| The White
Paper on the regulation of health professionals, published
last week (PJ, 24 February, p207), announced major reforms to the way
in which the pharmacy profession will be regulated. A General Pharmaceutical
Council is to be established to regulate the profession and a “royal
college” is proposed to provide clinical and professional leadership.
At a press briefing following publication of the White Paper, Keith Ridge,
chief pharmaceutical officer for England, indicated that he hopes the
Royal Pharmaceutical Society will take the opportunity to transform itself
into this professional and clinical leadership body. He emphasised that
this body would not be a trade union of any sort. “This is about
a body that is about innovation, excellence and authority. One which
will support the science and practice of pharmacy. I hope that as a profession,
we choose that that is something worth establishing,” he said.
The Society confirmed this week that it believes that it is in a good
position to evolve into a body akin to a royal college. Alan Ali, a spokesman
for the Society told The Journal: “It makes good sense to do this
because the Society already performs most of the functions of a royal
college and works closely with many of the medical royal colleges. Many
pharmacists will see this as a positive step forward and an opportunity
for the Society to better engage with its membership.”
He adds: “The royal college will have a role in revalidation, according
to the White Paper. The medical royal colleges are already looking at
their future roles in relation to revalidation. We believe that it is
likely that the model for pharmacy will be similar to that of medicine
and that the supportive role of the medical royal colleges would be mirrored
in pharmacy.”
Mr Ali says that if compulsory membership of a royal college gives it
sustainability, the Society would welcome that. “However, in that
eventuality, it will be vital that we remain focused on meeting the needs
of the membership. We know the profession is looking for more support
and we will be looking to meet its needs. This is something we would
have done whatever the White Paper said.”
Support from all parts of Britain
At the inaugural
meeting of the Scottish Pharmacy Board of the Society
held last week (p260), chairman Rose Marie Parr highlighted the considerable
opportunities for the profession in Scotland in embracing the formation
of a professional leadership body. “The formation of a professional
leadership body, akin to that of a royal college, provides a real opportunity
for the newly formed board to exert a more positive influence on the
practice of pharmacy in Scotland,” she says.
The College of Pharmacy Practice, which was established by the Society
26 years ago with a view to it evolving into a royal college, has also
welcomed the proposals. “This is something we suggested in our
response to the Foster and Donaldson reviews on the regulation of health
professionals,” Ian Simpson, chief executive of the college told
The Journal. In fact, before the White Paper was published, officers
from the CPP attended a meeting of the Society’s Council to propose
closer working between the two organisations, including the development
of a royal college, he says.
“We are also keen to work with the other pharmacy organisations that exercise
a professional and clinical leadership role,” says Mr Simpson. “I
believe that this is a golden opportunity to get all the pharmacy organisations
under one umbrella,” he adds.
The medical royal colleges (see Panel below) are seen as the custodians
of specialist standards. But will the pharmacy profession be able to
support
more than one royal college?
What is a royal college?
There are a number of medical royal colleges, and associated
faculties, throughout Britain that represent the many disciplines
of medicine.
These include the Royal College of Physicians of London, the
Royal College of Surgeons of Edinburgh, the Royal College of GPs,
the
Royal College of Psychiatrists, and many more.
The medical royal colleges are independent bodies that represent
their members and provide leadership, support and advocacy. Their
aim is to maintain and promote the highest standards of practice
through their work in education, training and standards. The
royal colleges are governed by councils, which comprise elected
members.
The councils carry out their work through a network of boards
and committees.
Other health professions, such as nurses, also have royal colleges.
However, the Royal College of Nursing and the Royal College of
Midwifery are both trade unions as well as representative bodies.
Trade unions
have not been able to have corporate status since 1974, hence
the Society, as it is currently constituted, could not be a trade
union
and the Government would not support such a model. |
Mr Simpson told The Journal that, at a Department
of Health meeting following publication of the White Paper, stakeholders
generally agreed that the
profession is too small to have more than one royal college.
Mr Simpson sets out his vision of how a royal college might work: “Pharmacy
has a rich diversity of special interest groups and it is important that
their professional knowledge and expertise is recognised. This could
be achieved through the royal college operating a faculty system, such
as the one that we have run for the past five years.”
There are many special interest groups within the profession. In a study
recently carried out by the Society (PJ, 3 February, p148), 188
support groups were identified across Britain. These included the
Society’s
own networks, groups from all professional sectors, networks for specialised
areas of pharmacy practice and organisations that provide competency-based
support.
Duncan McRobbie, chairman of the UK Clinical Pharmacy Association, told
The Journal that the UKCPA would be interested in participating in a
royal college. “We would like to work with other interested parties
to define the structure of a royal college. It is important that the
breadth of the profession is incorporated and that the expertise within
that breadth is recognised,” he says. He would like to see pharmacists
who work at a specialist level recognised by a royal college.
Mr McRobbie adds that the value of having a royal college would be that
it could speak with one voice. “At the moment, the number of organisations
with different agendas result in no cohesive voice for the profession.
However, it is also important that the interests of smaller specialties
are recognised and reflected.” Accreditation should not be diluted
Celia Feetam, president of the College of Mental Health Pharmacists,
is concerned that a royal college that does not have a strict accreditation
process for membership — as do the medical royal colleges — would
dilute the accreditation processes already in place for some specialist
pharmacy groups.
Ms Feetam and others raised these concerns at a DoH stakeholder meeting
last week when it was indicated that the royal college of pharmacy would
not be “elitist” and that there is already a stringent accreditation
process in place for pharmacists, namely the MPharm and the preregistration
training year.
“This is not quite the same as in medicine where a medical degree must
precede further additional accreditation for membership of a royal college,” Ms
Feetam points out.
The British Oncology Pharmacy Association would be keen to be involved
in the formation of a specialist faculty within a royal college. Geoff
Saunders, chairman of BOPA, says: “Its purpose would be to facilitate
the accreditation and revalidation of specialist skills and knowledge
required to practise competently within this field. It would also form
the focus for the development of leading edge practice,” he says.
He emphasises that it is vital that a royal college is not merely concerned
with ensuring that practitioners are minimally competent but is also
able to accredit advanced levels of practice.
Eilish Smith, chairman of UK Medicines Information also supports a faculty-based
structure: “In view of the number of areas of specialist interest
we accept that there will be a need to have faculties, perhaps based
on geographical and specialist areas. UKMI may seek to establish its
own faculty. More importantly we feel that the generic principles of
information governance, championed by UKMI, would be relevant to the
whole college.”
Associates of a royal college
It may be more appropriate for some pharmacy organisations to work
closely with a royal college, without coming under its
umbrella.
Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating
Committee, says that the PSNC would expect to work closely with the organisation
to ensure that the professional skills and the services provided by pharmacists
were aligned. However, she adds: “It would be entirely inappropriate
for a royal college to take any direct responsibilities for business
matters or to seek any involvement in this area. None of the medical
royal colleges does this.”
Mrs Sharpe also warns that the profession should be wary of a Government-created
leadership body. “Leadership and influence should come
from the profession itself,” she says. She highlights that the
medical royal colleges comprise members with knowledge and skills in
specialist areas. The colleges have influence as a result of their specialisms.
“It is unclear how this model would be reflected in the proposed royal
college, particularly if, as has been suggested by the Government, membership
might be mandatory. This would not be consistent with the principles
of the royal colleges and, at the launch event, representatives of pharmacy
specialisms expressed strong reservations about this proposal.”
The National Pharmacy Association believes that several questions need
to be answered before proposals to establish a GPC and a royal college
can move forward, including what will be the role and remit of the royal
college. Will there be more than one royal college to reflect different
areas of practice? And what will happen with regard to the Society?
John D’Arcy, chief executive of the NPA, says that he does not
see the NPA coming directly under the umbrella of a royal college but
clearly it will want to have a say in its composition and function.
“What has been lacking recently is professional leadership. A royal college
is good news and everybody needs to have a say in making it work,” he
says. He believes that it is important that any royal college gets up
and running even if it is not 100 per cent right at first. It can then
be reviewed and refined, he says. Mr D’Arcy believes it would be
sensible if, in the early stages, everyone could join. “Certainly
to start with we need a royal college that says this is pharmacy’s
position.” Beneath that there could be faculties, which in future
may require members to take examinations to join, he suggests.
Rob Darracott, chief executive of the Company Chemists’ Association,
warns that those tasked with shaping a royal college model for pharmacy
will have to be clear about what this body is, and what it is not. “The
CCA is fairly clear about the role of the medical royal colleges as they
are now, but that tells us that there is no one model,” he says.
“If this is about leadership, then we would hope that that leadership
recognises where the cutting edge is, across the sectors of pharmacy,
celebrates it and, crucially, provides real support to help others within
the profession achieve. That will require the involvement of the real
leaders of the profession, those who in their daily professional lives
lead by example, inspire and support their colleagues into being better
practitioners themselves, and are recognised as doing that,” says
Mr Darracott. He adds that the CCA is ready to contribute in whatever
way it can as the proposals for a royal college emerge.
The Guild of Healthcare Pharmacists would also like to be involved in
how the royal college is set up. Anthony Oxley, chairman of the national
professional committee of the Guild of Healthcare Pharmacists told The
Journal that the guild is broadly supportive of the direction set out
in the White Paper.
“The guild has been concerned for some time that pharmacists in secondary
care have not been adequately represented by the Society,” he says.
The guild says that it will work with other pharmacy organisations to
maximise the unique opportunity that development of a royal college model
offers the profession. Critical to the success of such a college, it
says, is that all areas of practice are effectively represented.
“If a prime function of the royal college is to carry out revalidation
of pharmacists and pharmacy technicians, it should be structured to accommodate
the clinical roles of pharmacists now, and in the future, when we expect
to see far less emphasis on ‘hospital’ or ‘community
pharmacy’ work, and much more focus on the developing clinical
roles in a multidisciplinary environment,” it says.
Membership for active practitioners
The Pharmacists’ Defence Association will be lobbying strongly
for the Society to take on the role of a royal college, with significant
involvement in continuing professional development, support issues and “pushing
the professional envelope”, says Mark Koziol, director of the PDA.
He told The Journal that pharmacists need a huge amount of support to
be able to do their jobs properly. “We believe the organisation
providing that support should be the membership body.”
In terms of the sustainability of a royal college, Mr Koziol suggests
that only royal college members should be eligible to join the pharmaceutical
register: “We are of the view that it should be a GPC register
requirement to be able to practise competently. We believe that the body
to help people remain competent would be the royal college-type body.”
Christopher Cutts, director of the Centre for Pharmacy Postgraduate Education,
envisages that the CPPE would continue to be a provider of educational
solutions for the NHS pharmacy workforce across England. This, he says,
would support the process of revalidation, which is a central plank of
the White Paper. However, the funding of the CPPE would continue to be
through the Department of Health, while a major component of a royal
college’s income would be through membership subscriptions, he
says.
David Temple, director of the government-funded Welsh Centre for Postgraduate
Pharmaceutical Education, says that the idea that the WCPPE might have
a role in the revalidation of pharmacists is a distinct possibility in
the future.
There is clearly still much to play for as the future of the Society
unfolds. |
The
Pharmaceutical Journal