|
Alison Ewing is clinical director of pharmacy at
Royal Liverpool and Broadgreen University Hospitals NHS Trust and
a former vice-president of the Royal Pharmaceutical Society
|
We have arrived at the watershed. The Royal Pharmaceutical Society is to split, to fit in with the Government's perception that the public needs reassurance that pharmacists are fit for purpose and safe to practice. Where, I would like to know, is the outcry from the public that we are not?
Pharmacists have never had a problem meeting the criteria for good regulation,
but we now have to conform to a structure set out in response to problems
with the other health care professions, such as the Harold Shipman and
Bristol Royal Infirmary cases. Lord Carter of Coles is leading a particularly
short-lived working party to set out the costs and options for the future
format of the profession.
What are the implications of this for hospital pharmacists? One might
question how interested hospital pharmacists are in the future of the
profession. The fact that only one member of the Society’s Council
is a hospital pharmacist and that no hospital pharmacist stood for election
this year indicates a degree of ambivalence. Nevertheless, pharmacists
have an excellent track record for adapting to and promoting change which
could be beneficial to the future debate. We need to get involved to
make sure our voices are heard.
The Society currently regulates and represents the entire profession,
with various special interest groups such as the Hospital Pharmacists
Group. Perhaps, as I know many of my colleagues believe, the Society
has failed to be truly representative of hospital pharmacy because of
the domination of the community sector on the register. The new structure
presents an opportunity to put this right.
Many of the models for educational development originated in hospital
pharmacy. A larger proportion of hospital pharmacists have higher degrees
and clinical diplomas than community pharmacists, and these qualifications
are essential for promotion in a competitive NHS. Furthermore, the “clinical
revolution” started in hospitals before spreading across the profession.
Opportunities
The proposed “royal college” would formalise and standardise
processes. This may be the opportunity to address concerns such as the
future of clinical leadership, accreditation of specialist pharmacists
and succession planning. However, we must ensure that the profession
remains cohesive and that the change process itself does not become discordant.
Many are looking to compare our proposed royal college to those in the
medical profession since the proposed function will largely be similar.
However, we need to look at the facts. There are many more doctors than
pharmacists — enough for them to have royal colleges for each specialty.
With just over 40,000 members pharmacy will struggle to emulate this
model. But should we try? Doctors’ specialties are clearly defined — surgery,
medicine, paediatrics, etc. We have no such clarity in our roles. We
can be classed as working in hospital, community, primary care, industry,
or academia, but many people work across these sectors. To which sector
would they pledge allegiance?
The General Pharmaceutical Council will be the body that admits pharmacists
to the register and sets the educational standards for entry. Postgraduate
education, especially for hospital pharmacists, is well developed but
relatively unregulated. This will be a role for the royal college. The
medical royal colleges are all registered charities — a route that
the Society chose not to take some years ago — therefore the educational
element would be to the forefront of the college.
Membership of the Royal College of Physicians is not compulsory. Most
doctors in the hospital sector will take their entry examination to achieve
a recognised standard of excellence and will then be entitled to use
the letters after their name, but there is no compulsion to continue
to pay to be a member of the college thereafter. The Guild of Healthcare
Pharmacists and the UK Clinical Pharmacy Association are likely to compete
with the royal college for members, since pharmacists will be selective
in where they pay to join. Credibility and value for money will be paramount.
As a smaller profession, our strength comes from cohesion and any attempt
to split entirely into minority groups will be divisive. Numbers alone
are against us but there is also the issue of devolution. Should Scotland,
where health is a devolved power, have a separate college? The professional
regulation is currently a reserved power but if Scotland becomes completely
devolved, a whole new GPC will need to be established for Scotland. Would
we lose the synergy that comes from bodies working together across Britain?
The future is now extremely uncertain for the representative role of
the profession. It seems fair to assume that the representative part
of the Society will, as of right, become a “royal” college,
but this is by no means certain. We will have to prove that we are a
fit organisation with appropriate aims and objectives to be granted this
status. We will probably need a whole new Royal Charter — if this
is the case let us hope that that the process is a lot less tortuous
than the last time. Perhaps we should we retain the name Royal Pharmaceutical
Society and make it more suitable for purpose rather than try to create
a whole new system.
After the Carter working party has made its proposals, the profession
itself will be left with the huge task of laying the foundations for
the next and future generations of pharmacists. We must work together
and ensure that the profile of pharmacy as a whole is maintained. We
must put personal and sectoral issues behind us and put the profession
first. |
Hospital Pharmacist