The Pharmaceutical Journal
Vol 274 No 7339 p279
5 March 2005

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Pharmacists Defence Association

Pharmacists blamed for matters that are beyond their personal control

Pharmacists are expected to take professional responsibility for matters that are beyond their personal control, according to Mark Koziol, director of the Pharmacists Defence Association.

A survey of PDA members found that 72 per cent of them believed that the Royal Pharmaceutical Society’s Code of Ethics made them accountable for other people’s failures, Mr Koziol said. “This is completely illogical and is something that we will address in the near future,” he said.

“The old adage that you don’t need your own insurance if you are working in somebody else’s shop is just not relevant today, Mr Koziol said. Less than a quarter of the situations in which individual pharmacists need legal support involve complaints or damages claims by patients that are covered by employers’ insurance.

Over half (52 per cent) of claims coming to the PDA (PDA) from its 10,000 members relate to disputes between employers and their employees or locums. A further 9 per cent are from members seeking help in connection with Royal Pharmaceutical Society investigations, with 8 per cent each involving locum contract difficulties and criminal prosecutions.

As well as giving pharmacists legal support when they need it, the PDA aims to learn from the problems that pharmacists experience and give them advice on how to try to make sure that the same thing does not happen again. It will also try to persuade employers to change procedures and employ enough staff to stop problems arising and will try to persuade the Royal Pharmaceutical Society to change its Code of Ethics so that pharmacy employers face disciplinary action if they fail to implement safe systems of work.

“This is not a universally popular message.” Mr Koziol warned. “There are some very good employers out there, but there are also some who are not good at all. If we have situations where we see employers point-blank refusing to adopt a standards agenda, a safety agenda and a patient-interest agenda, we will pursue them through the civil courts, through the criminal courts and through the disciplinary procedures of the Society.”

Society gets few complaints

Few complaints about pharmacists are made to the Royal Pharmaceutical Society, according to Mandie Lavin, the Society’s director of fitness to practise and legal affairs.

“I think that the Society gets surprisingly few complaints, particularly given the nature of community pharmacy practice,” Ms Lavin said. “The level of exposure that practitioners have to the public is unprecedented and the sorts of issues, problems and services that patients and public are coming to you for are far more likely to lead you into areas where they may feel disposed to complain.”

She said that one reason that a lot of complaints that should be brought to the Society’s attention were never made was because the public held community pharmacists in high regard.

About 800 complaints were received in 2004, but only 333 of these reached the Infringements Committee. Few of these were referred to the Statutory Committee and only 11 pharmacists were subsequently removed from the Register.

“These are very, very small numbers,” Ms Lavin said. “You do not get removed from the Register for minor misdemeanors.”

She hoped that pharmacists who read reports of Statutory Committee cases in The Pharmaceutical Journal were clear about why its decision were made.

“If it is not clear then we would have failed as a regulator, because if you don’t understand it, then members of the public aren’t going to understand it,” she said.

Ms Lavin also expressed doubts about the conditions in some pharmacies. She had visited a pharmacy before Christmas where carols were being played so loudly that she wondered how anyone could dispense.

“I think there is a whole issue over the environment in which this important work is taking place,” she said.

Work pressures put patients at risk

The pressure that pharmacists are under puts patients at risk, was the message from Welsh community pharmacist Bob Gartside.

Advocating a limit on the number of prescriptions a pharmacist should be allowed to deal with in a day, Mr Gartside said: “I think it is possible for the Royal Pharmaceutical Society to say there is a maximum workload that a pharmacist can handle.”

Presenting evidence from the US that the prescription error rate rises when pharmacists are required to dispense more quickly, Mr Gartside said that some US states had a recommended maximum of 150 items per day per pharmacist. Although this was not enforced, higher workloads were considered to be evidence of malpractice if errors occurred.

“Any job should so designed and structured that it can be handled on an average day by average personnel with average equipment,” Mr Gartside said. “You shouldn’t need to be Michael Schumacher to drive a bus.”

Simple, but effective, steps that contributed to lower error rates included better lighting, appropriatemanagement and adequate breaks.

During discussion, Joy Wingfield, professor of pharmacy law and ethics at the University of Nottingham, said: “If you were going to design a system for dispensing prescriptions today, you wouldn’t do it in a shop. A shop is not the right environment to undertake the technologically, intellectually detailed cognitive process of dispensing prescriptions.”