Only 4 of 8,000 pharmacies rated 'excellent' by inspectors

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GPhC never intended for large numbers of pharmacies to achieve top rating
GPhC never intended for large numbers of pharmacies to achieve top rating
Only four out of 8,000 pharmacies have been rated ‘excellent’ by the General Pharmaceutical Council (GPhC), C+D has learned.

More than 8,150 pharmacies have been inspected by the regulator between November 2013 – when it introduced its new approach to inspections – and September 9, 2016.

However, only four of these achieved the top rating, according to information obtained by a pharmacy contractor under a freedom of information request.

Of the remainder, 17% (1,396) were rated ‘good’, 77% (6,316) were rated ‘satisfactory’ and just 5% (443) were rated 'poor', according to the information, seen by C+D.

Despite the inspections being carried out by 39 different inspectors, three of the four ‘excellent’ ratings were handed out by one individual. The GPhC argued that revealing the names of any of the inspectors would be a breach of the Data Protection Act.

The contractor who requested the inspection information – and wishes to remain anonymous – told C+D they were prompted to do so by the “difference in [inspection] results for my branches”.

“We all have the same standard operating procedures, support team etc, and yet we have had ‘poor’ and ‘good’,” they said.

“I know it could be due to individual pharmacists and team members on the day, but I would have at least expected that they would be about the same.”

“Also, the process varies, with some pharmacists telling me that some inspectors spend an hour [at the pharmacy], and others [spend] four hours,” the contractor added.

‘Excellent’ rating reserved for small number of pharmacies

Commenting on the findings, the GPhC told C+D that it never intended for large numbers of pharmacies to receive the top rating.  See below to understand how the GPhC decides on this criteria.

The first pharmacy to receive an ‘excellent’ rating was Wicker Pharmacy in Sheffield. Read how they won the C+D Award for Pharmacy Team of the Year 2015 here.

What makes for an 'excellent' pharmacy?

"To be considered as 'excellent', a pharmacy will need to not only meet all the standards consistently well but also demonstrate innovation in the delivery of pharmacy services, with clear positive health outcomes for its patients.

"This is effectively a ‘good +’ pharmacy. It is good and in addition demonstrates excellence. It is envisaged that there will be very few pharmacies where the outcome of the inspection is excellent, especially in the early days of the new inspection model."

Source: GPhC website

    20 Comments
    Question: 
    What was your experience of being inspected by the GPhC?

    Rampant Locum, Community pharmacist

    y'all watch your posture whilst you post comments here....may i remind you that you are all registered pharmacy proffesionals... and even if you are at home posting...you posture may be in breach of standards...

    Lucky Ex-Locum, Superintendent Pharmacist

    Spelling and grammar my friend....spelling and grammar

    Valentine Trodd, Community pharmacist

    Dunkin Rudkin. There, he's name has been mentioned. So can any of you folk from the GPhC reading this please, on account of his name been mentioned, please tell him to take a look at this thread? If he doesn't know already (and frankly I don't believe he gives a monkey's anyway) there is absolutely no faith in the GPhC, not to mind the current inspection model, among grass roots pharmacists. Furthermore, we're sick to the back teeth of being asked to contribute to consultations on standards, patient care, etc. when nothing is taken on board. I contributed to the last one, and the most popular contributions were about workplace pressures, MURs, etc. yet it has all been ignored. Furthermore  the PDA made its views known to the regulator in a consultation last year, as did numerous pharmacists – but these were ignored - hence the current legal challenge. The GPhC has been letting down working pharmacists since it's inception - it placates and changes it's rules to suit the multiples and internet pharmacies - yet we are the ones propping up the organisation with our registration fees! It's a sick joke - thank God I'm out soon.

    Lucky Ex-Locum, Superintendent Pharmacist

    Are you contributing to the new one Val? I think I detected your style on one of them! I upvoted it either way.

    Valentine Trodd, Community pharmacist

    Oh, and since the GPhC is largely financed by OUR registration fees, and the PDA is financed by OUR membership fees - aren't we effectively paying for BOTH sides to fight it out?! Brilliant - only in the worl of pharmacy! 

    Joan Richardson, Locum pharmacist

    Having been present for an unannounced inspection due to postal issues I was left wondering what on earth is necessary to get good let alone excellent.

    Shaun Steren, Pharmaceutical Adviser

    Well you need a more reliable postal service. This gives the branch a chance to: 

    1) Cover up the most egregious elements of their practice

    2) Coach all staff to give the formulaically 'correct' answers to inspector questions 

    3) Sign and organise all folders/protocols as if they are actually followed 

    4) Clean and tidy the branch for the first time since the last inspection 

    5) Obtain cover for the chronic understaffing for this limited period only

    6) Be excessively friendly/helpful to all customers for this limited period only 

    7) Practice sycophancy and faux calmness for when his/her Excellency arrives

    8) Attenuate any visual indication of performance to targets 

    9) Inform the corporate owner of the forthcoming event and of the willingness to 'protect' the 'brand' 

    10) Convince yourself you are not doing any of this out of fear but because of your belief in good GPhC practice 

     

     

    Yuna Mason, Administration & Support

    To be excellent they are likely to be high profile pharmacies. A high profile independent would have told everyone about the rating at the time. The multiples would not because they'd see it as embarrassing if someone could say "out of X pharmacies in the chain only 1 is excellent". The pharmacies I think must belong to the multiples.

    It would be embarrassing if it turned out that the other three excellent ratings were for pharmacies without patient contact e.g. internet pharmacies. Especially if they were multiples without patient contact "... only 1 is excellent and it's the one without any patients."

    The identity of the inspector for what it matters could be worked out from the identities of the pharmacies. Will the GPhC be reluctant to release that information too?

    https://www.pharmacyregulation.org/sites/default/files/inspareasdec2014_15_1.pdf

    S RAHMAN, Locum pharmacist

    The inspectors don't live in real world. They have wonderful ideas about things but it is not possible to apply in real world. A true inspection model should consider what is realistically possible.

    Shaun Steren, Pharmaceutical Adviser

    Why be concerned about the excellent rating? 

    "To be considered as 'excellent', a pharmacy will need to not only meet all the standards consistently well but also demonstrate innovation in the delivery of pharmacy services, with clear positive health outcomes for its patients"

    Well, as genuine innovation has been virtually absent from community pharmacy for the last twenty years and evidence for clear positive outcomes (supported by robust evidence) hardly exists, 0.05% looks quite reasonable. 

    What is of genuine concern is that only 5.43% were considered poor. If only 5% of the pharmacies I worked in as a locum had been poor, my life as a pharmacist would have been wonderful. It has been my experience (and the experience of every locum I know) that the majority of pharmacies are disorganised and dangerous bombsites. Maybe being given notice of inspection has something to do with it? 

    Valentine Trodd, Community pharmacist

    Inspections are not fit for purpose. End of. Inspectors should be required to be working pharmacists and maybe rotate inspectorship duties with the pharmacist role. Methinks many are too eager to criticise a role they have lost touch with.

    Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

    A question, does it mean anything to the end user, the patient? When I think of what they would judge a pharmacy on, I get a whole different set of criteria.

    Lucky Ex-Locum, Superintendent Pharmacist

    Couldn't agree more - the average patient/customer doesn't give a toss about MUR/NMS et al. They just want a nice smiley face, maybe a bit of a chat and their prescription ready when they want it. I think that aggressive 'offering' of services that you encounter in some, mainly multiple, pharmacies is actually detrimental to the customer experience (for want of a better phrase - bit too much like corporate speak for my liking!)

    Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

    Being on the receiving end of that before. Spent longer being reeled a selection of services halfheartedly that I clearly had no interest in, than actually talking about the purchase I'd brought.

    Lucky Ex-Locum, Superintendent Pharmacist

    This tells it's own story - to get an excellent rating a pharmacy would have to participate in a lot of additional services (probably for no additional money) and very few of us have the time or inclination to do that. The inspection process is flawed - for a GP surgery to get a 'Good' or 'Excellent' rating on their CQC inspection they just have to do the common sense parts well whereas for a pharmacy that results in a 'Satisfactory' rating.

    A Hussain, Senior Management

    If you removed the three 'excellents' as they were down to just one inspector then that leaves one 'excellent' pharmacy!  Are we that bad or are the inspectors working to unrealistic standards?  I once had a lecturer that stated that nobody should be able to get 100% in one of his exams.  A student asked whether that applied to him too.  He said that it obviously didn't apply to him.  It was just arrogance.  What are the innovations that make you 'excellent?' If it can be measured then it can be given as a guideline surely.

    ajaz akhtar, Student

    Lol.........tick book exercise......

    Yuna Mason, Administration & Support

    Which 3 pharmacies received excellent alongside Wicker? Could C&D find out?

    John Munday, Locum pharmacist

    You would expect a normal distribution curve with such a big sample wouldn't you?

    Makes me wonder about the validity of the process as a whole.

    Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

    That is how I studied statistical analysis years ago. Extremes were to be considered abnormalities and offer little in the way of useful data.

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