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Colin Ranshaw is principal pharmacist, quality assurance
and control, at Cardiff and Vale NHS Trust and a member of the Council
of the Royal Pharmaceutical Society. The views expressed in this
opinion piece are his own and not necessarily those of the Council. |
I cannot help but notice the lack of comment to date about the draft Pharmacists and Pharmacy Technicians Order 2006 from my hospital colleagues in the pages of Hospital Pharmacist, The Pharmaceutical Journal and from the Guild of Healthcare Pharmacists. Is this because we have been so involved with Agenda for Change that we do not have time for other considerations, or because we do not think that it affects us? Or perhaps we are adopting the “heads down” approach in the hope that it will go away.
With the aim of promoting debate among hospital pharmacists, I put forward
my views as to what the effect might be of the main provisions in the
draft Order made under Section 60 of the Health Act 1999.
CPD
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Linking the KSF with CPD
This months’ Careers
article looks at how the KSF and CPD
can be interlinked (see p211–4) |
There is no doubt that the introduction of continuing professional development
has added value over and above the continuing education programmes that
have been established in the hospital service. However, several issues
are raised if the undertaking of CPD becomes mandatory.
First, as part of Agenda for Change, pharmacists working in the NHS have
the Knowledge and Skills Framework, with its annual appraisals and gateways
to pass for incremental pay awards. Are we needlessly keeping two records
and duplicating effort? Moreover, if the CPD criteria are not achieved,
but those pertaining to the KSF are, will the NHS be responsible for
supporting that pharmacist with time and finance to fulfil the criteria?
Second, CPD will be quite rightly directed to an individual pharmacist’s
career, including to the specialties in which they are working.Will this
make it more difficult for pharmacists to move between specialisms and
sectors? For example, if a new job requires certain CPD, will it become
a condition of employment to complete this in a set period of time? This
could restrict pharmacists moving within their careers and hence adversely
affect service delivery.
Third, most decisions about a pharmacist’s fitness to practise
have been fairly clear cut to date, especially if they are concerned
with contraventions of the Medicines Act 1968 or the Code of Ethics.
This may well change with the introduction of mandatory CPD, because
defining the right level of CPD is essentially new territory for all
concerned.
Fitness to practise
Among the new committees the draft Order proposes to establish is a
Health Committee, to be charged with, for example, deciding the health-related
issues that may prevent a pharmacist from working. Again, much of its
deliberations will be new territory. Moreover, how these relate to disability
rights law will also need to be considered.
In addition, it is proposed that all complaints about a pharmacist’s
fitness to practise, whether they relate to, for example, their competence,
inaccurate disclosure about convictions, errors, misconduct or health
impairment, be referred in the first instance to the Investigating Committee.
Unless they decide to take no further action, this newly-created body
will then need to inform a pharmacists employer of the complaint before
they, for example, refer the matter to the Health or Disciplinary Committee.
This might result in an employer suspending a pharmacist on full-pay,
potentially representing a further drain on NHS resources, if the complaint
is minor. Any suspended pharmacists (particularly if they are not receiving
full pay) will no doubt seek the help of the GHP. Will this new requirement
to inform employers early on in the process mean that the GHP becomes
overwhelmed with helping hospital pharmacists through the fitness to
practice machinery?
Insurance
The draft Order stipulates that pharmacists must have indemnity cover,
which can take the form of, but is not limited to, insurance. Does what
I understand to be the current situation — that my trust accepts
vicarious liability for my actions if I am acting within the terms of
my contract of employment and the GHP will act on my behalf (as a member)
if I am challenged by my trust — accord with this provision? Will
the GHP need to revisit its advice about insurance?
Technicians
Most of what I have so far discussed applies equally to registered pharmacy
technicians as to pharmacists. Moreover, the draft Order brings in new
technician-specific issues.
For example, it is a condition of my employment as a hospital pharmacist
that I am a registered pharmacist. This has generally not been the case
so far for technicians. Given that “pharmacy technician” is
set to become a protected title, will all trusts insist on registration
as part of employment? Will this extend to those currently in post and,
if so, will trusts have to finance such a change of contract (ie, pay
registration fees)? What if a person who is currently a technician and
is performing their job to a satisfactory standard does not want to register?
Does not employment law dictate that they will have to be allowed to
continue to carry out their job, even if they cannot call themself a
pharmacy technician? If so, will trusts employ those doing a technician’s
job, who are not registered, at a lower band under Agenda for change
than those who are registered?
Conclusion
The draft Order is a potentially high level, enabling legislation. It
represents the biggest change to how the pharmacy profession operates
in over 50 years. Organisations such as the Society’s Hospital
Pharmacists Group and the GHP, as well as individuals working in the
hospital service will need to monitor carefully how it is implemented. |
Hospital Pharmacist