The Pharmaceutical Journal
Vol 277 No 7483 p715-716
22/29 December 2007

Society summary

Council responds to responsible pharmacist consultation

The Royal Pharmaceutical Society’s response to the consultation on Government proposals for the content of the responsible pharmacist regulations was considered at the December Council meeting.

Recommendations for a response, put together by the Society’s law and ethics committee and a the Health Act working group (led by Vice-President Martin Astbury), were presented by Priya Sejpal, acting head of ethics at the Society and secretary to the group.

“This is not a group of five people sitting down dictating policy. From start to finish, it has been an 18-month process with probably over 100 people inputting into the process. It is quite important to recognise that,” Hemant Patel, President of the Society, commented. Despite this, however, some Council members were unhappy to agree without a sound debate.

“If it is true that working parties consider everything and working parties are the be all and end all, and we should simply lay down and receive the legislation without revision, there is no point in Council meeting at all. We are here to revise that legislation on behalf of those who have elected us to do that,” said John Gentle.

He added that although he appreciated the work and time that had gone into the draft response, this did not preclude any Council member objecting to part of the document. “I do not want my concerns to be wiped away in a general ‘aye’,” he said.

Areas that raised strong reactions were the proposals surrounding the absence of a responsible pharmacist from a pharmacy and the qualifications and experience needed to be a responsible pharmacist.

Minimum absence

According to Ms Sejpal, the Government is looking at a “two-pronged approach”. It proposes to set a minimum amount of time for the responsible pharmacist to be in the pharmacy and a maximum amount of time for which he or she can be absent.

With respect to the former, it is proposing 50 per cent and in terms of the latter, three hours per pharmacist per shift. The working group and committee believe that 50 per cent would not be enough, and have recommended the use of the wording “substantially more than half”, Ms Sejpal said.

In addition, if the regulations were to specify a percentage, the working group recommended this should be 70 per cent of the working day. However, Gerald Alexander pointed out that “normal working day” needed to be defined to set limits for 100 hour pharmacies.

Moreover, Dorothy Drury pointed out that the regulations should also cover rotas and bank holidays.

Graham Phillips was fundamentally opposed to the pharmacists being absent from pharmacies: “I believe a pharmacy without a pharmacist in it is not actually a pharmacy. I know to some extent it is a slippery slope argument. We have argued two rather than three hours.

“To be honest, whether it is two or three hours I do not think is particularly relevant. Once you get to significant periods of absence, it is very hard to defend it from there to half a day, to a day and so on and so forth. If we had the luxury that certain European nations have, both in terms of huge investment in technology and huge investment in terms of support staff (graduate technicians and that kind of scenario), then I could well imagine that we may look at this differently.

“But I see no prospect whatsoever of the injection of the necessary resources being made in order to provide that situation. It worries me that we go apace.”

Stephen Denyer pointed out that there would be other professionals who would be able to offer a meaningful service to the community during that time, although within constraints. “I would like to observe that the pharmacy that is vacated by a responsible pharmacist will not be a Mary Celeste,” he said.

Douglas Simpson, who sits on the law and ethics committee, commented: “The Health Act was predicated on the pharmacist possibly being absent from the pharmacy for some time during the time the pharmacy is open. So if we are to vote against it now, it would be slightly ridiculous.

“The second point I would like to make is that it will not be compulsory to leave your pharmacy. You can, if you want to, stay there all the time. You can, as a pharmacy owner, insist that your pharmacists are present all the time. You can set up the system to suit you.”

Mr Gentle also expressed concerns: “If this absence is going to be part of our recommendation, I would like us to assume that this is to be in urgent circumstances, in extremis, unusual circumstances or something that means that it will not become the norm. Because I have real concerns if community pharmacies the length and breadth of the country regularly open for a large percentage of their time without pharmacists in them.”

Mr Gentle also said that the public would find it difficult to understand when they go into a pharmacy and they cannot get the services advertised, as may primary care trusts. He described the medicines management team in his PCT, in Shropshire, as being “increasingly concerned” that when a service is agreed with a community pharmacy and the pharmacist is trained and accredited to provide that service, on days off, holidays and absences, no one else can be found to provide the service.

“I am not, in principle, against a pharmacist leaving the pharmacy, as this paper says. What I am against is that practice becoming the norm,” Mr Gentle said.

Another concern, put forward by Sue Kilby, was that community pharmacists working for multiples could be pressured into leaving pharmacies to perform services when they are not happy to leave the pharmacy to be managed by technicians. Ms Sejpal said that this was a separate issue and not a reason for absence not being allowed.

Mr Astbury emphasised that absences were for the purposes of emergencies, rest breaks and professional services and that, at first, he had not supported the policy. It was only after a number of safeguards had been put in place to ensure that absence could not be abused, that his view had changed.

He explained absence must be justifiable and the working group’s recommendation is that absences and reasons for absence must be recorded. “At the moment, that is not Government policy. So we will be pushing very hard … and will be lobbying [for this],” he said.

“One of [the] points the Department is trying to make with this legislation is that this is to cover things for quite a considerable period into the future into which we are not very good at gazing with our crystal balls, and that they want a bit of flexibility for the future. We are thinking of what is happening now in pharmacies and things may be different in the future and we may want this flexibility,” Jonathan Buisson commented.

Mr Gentle then called for a named vote (seconded by Dorothy Drury) on the recommendation for the maximum period of absence of two hours per working day.

The recommendation was carried.

Those voting against the recommendation were Andrew Gush (treasurer), Jonathan Buisson, Steve Churton, Dorothy Drury, John Gentle and Graham Phillips. The President abstained.