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Allow dispensing ‘without pharmacist on site’, says CPE-commissioned report

The King’s Fund and Nuffield Trust’s “vision” for community pharmacy has recommended prescription dispensing without a pharmacist on site, saying it will “level the playing field” with GPs.

Laws should change to “allow dispensing without a pharmacist on site”, according to think tanks the King’s Fund and the Nuffield Trust’s vision for the sector, commissioned by Community Pharmacy England (CPE) and published today (September 19).

According to the vision document, the Department of Health and Social Care (DH) and NHS England (NHSE) should “implement legislative changes” so that medicines can be dispensed “without a pharmacist on site”.

These new rules should be accompanied by the “development of systems that allow safe and accurate dispensing in this scenario”, it said.

Read more: Supervision of individual transactions ‘no longer’ needed, cross-sector group finds

CPE - then known as the Pharmaceutical Services Negotiating Committee (PSNC) - announced in October that it had appointed the two think tanks to develop a “new vision and strategic options” for the community pharmacy sector in anticipation of negotiations for a new contractual framework in 2024.

The report offers a wide-ranging look at how the sector could change over the coming years, in particular how pharmacists will expand their clinical services, with a view to influencing the government’s approach in negotiations to come.

 

“Level playing field” between GPs and pharmacies

 

The document said that permitting dispensing without a pharmacist on site would “level the playing field” between dispensing GP practices and community pharmacies and provide “an opportunity to collaborate with the wider system”.

It added that the move could also help community pharmacies in rural areas become “financially viable”, saying that it sees pharmacy technicians developing “skills and ability” to take up “much of the dispensing role” to “free up pharmacist capacity”. 

Read more: ‘Daft bureaucracy’: Shadow health secretary questions supervision rule

Research conducted for the report showed that laws requiring a pharmacist on site for dispensing “may be hindering collaboration and innovation”, the think tanks said.

The vision document added that the new contract should fund community pharmacist “collaboration within primary care networks and at ICB level” and that changing the rules on pharmacists’ physical presence for dispensing will “facilitate this wider engagement”.

It stressed that the “workforce implications” of the paper were “significant and should not be underestimated”, warning that pharmacy professionals “need to be prepared for change” as they “shift towards more clinically focused roles”.

 

Cause for controversy

 

Proposals on dispensing without a pharmacist present have been a divisive issue in the sector. 

The new recommendations come after the Supervision Practice Group (SPG) agreed that the “physical presence” of a pharmacist on the premises was the “defining element” of community pharmacy, in a report published last month.

Read more: Pharmacy supervision: The DH seems committed to changing the law; we must set the terms

While the SPG, a cross-sectoral working group formed to provide recommendations to the government regarding the nature of supervision in pharmacy, noted differences within its constituent members, it also found key areas of agreement around changes to supervision.

It pushed for rules on the pharmacist supervision of individual transactions to be scrapped and agreed that the preparation and assembly of medicines outside of opening hours without a responsible pharmacist present should be permitted.

 

Dispensing with pharmacist dispensing

 

In September last year, C+D reported that shadow health secretary Wes Streeting had railed against the “daft bureaucracy” that means a pharmacist must be on site to supervise every prescription at the Labour party conference.

It came after the DH did not include changes to remote supervision in a consultation on a raft of proposals aimed at “clarifying” the role of superintendent and responsible pharmacists in April 2022. 

Read more: Catch up on C+D's Big Debate on pharmacy supervision 

The DH said at the time that supervision would be subject to further discussion under the cross-sector SPG, in response to a number of submissions that opposed remote supervision over fears for patient safety.

In December 2021, C+D hosted a Big Debate on modernising supervision featuring members of the SPG. At the time, Gareth Jones of the National Pharmacy Association (NPA) said that the organisation was “against the practice of remote supervision in almost any conceivable circumstances”.

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