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Well the day has dawned. Community pharmacy in England is now officially
being policed by primary care trusts. At the moment, this only applies
to bodies corporate and pharmacy owners and not to individual pharmacists — our
time comes next year.
I was filled with trepidation when I first heard that this was to come
about. Pharmacy was to be regulated by unelected, largely autonomous
organisations. We are not even talking a coherent whole here, but a different
one for each area, to which pharmacists have to answer.
I have only had limited experience with my local PCT. When a PCT member
complained about me to my employer I chose to ignore it. But now I find
that the unanswered complaint could have been kept on a file that may
be examined before I am deemed “fit to work”.
I am worried about this to some extent, but there are pharmacists who
are having a much worse time, with little or no help. For example, one
pharmacist who questioned a GP’s prescribing habits has had her
sanity questioned by her PCT because the GP in question made a complaint.
Anyone else ever done the same thing? Soon you may find that your livelihood
rests on an uninvestigated complaint.
Another pharmacist, who has been a contractor since the mid 1980s, was
taken to task for “compromising patient safety” because she
did not have a fax machine. When it was pointed out that this is not
a contractual obligation, the PCT held a meeting which the pharmacist
knew nothing about, so she could not defend herself. This led to a threat
of suspension on mental health grounds. The contractor has now run up
considerable legal fees to establish the validity of the PCT’s
claims as professional indemnity insurance, apparently, does not cover
this sort of action.
The case has dragged on for six months with no evidence forthcoming from
the PCT and has even caused the local MP to ask parliamentary questions
on how health service workers can be protected against overzealous PCTs.
In a bid to bring balance to this article I looked for another side to
the story. A pharmacist who works on four PCTs says that three of them
are working hard to implement all the changes incumbent upon them. The
fourth has problems because of a lack of funds. The pharmacist believes
that the Department of Health is responsible because it is not passing
on enough information.
Two locum pharmacists have contacted me to say that they find it hard
to get information because some of the PCTs they work in do not see locums
as being part of the information loop. I must say that this is not a
problem I have experienced because I can usually
get information from one PCT or another. One even e-mails me with training
information.
An article in the Chemist & Druggist (3 September, pp30–1)
contained interviews of 10 pharmacists, in different situations, regarding
PCTs and the new contract. The general feeling was that those PCTs that
were helpful lacked either resources or knowledge of how pharmacy really
worked. This just seems to be proof, yet again, that there is a lack
of coherence across the country.
One pharmacy contractor whom I work for was told that, despite giving
more than 90 days’ notice, the pharmacy could not close one hour
early on a Christmas Eve Saturday to fit in with the closing time of
the shop in which it was situated. He was “not allowed to alter
one day just like that”. So the contractor could write and say “we
will shut one hour early every Saturday” but not just on one Saturday.
Another thing that the PCT had a bee in its bonnet about was the pharmacy
accepting sharps: “Under no circumstances should we accept them.” Whether
or not we are supposed to root through the bin bags of returns while
the customer waits at the counter I am not sure. Then there is the question
of whether the person who has tried to dispose of his or her drugs responsibly
will then make the effort to travel to the GP surgery to dispose of the
sharps or just throw them in a dustbin somewhere. I know we are not supposed
to accept sharps but I was taught law and ethics at university and if
any pharmacist can say that they have never broken the law I would love
to hear from them.
I was recently hired as a second pharmacist for a PCT visit. It made
me smile because I believed that the idea of restructuring the NHS was,
at least, partly to save money. However, every pharmacy must have a second
pharmacist for their PCT visit. And the PCT will pay for that pharmacist.
In contrast, the Society’s inspectors and drugs squad inspectors
managed to visit with no locum cover. Moreover, when the visit actually
took place, three members of the PCT turned up. I know how the PCT could
cut their costs for the visits by two thirds immediately.
Where does this leave us? I can see that it must be difficult for the
PCTs to implement a number of ever-changing laws and regulations but
I have always believed that in law ignorance is not a defence. If the
PCTs do not have enough information yet, then they should not be policing
us. How far would we get if the bobby on the street had to consult his
manual every time he thought a crime had been committed?
In a lot of cases the PCTs are under-funded or do not have the information
or experience to know how a community pharmacy is run, or both. They
have their guidance book and if your case does not fit it then you need
to do something about it.
The PCTs do not seem to show the same transparency and self-regulation
that is now required of the professional bodies that they are now policing.
Through making several telephone calls and sending out several letters
I have found out that pharmacists who feel they have been mistreated
by their PCT can appeal to their regional Strategic Health Authority
or the Family Health Services Appeal Authority. I am inviting such pharmacists
also to contact me via e-mail (cmorrislocum@hotmail.com). Together with
some fellow pharmacists, I am putting together a group to provide for
advice and moral support for pharmacists who believe they have been ill-treated
by PCTs.
I believe that for more than a few people PCTs do pose a serious problem
and, if left unchecked, they could become a problem for a lot more people. |
The
Pharmaceutical Journal