Council agrees new guidance on supervision during consultations
Guidance should help phamacists who use a private room to carry
out MUR |
The Council of the Royal Pharmaceutical Society has agreed guidance on supervision that will allow the sale and supply of pharmacy and prescription-only medicines while a pharmacist is involved in a private consultation with a patient.
The guidance was approved at the December
Council meeting on the recommendation
of the Law and Ethics Committee. It appears as a Law and Ethics Bulletin
item in the panel overleaf and is also available through the ethics
section of the Society’s website.
The guidance was drawn up in response to enquiries from community pharmacists
about how they should conduct their pharmacies while carrying out medicine
use reviews (MUR). The new contract for community pharmacy in England
and Wales requires that an MUR is normally carried out by the pharmacist
face to face with the patient in a part of the pharmacy premises that
is clearly signed as a private consultation area and allows them to sit
down and talk at normal speaking volumes without being overheard.
Because a pharmacist in such a consultation is unlikely to be aware of
medicine sales or supplies being made, or of conversations between staff
and patients, pharmacists have asked how the supervision requirements
can still be met and, in particular, whether dispensed prescriptions
can be handed out and pharmacy medicines sold while the pharmacist is
undertaking a private consultation.
The Council was reminded that the Society’s interpretation of supervision
has insisted on a higher level of supervision than necessarily required
by the Medicines Act. It has traditionally advised that when a pharmacist
is not present in the area of the registered premises where the medicine
sale or supply is taking place, the sale cannot be said to be supervised.
The introduction of the medicines sales protocols in the mid-1990s recognised
that medicines sales could be carried out by suitably trained and competent
members
of staff acting in accordance with agreed protocols, but did not take
away the need for the pharmacist’s physical presence.
The Law and Ethics Committee therefore proposed that while a pharmacist
is undertaking a private consultation trained staff should be able to
sell pharmacy medicines in accordance with a standard operating procedure
that would forbid any sale that the pharmacist would not want to take
place. Furthermore, staff should be able to hand out dispensed medicines
that have had a clinical check and are ready for collection.
The committee believes that such an approach will be in the spirit of
the policy developed by the Society in its response to the consultation
document “Making the best use of the pharmacy workforce” and
will be within the spirit of the way Government policy is moving, as
seen in the Health Act 1999.
Asked whether the easing of the restriction applied also to other circumstances
in which the pharmacist was otherwise occupied, Douglas Simpson, chairman
of the Law and Ethics Committee, said that the guidance applied only
to the situation where an MUR was taking place because that was the circumstance
that members had asked the Society to address.
After the Council meeting, Lynsey Balmer, the Society’s head of
professional ethics, said: “The new guidance will help the Society
ensure the safe and effective supply
of medicines as more pharmacists start to undertake private consultations.
In light of the proposals to change the current supervision and personal
control requirements of the Medicines Act, the Society has adopted a
pragmatic approach to its guidance, while taking into consideration the
existing legal and ethical framework.”
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The
Pharmaceutical Journal