Picture the scene. It is the last day of a long trial. The courtroom is packed with pharmacists, and the gallery full of reporters from C+D and other pharmacy journals.

In the dock is the pharmacy superintendent of a major high street chemist, representatives from the General Pharmaceutical Council (GPhC) and NHS England, and the Secretary of State for Health Jeremy Hunt. They are all on trial for corporate manslaughter.

The prosecution lawyer stands to sum up his case, and indicates to the dock.
 
"My Lord, and members of the jury. There are many who said this case was a waste of taxpayers’ money, and an infringement upon the even more valuable time of these four gentlemen. However, I would assure you that this trial goes to the very root of medicines safety in the NHS.

Over recent years, several pharmacists have been prosecuted under the Medicines Act for having made, or not identified, a dispensing error.

On their part, this was simply human error, but with tragic consequences. And on each occasion, there has been no impropriety or unprofessionalism on the part of the experienced health professional. However, they have been working under conditions of extreme stress and pressure.

This is nothing new: pharmacists have been warning of the dangers of workplace stress for over 10 years, and yet the defendants have done nothing to address this. Decisions about minimum staffing and maximum service levels have been accepted by pharmacy superintendents, ignored by the GPhC, exacerbated by draconian contractual requirements set by NHS England, and forced through by the Department of Health-imposed funding cuts.

For that reason, the Director of Public Prosecutions was minded to bring a charge of corporate manslaughter, by way of vicarious liability.
 
To find them guilty of corporate manslaughter, they must be guilty of a failure that resulted in a gross breach of a duty of care – in other words, a reasonably avoidable occurrence.

Think of, for example, a fatality involving a tipper truck on a hill with faulty brakes. The man driving may be responsible, but not accountable, for the deaths. Instead, the company’s mechanic and director could be guilty, as they knew the brakes to be faulty and chose not to pay for maintenance.
 
I would draw the same parallel with a tragic, fatal dispensing error. Research has shown such human errors can be brought about by 'disruption distress’, such as that which can come with the stress of managing a high workload while under constant distraction and interruption.

A paper published in a journal of the Royal College of Psychiatrists suggests this may be a precursor to post-traumatic stress disorder. And a 2013 study from a Danish hospital demonstrated a relationship between 12 stress factors – such as interruptions, time-pressures, isolation from colleagues, and staffing shortages – and clinical errors.

All of these stressors are a daily occurrence in a community pharmacy. Meanwhile, this stress has been intensified by commissioning pharmacist-specific services, such as medicines use reviews, the new medicine service, and flu vaccinations – with the accompanying target-setting.
 
Therefore, pharmacists should not be criminalised for being human. In fact, they are experiencing criminal contractual requirements and lack of support from the wider health service – represented by the individuals in the dock today. Members of the jury – there is only one possible verdict.”