the branch committees but because of the changing nature of the information branch secretaries are in a better position to check regularly that the data is up-to-date by obtaining confirmation at branch meetings. Many branch secretaries now request and collect members’ e-mail data. This provides a useful way of reducing postage costs and time spent on administration.

7. South Cheshire That the Society should review the scale of annual fees payable by members. It should include a fee for non-working members below retirement age, which is more commensurate with that payable by those over retirement age.

The branch says: Non-working members do not necessarily have any income, but if below retirement age are required to pay an annual fee of £116. Those over retirement age, and therefore assumed to be in receipt of a pension, pay a fee of £22. If members in either group plan to work occasionally as locums then the current fee of £116 remains appropriate.

The Council says: The Society’s fee structure is detailed in the Byelaws. The Council considers and makes proposals in relation to fees. The Society’s fees have to be agreed by Privy Council and, as part of the process, members are invited to comment on the proposals.

A review of the entire retention fee structure is in train. This will address the issue raised specifically in this motion as well as other inconsistencies and revise the Society’s fee structure in line with its role as a modern regulator.

8. South Staffordshire That each community pharmacy should have a local nominated pharmacist contact to develop effective working relationships with other health professionals and their local community.

The branch says: This motion has arisen from the need for other health professionals and primary care organisations to have a local pharmacist contact for each community pharmacy where the pharmacist in charge varies from day to day and where a local issue is unlikely to require escalation to the overall responsible pharmacist, for example, the pharmacy superintendent.

The Council says: The Society recognises that it is a problem when community pharmacies do not have a regular pharmacy manager. The Society also recognises that this can cause problems of continuity, leading to confusion and breakdown of communication between pharmacy, other health professionals and the local community. Effective working relationships are extremely important to integrating pharmacists into the health and social care team, successfully providing new and existing services and ensuring that each patient receives the best possible care.

The Society agrees that a pharmacist or other regular member of staff should be nominated as key contact for each community pharmacy and it will raise this with superintendent pharmacists and encourage them to address this issue.

9. British Pharmaceutical Students’ Association That there should be a formal national reporting system for pharmacy-related medication errors.

The association says: Each year thousands of pounds are spent caring for, and recompensing, patients who have been adversely affected by medication errors, draining resources from other areas of patient care.

An anonymous, confidential reporting system, similar to the “yellow card” scheme should be developed to assist in the identification of common errors. With an overall aim to improve the quality of dispensing practice in line with the ideals of clinical governance, it would allow all pharmacy staff to learn from one another and develop strategies to minimise errors. Many hospitals and community pharmacies already have such a system in place, extending it to a national level can only benefit the profession.

The Council says: Since the BPSA proposed this motion, the National Patient Safety Agency has launched its National Reporting and Learning Scheme. This scheme will monitor and share the learning from all errors reported throughout the NHS. The lessons from the errors will be fed back to the profession and to the NHS. The Society has worked with the NPSA on the scheme and is confident that it fulfils the BPSA’s goals.

10. Brighton That all prescriptions should provide the age of the patient. This will ensure that the pharmacist is able to check the suitability of the dose and that the advice given about the medication is tailored to the individual and so will improve concordance.

The branch says: For the pharmacist to impart relevant and current information on the medicines prescribed, all necessary information should be given on the prescription to ensure this is as accurate and pertinent as possible.

The Council says: The Society believes that pharmacists need access to all relevant information about the patient in order to ensure that the patient’s medication is appropriate. This goes much further than information about the age of the patient. The Society would like to see pharmacists have access to relevant parts of the patient’s medical records, with suitable patient agreement. The Society is working with the Department of Health and the NHS IT programmes to make this happen in practice.

11. West Metropolitan; Oxfordshire That it is the opinion of this meeting that, in the interests of patient safety, the registration requirements for European pharmacists wishing to work in Britain should include an assessment of competency in English, in law and in ethics, and that the RPSGB should lobby for a change in European legislation to allow this to be done.

The branches say: Currently, pharmacists who are nationals of a member state of the European Economic Area, who have a degree in pharmacy from a member state of the EEA which complies with training directive 85/432/EEC and who are in good standing with their professional authority in their member state are eligible to register with the RPSGB without any further testing.

This contrasts with non-European overseas pharmacists who are required to be tested in the International English Language Testing System (listening, reading, writing and speaking) and gain a score of 7 in each test parameter.

Training directive 85/432/EEC ensures that European pharmacists are well trained as pharmacists, but unless they have a good comprehensive grasp of the English language and its nuances, as well as of pharmacy law and ethics as they apply in this country, patient safety will be compromised.

The Council says: An EEA national with a pharmacy qualification, which complies with the relevant directives and is listed in the Schedule to the Pharmacy Act as amended by SI 2003 No 3148 is entitled to automatic recognition of that qualification and registration with the Society.

A new Directive on Recognition of Professional Qualifications 2002/0061 is currently being negotiated and is likely to be adopted in 2005. The purpose of this directive is to consolidate existing directives, take account of European Union enlargement and promote greater mobility of workers and services. Under Article 49 it is proposed that EEA nationals who move to another member state to practise a profession “have a knowledge of languages necessary for practising the profession in the host member state”.

It is not yet possible to language test EEA nationals before registration at this stage.

“Employment of EEA nationals: ensuring language competency” (HSC 1999/137) provides guidance to NHS employers in England. This guidance reminds employers that evidence of registration of EEA nationals does not of itself guarantee linguistic competence. It advises employers to assess competence to communicate in English, to the standard required by the post concerned, of all job applicants, regardless of their nationality. Under the Code of Ethics pharmacist proprietors, superintendent pharmacists and pharmacist managers in hospitals must ensure that pharmacists employed by them are sufficiently competent in English.

12. South Cheshire That the Society should amend the Data Protection Act registration, enabling other non-profit making organisations to access membership lists for educational and joint working purposes.

The branch says: The Society has accepted that CPD is a necessary part of practising as a pharmacist. At BPC 2003 it was reported that 50 per cent of pharmacists work as locums and as such are not necessarily tied to one employer. It is the responsibility of the individual to maintain and/or update their skills, but organisations offering local educational courses, eg, primary care trusts, are denied free access to local membership details. Currently pharmacists can only be contacted via their workplace. Access to localised lists could target pharmacists in employment, on long-term leave or taking career breaks, thus encouraging a stronger local network, encourage return to work following career breaks and building bridges between various local organisations.

The Council says: The Society’s current notification entry on the Information Commissioner’s register of data controllers does not explicitly preclude any particular use or disclosure of data. The Society’s privacy statement (available on the website, www.rpsgb.org) allows disclosure to third parties “where this is in pursuance of the Society’s aims and objectives”. There is a process for taking such decisions on disclosure requests.

If it is decided to disclose to a particular recipient group, the Society is responsible for ensuring, insofar as it can, that the data is correctly handled and only used for the purposes agreed.