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For the President of the Royal Pharmaceutical Society the issue
is clear cut: “We as a profession have demanded a role in clinical
care,” he declares. The creation of a royal college type body and
the General Pharmaceutical Council is, for him, an opportunity for pharmacists
to provide a wider range of clinical services in all settings — in
the community and in primary and secondary care.
He disputes the suggestion
that the separation is of the Society’s own making: “I say
it is not; it is a prelude for the development of services and for pharmacists
to be accountable [for what they do] in a modern way. And that is good
news for the profession.”
Nevertheless he acknowledges that there
have been difficulties. “At the moment we are trying to serve two
masters: the public through the regulatory role and pharmacists through
the professional association.”
Strong position
The President also acknowledges that in the recent past the Society
has been obliged to deal with major regulatory issues but there have
been
significant developments on the professional side that would not have
happened without the input from the Society. He says pharmacist prescribing
is a prime example of a successful Society activity. “People
knock [the Society] for the sake of knocking it. One of the things
the Society has done less well is dealing with the here and now, instead
maintaining commitment and focus on long-term issues. Once the two
functions are separated it will be clear what the royal college body
can achieve.” He adds: “The Society is in a strong position
to form a single royal college, or a structure similar to that, for
all three countries.” The President emphasises that the separation
of the two functions of the Society will not result in a trade union: “I
do not know anyone on Council who is supportive of that. And neither
will the Society turn into the regulatory body,” he says.
There are rumours circulating in pharmacy circles that the Society
might not form the foundation of the royal college and that other arguably
more academic bodies might take on that role. In response, the President
says: “We are not arrogant. We have always sought to work with
other bodies to develop the pharmacy agenda. I have heard about the ‘Waterloo
agreement’ [see p357].” He wishes, however, that these other
bodies had made their views clear at the time of the Charter debate. “We
might have had a slightly different Society to the one we have now,” he
says.
“I have been told by Lord Hunt [the health minister with responsibility
for pharmacy] that the Society is in a very strong position to form the
royal college but he was also keen that we work with other relevant bodies
so that the future structure is robust and fit for purpose. And, for
example, we have worked with the Academy of Pharmaceutical Sciences
and the College of Pharmacy Practice over the past 18 months,” he
explains.
Although the establishment of a royal college is primarily a professional
pharmacy issue, the President can understand why the Government has an
interest in it. “In the first place, removing the GPC side of things
[from the Society] could destabilise the organisation — the Government
has a moral duty to ensure that it survives. Secondly, the Government
would want us to have a strong and robust royal college with good governance
arrangements because it will have to work with the regulatory body and
develop the pharmacy practice agenda. They will have to work closely
together on a number of issues.”
So who would join the royal college? Currently there are fewer than 5,000
pharmacists who are members of a special interest body. That number is
not sufficient to sustain a royal college and, as the President says,
the fees would be prohibitive. “The Society should not just restrict
its deliberations to those involved or invited to sign the Waterloo agreement.
We have to involve other bodies like the Academy of Pharmaceutical Sciences
and the National Association of Women Pharmacists — there are so
many women in pharmacy we must include them,” he adds.
The President mentions the exercise undertaken in 2005 — to scope
the profession and to determine what bodies existed outside the Society
and what their needs were. “Scoping the profession revealed that
some wanted to be taken over, some wanted to work closer with the Society
others wanted to remain autonomous. If the royal college only had 6,000
or so members it wouldn’t take the public protection agenda or
the professional development agenda forward fast enough. It is important
to work with many other groups — scientists, technicians and others — so
that together they come up with a structure that meets not only the future
needs of the profession, but also the NHS and the public.”
Although this is an exciting prospect for specialist pharmacists, what
will the new structure offer community pharmacists? Far less than 10
per cent of them have clinical diplomas, for example. “I agree
that there must be greater opportunities for them. We are being told
constantly that pharmacy has so much to offer the NHS but this is not
matched at local level. They are not given the opportunities to make
a contribution despite the Government’s desire for joined up working,” he
comments. And he gives a topical example: “The Government spends
millions on no-smoking campaigns but does not make sure that pharmacy
services are kept going or encouraged. So it is not only a question of
being inspired to join the royal college, there must be a resourced strategy
to ensure it is successful. Without new and additional resources I cannot
see any of this happening. “ Great deal of work
However, the President admits that a great deal of work has still to
be done before the costs of having two bodies are completed. “My
guess is that we will need between £10m and £12m a year
to run a royal college and a further £8m for the GPC. Pharmacists
must be aware that all royal colleges and regulatory bodies have seen
their fees rise over the past 10 years because of the demands of Government.
Fees for pharmacists will increase but not, primarily, because of the
split. They will increase because of the legislative burden on the
Society and the new demands of a clinical profession — it will
cost money to develop that agenda.”
The resources are clearly a significant issue: “I cannot believe
that [the establishment of the GPC and royal college] is possible without
a huge injection of cash to speed things up. If there is not any additional
money I see the GPC will be formed — because that is mandatory — and
a very weak royal college, as well, that would not serve adequately the
public, the profession or the government. Neither specialists nor generalists
would be happy. Without the generalists on board there will not be enough
resources for the specialists to do anything.”
The President suggests one way of attracting the generalist to join the
professional body — in addition to offering assistance for undertaking
continuing professional development and, in time, revalidation — would
be through the development of support services for clinical activities.
Clinical standards could be developed that are used all over the UK — and
the President gives the examples of smoking cessation and emergency hormonal
contraception. “Standards for service development could be set
centrally and then be tweaked locally instead of hundreds of different
services being developed. A range of support services would be available
for members and a reduced rate would be paid compared with non-members,” he
adds. According to the President, membership of the Society is often
taken for granted but it gives members a certificate to practise. In
a similar way he believes that membership of the royal college would
impact on pharmacists by enhancing their status and their income — over
and above being registered with the GPC.
The President believes that there will be an international element to
membership of the royal college. The opportunity to register members
working abroad will give them status and credibility and will be an important
area to develop. “We will need strong leadership with people working
hard and honestly with each sector of the profession.” Two sides of the same coin
The President is clear on one matter: “Voluntary membership is
the way forward but with a strong support structure which would make
a compelling case for pharmacists to join. I see regulation and a professional
body as being two sides of the same coin and the Department of Health
morally compelled to help create the new bodies. The Society’s
strong infrastructure and high calibre staff are great assets. There
is an opportunity for us to develop two separate structures which are
effective and cost-effective. I would argue for co-location because business
continuity is critical but with areas such as human resources and IT
shared.”
He explains that the whole Council is committed to moving forward to
form a GPC and a body akin to a royal college. “We are committed
to working with other bodies, with other health care professionals and
others who are keen to see pharmacy succeed. We also need to start working
at a comfortable speed — we cannot continue to work at the speed
we have done for the past six weeks because it would burn people out.”
Meanwhile, the Society is advertising for a replacement for the Secretary
and Registrar, Ann Lewis, who is retiring in the autumn (see pA19). Whoever
is appointed must have a strong personality, the President believes: “Also
strong change management and culture management experience. Most definitely
it does not mean that it is exclusive to a pharmacist. It would help
if there were a pharmacist but the main requirement is that the individual
will make changes for the profession and the Society. The Society needs
to be more member-focused. ”
It is hard to believe that the White Paper announcing the separation
was published as recently as 21 February and the momentous decision is
likely to be put in train shortly and the two bodies up and running by
2010 or 2011. The President’s greatest anxiety is that the resources
to carry out these changes will be insufficient and staff morale in the
Society and within the profession in all sectors will drop even further: “If
this is not handled carefully by the Government it will make co-operation
of pharmacists even more difficult, and morale will sink lower. I intend
to share with them as much information as possible, to consult
them and engage them in discussion. But I still have concerns that, like
the Section 60 Order, there may be delays and these delays cost us money.” |
The
Pharmaceutical Journal