The Pharmaceutical Journal
Vol 273 No 7328 p809-810
4 December 2004

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To practise or not: that is the question

Members of the Royal Pharmaceutical Society will begin to receive requests for next year’s retention fees from 7 December. The fee structure has been simplified and pharmacists now have to declare themselves as either practising or non-practising. Clare Bellingham (on the staff of The Journal) reports

The retention fee forms dropping through pharmacists’ letterboxes over the next couple of weeks are somewhat different from previous years’ forms. Rather than having five categories of membership of the Royal Pharmaceutical Society to choose between, for the 2005 fee, pharmacists will have just two: practising or non-practising.

The decision to make this change was made at the August meeting of the Society’s Council (PJ, 14 August, p233). The reason for it lies in the introduction of mandatory continuing professional development, something that all those on the practising Register will be required to undertake. Non-practising pharmacists will not have to carry out CPD but, although they will still be able to call themselves pharmacists, they will be required to declare that they are no longer practising. The crux of the matter is that if a pharmacist is not undertaking CPD, they cannot be sure that they are up to date. It does not matter if a pharmacist only practises occasionally: the public rightly expects to get correct information from a pharmacist and ensuring that all practising pharmacists undertake CPD is essential in meeting this expectation.

New registration categories

Until now, pharmacists have had a choice of five categories of membership: full-time, part-time, overseas, not working due to ill-health and aged over 60 years. The breakdown of current members into these five categories is shown in Table 1. What members now have to decide is whether to define themselves as practising or non-practising.

In order to change the fee structure, the Society’s Byelaws have had to be amended, something that was finalised this week (p833). The amended Byelaws define what is meant by practising and non-practising as follows:

· A practising pharmacist is a member who undertakes any work in, or gives advice in relation to, the science of medicines or the practice of pharmacy or health care

· A non-practising pharmacist is a member who does not engage in pharmacy practice, is not involved in patient care and does not work in or give advice in relation to, the science of medicines or the practice of pharmacy or health care

From these definitions, it is clear that “practising” does not just mean having contact with patients. It also includes any pharmacist who undertakes work in the science of medicines, pharmacy or health care. This covers areas such as academia and industry. However, there are “grey areas” where it is unclear into which category a pharmacist falls. Examples include a pharmacist appointed as a non-executive director of an NHS trust in a personal rather than professional capacity or a pharmacist working in an IT role in the pharmaceutical industry.

Andrew Gardner, the Society’s head of registration, says that workforce data from 2003 shows that 2.6 per cent of respondents said that they worked entirely outside pharmacy. “It is this group — 1,200 members — who are likely to form the bulk of the grey area,” he explains. But he adds that it should be clear to most of these whether or not they are practising.

Ultimately, it will be up to individual pharmacists to decide whether they are practising or not. It is an important decision: every pharmacist will have to make a declaration on paying this year’s retention fees and pharmacists who incorrectly declare that they are non-practising will face sanctions.

The Society’s guidance (distributed with this week’s Journal and available on the Society’s website at www.rpsgb.org) is that only those pharmacists who have truly retired from working in health care, which includes providing advice, or those who have moved to non-related careers, can define themselves as non-practising. The Society makes two illuminating points. First, it says: “Just because you undertake work or give advice that could be provided by someone who is not a pharmacist does not mean that you are non-practising. The fact that those who you work with or advise know you are a pharmacist adds professional credibility to your work and advice.” And second, it points out: “It may be helpful to ask yourself whether you or others feel that the work you undertake or advice you give has added value or credibility because you are a pharmacist. If so, you are practising.”

If, after reading the guidance leaflet, pharmacists are still unclear as to whether they are practising or not, the Society has set up a specific support line which will be operational from 6 December. The telephone number is 0845 606 6285 or e-mail am_i_practising@rpsgb.org. Failing that, queries can be referred to the chairman of the Society’s Education Committee who will make a final decision.

So what will happen to pharmacists who make an incorrect declaration? It could result in the Society taking action against them. Peter Wilson, the Society’s head of post-registration, explains that sanctions will be proportionate to the circumstances and will include all the usual disciplinary procedures including, ultimately, striking off. He adds: “Once the Section 60 Order has been enacted, practising while registered as non-practising will be illegal. A pharmacist who does this deliberately is liable to be struck off immediately.”

Having said all this, these are the Society’s interpretations of the definitions in the Byelaws. It is theoretically possible that in the future a pharmacist will legally challenge the Society’s interpretations.

David Reissner, head of the pharmacy group at Charles Russell law firm, thinks this is unlikely. Although the Society might threaten to remove a pharmacist from the Register for incorrectly identifying themselves as non-practising, he believes that unless the pharmacist acted dishonestly this action would be disproportionate. And he points out: “I don’t think the Society should be treating the Statutory Committee as a debt-collecting agency.”

Retired pharmacists

What proportion of pharmacists does the Society think will fall into each category? Mr Gardner says that it is difficult to estimate. “We can only really be certain that members in the ‘over 60 and not working’ and the ‘ unable to practise due to ill health’ categories will move en masse into the non-practising category. This is a total of about 4,900 pharmacists,” he explains.

“ A proportion of the ‘overseas’ and ‘part-time’ members may also move into the non-practising category,” he adds. And it is largely here where the controversy lies. Pharmacists who currently pay reduced rates in these categories may well discover that they now have to pay the practising fee of £256 (Table 2).

For a number of pharmacists, most likely those who are retired and undertaking occasional locum jobs, this will be a substantial increase in fee. It has led to the letters pages of The Journal in recent months being inundated with complaints from members unhappy at the changes. Even for those who are not practising at all and opt for “non-practising” status, the fee, at £46, is still higher for those currently in the £22 bracket. And in the future it will rise further since the non-practising fee is to be maintained at one-third of the practising fee.

For some of these pharmacists, there is another option: to retire from the Register altogether. Bruce Rhodes, a former assistant secretary of the Society, is one member who has hinted that he plans to resign from the Register (PJ, 30 October, p642). “My membership now confers no benefits save The Journal and is retained purely for sentimental reasons,” he explains. “I intend paying this year’s increase so that I may continue to be a thorn in the flesh of those members of Council who knowingly and so callously decided that the future Register should largely consist of practising pharmacists and the older ones can simply go to the wall.” Mr Rhodes hopes that the Council will have second thoughts and not proceed with the future proposed increases for retired pharmacists. “Sadly this will be too late for those who cannot or will not pay this year’s increase.”

Similarly, Miall James, a retired member from Colchester who works less than 10 hours a week, comments: “I haven’t made a final decision although I have much sympathy with Bill Brookes’ view [PJ, 6 November, p683] that we, the disgruntled, should stay on the Register for one year at least in order to vote, or even be a candidate, in next year’s elections.” But he adds: “I shall be very sorry indeed to leave the profession and really do not wish to do so.”

Rodney Lee, a member from Cambridge, says that he plans to take early retirement and resign from the Register this year. “It is not the retention fee increase that I object to, it is what it represents,” he says. By this, he explains, he means that the Society has failed to take pharmacy forward or to reverse a general malaise in the profession. He also objects to the introduction of mandatory CPD, pointing out his 42 years of experience.

Of course, retired pharmacists do have the option of staying on the Register as a non-practising pharmacist. But there have been other voices of concern. Some pharmacists working overseas, particularly those practising in third-world countries and earning low salaries, have complained about the fee hike they face. Then there are pharmacists whose jobs do not require them to be a pharmacist, for instance in industry. Some of these members are also considering leaving the Register.

Overall, the number of pharmacists falling into these categories is small. The majority of pharmacists classified themselves as “full-time” this year and nearly all of these will become “practising” next year.