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Shipman inquiry
Evolving distance learning programme needed
From Mr B. Shooter, MRPharmS
Dame Janet Smith’s fourth report into the Shipman
Inquiry makes
riveting reading. I think that even my hero, Hercule Poirot, would have
had a job realising that an apparently caring and charismatic GP was
in fact the most prolific peace time mass murderer ever.
Pharmacy training and education has changed over the past years because
of the first Which? report and the peppermint water tragedy and will
now do so because of Shipman.
The inevitable reaction to these sorts of events has been crisis management;
the education and training of members of our profession deserves more
than that.
I would like to see the Royal Pharmaceutical Society, the schools of
pharmacy and the Centre for Pharmacy Postgraduate Education come together
to devise an ever evolving distance learning programme that pharmacists
would have to complete as part of their continuing professional development.
The current CPPE initiatives should continue as at present and much of
its superb resource would be used in the new programme.
The programme, personal to each member, should cover at least the first
10 years of post qualification experience and those aspects of pharmaceutical
education and training that, for the reasons stated by recent correspondents,
are not included in the undergraduate courses or in the preregistration
year. It would also ensure that all pharmacists would be accredited for
the new roles that the new contract will highlight.
Barry Shooter
Romford, Essex
Professional back-up lacking
From Mr B. S. James, MRPharmS
It is a shame that the Society is considering whether action should
be taken against Ghislaine Brant following the Shipman Inquiry (PJ, 24
July, p103). I cannot agree more with C.
Anderson, Chris Legg and Chris Morris (PJ, 31 July, p147). This case shows a complete lack of support
for this pharmacist, instead seemingly intent on finding fault in her
otherwise dedicated work, which can be difficult enough at the best of
times as any pharmacist who has worked in a busy pharmacy will testify.
Dame Janet Smith’s notion that she did not fulfil her professional
obligation to “scrutinise the prescriptions to ensure they were
appropriate for the patient” is absurd. Would any pharmacist refuse
to dispense a prescription confirmed by the prescriber for a terminally
ill patient they had never seen? Should it not be the chemist inspection
officer who is called into question in this case, since his or her prime
role, or so I was told by a visiting inspector, is to examine doctors’ prescribing
habits and to look out for addicts who may be signing on at more than
one surgery.
I once worked in a dispensing doctors’ practice and was surprised
to find that there was no regulation of Controlled Drugs whatsoever,
to the point that the technician was keeping Oramorph in the CD cabinet
and MST on the shelves. Whenever one of the doctors needed anything for
their bag they could just walk into their own dispensary and take whatever
they wanted. If doctors really wanted excessive supplies of CDs all they
would have to do is get a job in a dispensing doctors’ practice.
In conclusion, this appears to be a situation whereby a member of our
profession in need of professional backup has received the exact opposite.
The sooner we have separate professional support like the British Medical
Association, the better.
B. S. James
Cardiff
Report GPs to primary care trusts if concerned
From Ms A. M. Baker, MRPharmS
The letters from Chris
Morris and Chris Legg in this week’s Pharmaceutical
Journal (31 July, p147) both raise the issue of reporting prescribing
which causes concern. Mr Morris in particular was wary of putting his
concerns in writing.
Can I suggest to any community pharmacist who is genuinely concerned
about the prescribing habits of a GP, that they contact their local primary
care trust? Either the medical director, the pharmaceutical adviser,
or those holding similar posts will be able to assist.
I have been involved in several investigations where concerns were initially
raised by a community pharmacist. I would like to reassure Mr Morris
that the pharmacist does not have to be named to bodies such as the General
Medical Council if the PCT can gather evidence of its own relating to
the prescribing in question. I cannot speak definitively for my colleagues
who work in other PCTs, but I would imagine that most will respect any
desire for confidentiality from community pharmacists. And most will
examine any concerns raised with them, even if this is done via an anonymous
letter or telephone call.
To take Mr Morris’s example of regular prescriptions for 500 temazepam
tablets once the concern has been raised it is a relatively simple matter
for the PCT to confirm or deny this prescribing using Prescription Pricing
Authority data. They need not involve the community pharmacist in any
way from that point forward, and the doctor concerned need never know
who first queried the prescribing.
Finally, I think pharmacists put themselves at far greater professional
risk by dispensing a prescription which causes them concern, than by
reporting those concerns.
Alison Baker
Head of Medicines Management
North Cumbria Health Services
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