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How did supervision proposals advance so far without a consultation?

C+D's editor asks if the promised consultation on allowing technicians to supervise medicines supply will be too little, too late

As a journalist, I believe in openness and transparency. But I also understand the need for off-the-record conversations, which allow individuals to frankly share their views away from the public gaze.

So I can appreciate why members of a Department of Health (DH) programme board broaching a subject as divisive as technicians legally supervising prescription-only medicine supply may have been keen for their early discussions to remain private.

However, judging by confidential documents passed to C+D, the board moved past the ‘preliminary discussion’ phase over a year ago. As far back as April 2016, a working group feeding into the board was debating the finer points of the legislative changes required for these proposals to become a reality. In fact, discussions were so far advanced that the board was apparently “asked to agree to the setting up of…workshops” to “test out the proposals for practical application”.

The DH has since confirmed to C+D that the board will consult with “a full range of pharmacy stakeholders, including patients and the public” before it settles on a “firm” set of supervision proposals. But where was the consultation to decide whether freeing up pharmacists to leave the pharmacy is a priority issue? The reaction from the National Pharmacy Association and many C+D readers suggest this assumption is not held by everyone.

Having read the documents in detail, I can believe the proposals were put forward in good faith, as a genuine attempt to allow pharmacists to provide care “in the right place at the right time”. But if that is the case, where are the government-funded services that would incentivise pharmacists to deliver greater care outside of the pharmacy? Instead, we currently have a funding environment – in England at least – where contractors are forced to consider stripping back domiciliary services in order to survive.

Against this backdrop, it’s hard to see why the board’s attempts to amend supervision legislation have raced ahead, while the long called-for decriminalisation of dispensing errors – a task the board was, until recently, most closely associated with – remains mired in delays.

Opening up the pharmacy supervision debate at an earlier stage would have released some of the pressure around this emotive issue. It will be harder to have a constructive discussion about the benefits and concerns of giving technicians greater responsibility, if grassroots pharmacy professionals feel they have been shut out of the initial conversation.

Surely this is an issue that all pharmacists and pharmacy technicians should have a say in?

James Waldron is editor of C+D. Email him at [email protected] or contact him on Twitter at @CandDJamesW

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