The Pharmaceutical Journal
Vol 274 No 7341 p341
19 March 2005

Society summary

Society wants fewer legal restrictions on pharmacists

Legal requirements on community pharmacists are too restrictive, says the Royal Pharmaceutical Society, and limit their ability to develop new services and to work with others to improve health care services.

In its response to the Department of Health consultation paper, “Making the best use of the pharmacy workforce” (PJ, 18/25 December 2004, p873), the Society says: “Current legislative requirements restrict the development of the role and working practices of pharmacists and prevent community pharmacists fulfilling the breadth of service provision framed by the new pharmacy NHS services contract.”

Some of the Society’s main proposals for better use of the pharmacy workforce are set out in the Panel (below). The Society’s response emphasises that public safety is the prime consideration and that reform should enhance the culture of personal professional accountability rather than detract from it. Reform should not inhibit access to pharmaceutical services.

On personal control, the Society says that each pharmacy must have a pharmacist with personal, professional accountability for all processes within it and who does not also act in a similar capacity for any other pharmacy.

Subject to appropriate safeguards, the pharmacist should be able to be absent from the pharmacy for short periods (eg, to have a rest break, to undertake professional activities such as patient medication review or to meet other health professionals). However, steps are needed to ensure that access to pharmaceutical services is not unduly compromised.

In accordance with defined criteria, pharmacists should be able to delegate the provision and supervision of certain services to appropriately trained staff. Robust protocols must define who tasks could be delegated to and stipulate when a pharmacist’s personal intervention is required.

Each pharmacy would need a defined scheme of delegation, says the response, and staff undertaking delegated activities would need to meet the requirements of a specified competency framework. Regular risk assessments would be needed, along with an appropriate audit trail to monitor activities undertaken in the absence of a pharmacist.

On pharmacies run by corporate bodies, the Society proposes a strengthening of the collective accountability of company boards. Superintendent pharmacists and board members should all have a statutory duty of care to patients for the pharmaceutical services provided by the business. The Society also notes that corporate dentistry and optometry have no requirement for a superintendent. Instead, most of the directors must be members of the professional body. The Society proposes a detailed review to determine an effective system that ensures appropriate levels of professional accountability while allowing pharmacies to operate commercially. It adds that sanctions must be available if bodies corporate fail to take appropriate steps to ensure patient safety.

On supervision, the response says that the current interpretation places emphasis on the pharmacist having knowledge of every transaction. This, it says, “is neither a viable nor realistic requirement in modern practice”.

The Society says that although a pharmacist must carry out a professional assessment of each prescription, this could be done remotely if the pharmacist has access to necessary information such as patient medication record details. Once the assessment has taken place, and if safe systems are in place and further intervention by the pharmacist is not required, the prescribed item could then be supplied in the pharmacist’s absence. The pharmacist would still need to be contactable and provision would need to be made for subsequent counselling by the pharmacist if required.

The Society suggests that in the pharmacist’s absence designated staff should be able to make sales in accordance with suitable standard operating procedures. The Society would not wish any pharmacy medicines to be sold in the pharmacist’s absence unless a suitably competent registered pharmacy technician was present.

On remote supervision by pharmacists, the Society says that, while still advocating the the benefits of face-to-face consultation, it recognises the need for a broad view of how patients can access information and pharmacy services. It accepts the concept of remote supervision subject to appropriate patient safeguards. Pharmacists supervising remotely would need access to all the relevant information they would have if they were in the pharmacy.

On supervision by other staff, the response suggests that suitably competent registered pharmacy technicians could be delegated to supervise the sale of certain pharmacy medicines, the assembly of prescriptions and the provision of defined professional services. The Society would wish to discuss the definition of “suitably competent” with interested parties.

Towards the end of the preregistration year, supervision could also be delegated to preregistration trainees with appropriate experience and competency. Supervision should not be delegated to other grades of staff. Remote supervision should be restricted to pharmacists.

The full text of the response can be downloaded from the policy section of the Society’s website.


See also p323