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Letters to the Editor
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White Paper
How a royal college for pharmacy might develop
From Mr E. O. Opaleke, MRPharmS
Further to the proposed separation of regulatory and representative
functions of the Royal Pharmaceutical Society, Dawn Connelly has shown
that there are differing opinions as to what the college should or should
not be and that finding
a model that will work will prove a huge challenge
(PJ, 3 March, p241).
In my view, it will be ineffectual for professional leadership if every
subset of pharmacy practice wants to evolve into a faculty within the
new college. Noting that 188 pharmacy groups were identified by a recent
study commissioned by the Society, there is going to be professional
leadership chaos if a sizeable proportion of these groups express a desire
to become a faculty. Furthermore, it may be counter productive, since
the inherent benefit of being a pharmacist, namely, being able to move
across various traditional groups with relative ease, will be lost because
of undue “pharmacospecific” specialisation. There will also
be significant workforce issues arising from any extensive fractionation
of pharmacy practice outside the traditionally recognised groups.
For the purpose of the college, I suggest that the Society retain the
major groups to evolve into six core faculties as follows:
• Faculty of industrial pharmacy practice
• Faculty of hospital pharmacy practice
• Faculty of general/community pharmacy practice
• Faculty of governmental/ primary care trust pharmacy practice
• Faculty of agricultural and veterinary pharmacy practice
• Faculty of academic pharmacy practice
These faculties should have advisory board members appointed from the
various subspecialties within the faculty.
Membership, associate membership at specialist status of any faculty
should be by virtue of the subjects studied. These could include (but
not exclusively) the following core areas:
• Medicines information with information analysis, and writing
and presentation skills
• Clinical pharmacy practice
• Industrial pharmacy practice
• Community pharmacy and business management practice
• Health service and management systems, including PCT-type work
• Agricultural and veterinary pharmacy practice
• Teaching and mentoring pharmacists
Of these, the first two should be made mandatory for all members, irrespective
of faculty. The argument for this lies within the central role of a pharmacist
being a custodian of medicines, effective at managing and providing medicines
information with adequate clinical knowledge to do so. Additionally,
it will show the Government and public that pharmacists are primarily
focused on providing an efficient public health care service, irrespective
of their area of practice and not seen just as shop-keepers, drug manufacturers
or “semi-doctors”.
Pharmacists on the current practising Register should automatically be
eligible as members of the college and allowed to continue being such
on production of verifiable continued professional development. For specialist-members
there should be a requirement to have an in-depth knowledge and experience
in their chosen subject, for example, passing an examination after a
minimum number of years of post-qualification experience. An additional
one or two subjects should be chosen relative to the specific requirement
of the faculty of practice.
There may be a need for a grandparent clause that allows a pharmacist
with extensive knowledge or experience in a particular faculty to be
admitted as a specialist member subject to ongoing validation via continuing
professional development. Each subject should comprise modules at both
basic and advanced levels to differentiate levels of competence and acceptable
responsibilities in practice. This approach would preserve the crossover
benefit mentioned earlier and safeguard against unforeseen workforce
issues.
Structuring the new college around the existing groups, with adjustments
where necessary, will assist the profession in adapting quickly to the
new requirement for professional leadership. It will also be easier to
ensure sustainability and limit damage that may result from unnecessary
fractionation of fields of practice and alienation of pharmacists from
the profession they chose to practise. There is an urgent need to get
going, with minimum disruption to the structure that has worked so well
for so many years. We should take care not to throw out the baby with
the bath water. Emmanuel Opaleke
South Harrow,
Middlesex
Do not forget pharmacy technicians
From Mr S. Maddern, RegPharmTech
Something that is niggling me is how the possible split of the Royal
Pharmaceutical Society will affect pharmacy technicians.
Mark Walker
commented (PJ, 17 March, p297) that although he notes the
need to discuss what happens to us technicians he thinks we should be
excluded. I would like to know why.
Pharmacy support staff have taken a back seat for too long. Now with
the voluntary register of pharmacy technicians in place (and nearly mandatory)
and technicians finally taking places on the Society’s Council
and groups, what happens to us if the Society does split?
We have progressed in leaps and bounds over the past 10 years with the
extension of technician roles into accuracy checking, medicines management,
educational and managerial roles and, of course, registration. We are
finally getting recognition. Is this about to be taken away?
Our development, in terms of the Society, was paved and now the view
is not exactly clear. If these issues are being brought to local Society
branches I do hope the technicians on board will be putting our views
across?
In these discussions, do not forget us technicians!
Steve Maddern
Prescribing Support Technician
Carmarthenshire Local Health Board
Points to consider
From Mr A. J. Rogers, FRPharmS
I have always had an immense pride in my profession and in the Royal Pharmaceutical
Society. However, in recent years, as I have become increasingly disillusioned
with the direction of health policy and the NHS; I have despaired as the
Society has struggled to jump through successive Government hoops.
Although we have been able to demonstrate a robust regulatory process,
we were still out of step with the other health professions, and my instinct
told me that the outcome was inevitable. This Government rarely listens
to sound argument and, in the end, the cosmetic appearance of an independent “modern” regulatory
body was always likely to outweigh proven efficiency and probity in the
established framework.
Now that the crunch has come, it is vital that the membership contributes
to the debate on its future. As you said in your editorial of 10 March
(p268), “we are
where we are”. The time for internal argument
and recriminations between factions is over. We must look to the future,
and rebuild a strong professional body.
The following points need to be considered, some of which have been raised
by previous correspondents:
• The Society was not a regulatory body until the 1930s, so it is
simply returning to its roots.
• The Society is not being “split”. It is simply relinquishing
some of its functions, so the Government has no rights to its assets.
• It will inevitably cost more to have two bodies. Although we cannot
expect good professional representation on the cheap, we are entitled to
expect value for money.
• Although it makes sense for many of the special interest groups
to be absorbed into a new professional body so that the profession speaks
with one voice, strict criteria must be set so that there is no internal
conflict of policy.
• Incorporation of other groups must not be allowed to push costs
up. We should be able to achieve economy of scale but, if not, there should
be a scale of add-on fees for participants in each “faculty”,
rather than a sharing out of extra costs among the general body of members.
Each “faculty” would then need to prove its worth.
• There will be arguments to move out of London to achieve savings,
but proximity to Westminster, Whitehall and the medical establishment will
be critical in the early days.
• Although Lord Carter’s working party will look at the shape
of the new General Pharmaceutical Council, we must be careful not to allow
the Government to dictate the future structure and functions of the Society.
• The discussions on the future of the Society should be ongoing and
open to all. A dedicated website should allow a free exchange of ideas
without the restraint of publication space and deadlines. The Council must
never again be accused of poor communication with members.
• Carwen Wynne Howells, chief pharmaceutical adviser for Wales, suggests
we are starting with a blank sheet of paper. I trust that in her urge to
modernise, she is not trying to wipe out 160 years of our pharmaceutical
heritage. We are starting with a professional body with a Royal Charter
that has served the profession well for most of its history. We now have
the opportunity to adapt it to suit our current needs, drawing on the experience
of other organisations.
In the call for professional leadership by previous correspondents, one
vital point seems to have been overlooked. The Secretary and Registrar
of the Society, the chief executive of the National Pharmaceutical Association
and the chairman of the Pharmaceutical Services Negotiating Committee are
all set to leave their posts this year. Although there will inevitably
be a need for fresh ideas to take the profession forward, there is also
a need for those with experience to offer wise counsel.
Is it too much to ask that an informal council of wise men and women can
guide their successors in the early days, without being back seat drivers?
A. J. Rogers
Ewell,
Surrey |
The
Pharmaceutical Journal