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RPS warned: Technicians supervising supply would be betrayal

An open letter signed by more than 500 pharmacists is calling for Royal Pharmaceutical Society (RPS) assembly candidates to stand against technicians legally supervising medicines

In the letter, published online yesterday (July 10), contractor Mike Hewitson and pharmacist Ben Merriman state that “many community pharmacists are extremely concerned” that the Department of Health (DH) plans to “empower pharmacy technicians to supervise pharmacies”.

A DH programme board set up in 2013 to "rebalance" medicines legislation – including the decriminalisation of inadvertent dispensing errors – is also tasked with "addressing" legislation on pharmacy supervision, which it considers to "restrict full use of the skills of pharmacists and pharmacy technicians, [and] put unnecessary obstacles in the way of new models of service delivery".

The letter's authors are concerned that the board's direction will lead to technicians being legally able to supervise medicines supply.

“This simply cannot be allowed to happen,” as “the public will be left without access to the knowledge and skills of the pharmacist”, they stressed.

“Anything other than a strong and robust opposition” to this possible outcome, would be seen as a “betrayal” of RPS members, they added.

"Too much emphasis on GP pharmacists"

In their letter – sent to each candidate of the RPS assembly elections yesterday – the contractors also accused the society of placing "too much emphasis" on the "emerging role" of pharmacists in GP practices.

The RPS has supported the concept since it launched a joint proposal with the Royal College of General Practitioners in 2015, but the letter's authors argued that pharmacists in GP practices "are no substitute for on-demand provision of professional care and advice" available from a community pharmacist.

The letter includes 469 contributing signatures, which the authors claim represents "a cross section of community pharmacists". An accompanying online petition had accumulated 511 signatures at time of going to press.

Click here to read the full letter

“Ton of opposition”

Dorset contractor and co-author of the letter Mr Hewitson told C+D yesterday he believes that current RPS president Martin Astbury is a “staunch advocate” of “maintaining the link between pharmacist and pharmacy”, which is “absolutely critical”.

Mr Astbury told C+D in May that it is “totally inappropriate” to legally pass supervision responsibilities to a technician.

However, Mr Hewitson told C+D that “should Mr Astbury not be the president”, he is concerned “we would see somebody with a very different view”, who could give in to pressure to allow technicians to supervise supply.

He also claimed there is a “ton of opposition” to this possibility. “This is just the tip of the iceberg.”

“Active consideration” around supervision

Last week, DH head of pharmacy Jeanette Howe said the rebalancing board and the UK's four chief pharmaceutical officers “are taking responsibility” for the “work programme” around pharmacy supervision.

“I don’t think I’m giving away any secrets when I say there is a range of views on this matter,” Ms Howe told delegates at the Association of Pharmacy Technicians UK's (APTUK) conference.

“Some of the things we have been doing is to look at quality systems…how that works in other regulated professions, and how that might work in pharmacy,” she added.

Ms Howe reassured delegates that “active consideration is still going on and we’re hoping to make progress”.

The APTUK was unavailable to comment on the contents of the open letter.

RPS response

Responding to the concerns raised in the letter, the RPS said it “has always believed that a community pharmacy requires a pharmacist to be present” – see more on the RPS's position below.

The society also argued that its support for investment in new pharmacist roles, in areas such as “care homes, A&E and GP practices”, has helped integrate community pharmacy into the wider NHS.

“These new roles have led to greater referral for medicines use reviews and the new medicine service in England, and discharge medicines reviews in Wales, as well as improving the professional relationships between GPs, social care and community pharmacists,” it claimed.

“We will not shy away from asking for investment in community pharmacy, as we know this service is vital to the safe delivery of quality healthcare,” the RPS said.

“We have listened to our members and they have told us now more than ever the sector should be coming together around a positive, constructive agenda,” it added. “This is where we will be concentrating our energy and focus.”

The RPS position on legal supervision

  1. There should be overarching principles that describe what patients should expect from all pharmacists – but supervision changes should reflect the differences between pharmacy sectors
  2. Supply of prescribed medicines to the public requires a clinical check by a pharmacist to ensure the medicine is appropriate, and this should comply with professional and regulatory standards
  3. Supervision changes must safeguard individual pharmacists’ autonomy in delivering pharmaceutical care and further empower them to exert their professional duty to patients
  4. Innovations that allow pharmacists to concentrate on patient care are welcomed. Such innovations should ensure continuity of, and enhance the quality of, pharmaceutical care.

Supervision requirements should be amended so the direct supervision of prescription assembly can be delegated to a registered pharmacy technician, so that pharmacists can develop their clinical and public health service role.

Do you agree with the views in the letter?

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