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The way forward: Remote supervision in community pharmacy

As community pharmacy welcomes the Pharmacy First service, Reece Samani explores how this coupled with remote supervision could shape pharmacy…

Since the government launched its 12-week consultation on pharmacy supervision on December 7, there has been a renewed focus on the contentious issue of the relaxing of supervision law.

I have heard and seen a lot of pharmacist colleagues expressing valid concerns. However, I see the plans to allow registered pharmacy technicians to dispense and supply prescription-only medicines with the authorisation of a pharmacist as a positive step.

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There are two main concerns that I have picked up on in conversations with colleagues and from reading articles on Chemist+Druggist and others. The first is around patient safety; the second is regarding the possibility that the changes will put qualified pharmacists - especially locums - out of a job.

 

‘A service-led profession’

 

The concerns described above are both potentially significant issues. But if changes are made carefully and correctly, I see a future where less stringent supervision law, combined with the Pharmacy First scheme, changes our industry for the better, making pharmacy a service-led profession where pharmacists are constantly putting all of their clinical skills to full use.

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Before I talk about the potential changes, I will first mention that I see inconsistency in current supervision law.

 

‘Times have changed’

 

While in a community pharmacy a pharmacist must be present while prescription medicines are handed out, I have noticed that no pharmacist is present for the delivery of medication to patients’ homes, which is becoming increasingly common. My point is that times have changed and legislation must be adapted to keep up.

From my perspective, the ideal scenario in community pharmacies would be to have pharmacists present in shops - whether those be large multiples or small independents - but rather than preparing and assembling medicinal products, they would be attending to patients with minor illnesses and other concerns.

There are many pharmacy technicians working in stores up and down the country who are able, dedicated and experienced professionals. And under the proposed changes to supervision law, only technicians authorised by a pharmacist would be permitted to perform tasks unsupervised.

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So, responsibility for preparing, assembling, dispensing and selling medication would not be handed to people who are not ready for it. And pharmacists, as I foresee it, would be close at hand to advise if necessary. In these circumstances, I do not believe patient safety is compromised.

As for the idea that pharmacies - principally multiples - would use the legislation to have fewer pharmacists in-store, meaning fewer shifts and lower rates for locums, I understand the source of the concern.

Locum rates dropped off significantly during the 2010s, and after somea recovery, have stalled again this year. Anything that could potentially have a negative impact on locums’ job security is of genuine worry.

 

‘It is simple economics’

 

But that is where Pharmacy First becomes important. From 2024, pharmacies will be able to access payments for offering advice and treatment for seven common health conditions.

Pharmacy First service contractors will be paid £1,000 per month for reaching a minimum number of consultations plus £15 per consultation for up to 3,000 consultations.

The demand for consultations will not be very high everywhere, and it may take time for patients to realise the extent of what is available to them in their local community pharmacy.

Read more: Back to the future: Are locum rates really higher than they've ever been?

Still, it is simple economics: if pharmacies can generate significant income from providing services, then it will be well worth having pharmacists, including fairly remunerated locums, in store to provide those services. That will, of course, mean that pharmacists are still on hand to offer advice and guidance over dispensing if required, ensuring patient safety.

We may be on the cusp of a significant change in how our industry operates and any change comes with potential pitfalls. But with careful management and input from the professionals this will impact, I think the changes can benefit pharmacists and patients, as well as the NHS.

All pharmacists are already skilled clinicians and increasing numbers of us are also independent prescribers. From 2026, all newly qualified pharmacists will be independent prescribers as soon as they register. I want to see all of us putting those skills to the best possible use.

Hopefully, with this new legislative framework, the stage is set for that to happen in a way that also has a positive impact on the health of our industry and all those who rely on it.

 

Reece Samani is CEO of The Locum App and SignatureRx

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