Layer 1

GPhC to consider ‘interim measures’ for new pharmacists to prescribe

The GPhC won’t wait six years to introduce prescribing to pharmacists’ training
The GPhC won’t wait six years to introduce prescribing to pharmacists’ training

“Interim measures” could help foundation year pharmacists “move quickly into prescribing” after they qualify in 2022, the GPhC has told C+D.

Pharmacists completing the foundation training year in 2022 will not be registered as independent prescribers at the point of registration – which is one of the aims of the newly approved standards for the initial education and training (IET) of pharmacists – General Pharmaceutical Council (GPhC) CEO Duncan Rudkin told C+D earlier this week (December 14).

This is because “prescribing is not an add-on” and “preparation for acquiring prescribing-related skills… is something that needs to be integrated through the five-year programme”, Mr Rudkin added.

However, he said the GPhC will work with its partners to introduce the “key change in terms of prescribing at the earliest opportunity” without having to wait six years following the introduction of the new IET standards, which will see a “continuum of five years of education and training” from September next year.

The GPhC will need to understand how “quickly we can implement prescribing for new registrants” and, “for those who are already in training and already qualified, how can we enable them to [proceed into] prescribing safely but also as quickly as possible, perhaps with an interim phase but sitting alongside the longer-term change”.

During the first half of next year, the council will work with partners to consider whether some “interim measures” could move new pharmacists “quickly into prescribing” but in “a safe way, so that people can feel confident going through prescribing”, Mr Rudkin added.

Last week (December 10), the GPhC approved the new pharmacist IET standards, which will make prescribing skills an “integral part” of pharmacists’ training.

Need for pharmacist independent prescribers

GPhC chair Nigel Clarke, who also spoke during the call with C+D earlier this week, said the move to prescribing is “not something we at the GPhC are pushing”.

Rather, the regulator is “responding to the wish of people employing pharmacists, especially the NHS, who made it very clear to us that they really want to see this in place in terms of training and as a sort of core skill for pharmacists going forward”, Mr Clarke said.

“I think that much of the speed of work around this has been because the NHS wants to see pharmacists playing this role to a much greater degree. That’s why we wouldn’t be waiting six years to see this happening, we need to be doing it quicker and need to work closely with a lot of people to ensure this can be done safely,” he added.

Mr Rudkin said the GPhC is seeing a growing demand for “clinically-minded pharmacists who are able to prescribe” across Great Britain and while the recently approved IET will “apply to the new entrants to the profession”, the council will also work to understand how pharmacists who have already qualified can benefit from a shift towards prescribing.

The GPhC will also work to overcome the challenge flagged in November by its IET advisory group – which suggested there might be an “insufficient” number of designated prescribing practitioners to supervise pharmacy trainees during the new foundation training year, Mr Rudkin said.

Other changes to the IET standards include the introduction of a foundation training year – which will replace the pre-registration year – greater emphasis on the application of science in clinical practice and a focus on key skills such as diagnostic and consultation abilities.

The new standards will “inform” pharmacy schools from next year, Mr Clarke told C+D.

What do you make of the new IET standards for pharmacists?

R A, Community pharmacist

Yep I was afraid of the new prescribing skill of pharmacist being commoditised and here we are at the end of 2020 marking new suffering for pharmacists, who invested time and skill to build some career stability with new skill set. 

This is no different to what happened to my year group in 2006 when we started our undergraduate studies at a prestigious red brick pharmacy school blissfully unware that almost all Universities which were formerly polytechnic were opening their own pharmacy schools catering to the group who couldn't get into the red brick pharmacy school. 

Fast forward to 2011 when I qualified and realised how stupid I was for studying pharmacy. At least I learnt my mistake and did not jump into the prescribing boat. Also with the advent of digital healthcare the locum GP will get a nasty shock because in years to come they will find themselves being made redundant. A brave new decade we enter!

Gerry Diamond, Primary care pharmacist

Community pharmacists are essential part of the primary care team, and I think a prescribing service tailored for community would be a tremendous plan. I feel as a prescriber a greater clinical role in partnership with GPs would be exvellent.

Leon The Apothecary, Student

I recall a thinktank a while back who considered a new paradigm. The GP would diagnose a condition, then the pharmacist would prescribe according to that diagnosis. It was an interesting idea.

R A, Community pharmacist

I think the rapid shift in AI and mobile technology i.e. smart phones and smart watches has convinced me that there will be huge changes for GP and Pharmacist job in the future. A key area that could potentially be automated is routine prescribing. After all if your smart watch can run diagnostics such as Blood Pressure, Heart Rate and Blood Sugar Level and Mobile Phones have advanced affordable scanners to take images and run ultrasound scans it will be a paradagim shift in delivery of affordable healthcare. 

Since each individual can in theory receive 24hr automated healtchare and be flagged to see a physcian when required. In the process it completely changes the allocation of GP resource. Unfortunately I think this means the prescribing 'skillset' of a pharmacist may become redundant. 

Michael Mustoe, Community pharmacist

My personal experience, underlined in bold this year, is very clear. The public love our pharmacies, and the services that we provide. They find the professional, friendly and easily/readily available Pharmacist a true blessing. They just want us to be able to provide more services for them. So, for example, in Wales, a big extension and upgrading of the good Common Ailments Service would be very well received, and a great way forward. It really isn't rocket science. Just get on with it - NOW. 

We don't need any more reports, just a good dose of common sense, and action

Benie Locum, Locum pharmacist

Most Locums and employee pharmacists are looking for any route out of community pharmacy. 

Leon The Apothecary, Student

£5,000 a year non-repayable grant to study any AHC course, with an additional £3,000 a year for needed professions, high demand, and dependant cover.

A LOCUM, Community pharmacist

I really don't see the point in adding more prescribers in the same inaccessible building hiding behind a team of receptionists , what the public want is to walk into a phamacy and see a prescriber face to face immediately , they're training the wrong lot.

Axed Locum, Locum pharmacist

The service in the community sector will be commoditised, and treated like a cash cow, whose udders the greedy contrctors will look to squeeze, by setting targets and bullying.. Best to deliver the services through the pharmacists in the GP surgeries. The greedy contractors will pay nothing to the pharmacists (Employed and Locums) . They will strech and extract using future bookings as a "ransom strip"

Benie Locum, Locum pharmacist

Not when pharmacists are treated poorly by their employers and remunerated at 2010 levels. Naturally when given the option of an escape route they will exit.

Adam Hall, Community pharmacist

While I appreciate and applaud the need for the profession to move forward, what about all those existing pharmacists who have decades of learning & experience? Are they to be relegated to the more menial pharmacy tasks, or thrown on the scrapheap completely? It's all well and good to have shiny new pharmacists with their shiny new prescribing qualification but we all know the reality - they will know nothing other than has come out of a book and will be at least 5 years in the job before they are of any genuine use. Let's not be so focussed on gazing into the future that we ignore what is under our feet

TC PA, Community pharmacist

I think it is pretty clear that most of the roles a community pharmacist performs now will cease in the not too distant future and there will be a lot less pharmacists required. A combination of  hub dispensing/online/automation/remote supervision/funding cuts will reduce the need to employ a pharmacist in a bricks and mortar pharmacy to spend 90% of their time putting initals in a small box or to source an item below DT price.

The GPHC are well aware of this, hence why they are implementing these changes. GPs want ready made prescribers, whether they have any relevant experience in dealing with patients is besides the point.

John Ellis, Community pharmacist

Automation automates dispensing not clinical checking, pharmacists would still be required, but I do agree there won't be a need for so many. Prescribing will take away work currently performed by GPs/Nurses allowing them to take on more complex roles. But there still would be a huge demand and need for a local community pharmacist, but it may no longer be a publicly funded role.

Leon The Apothecary, Student

I believe that for Pharmacists to truly engage in such an endeavour, there needs to be a fundamental change to the framework of what pharmacy provides from a dispensing structure to a pharmaceutical services-based one.

As it stands at the moment, putting a PP into a building does not create an effective system. The profession as well as a professional needs to be enhanced in equal measure.

Angela Channing, Community pharmacist

Leon, this has been going on for a quarter of a century! Back in around 1995/1996 Anne Lewis as Registrar helped launch PIANA, Pharmacy In A New Age.

It never took off really and was quietly dropped until we had the new contractual framework in 2005 introducing MURs. This could have been a useful start at providing a clinical service, but by not getting GPs on board by at the beginning by explaining to them what they were all about, most GPs either ignored them, or got angry. Then the multiples made the 400 a target and not a limit, and then tales of bullying in some chains, then the stories emerging in the Guardian newspaper, and the GPhC cases of fraud slowly led to their demise, which will occur next spring.

The problem has, and always will be, the balancing of professional interests against the commercial needs of running a business. Hence, the training of so-called clinical pharmacists to work directly for GPs in their surgeries. 

And the last but one paragraph above, which I quote here:- 

"Other changes to the IET standards include the introduction of a foundation training year – which will replace the pre-registration year – greater emphasis on the application of science in clinical practice and a focus on key skills such as diagnostic and consultation abilities"

Now, how useful will that be to the average community pharmacist churning out 500 items a day?! Which brings us full circle, back to your statement, 25 years on from 1995 fundamentally stating what was supposed to be developed back then. 

And for the dinosaurs amongst us, you can go even further back to the Nuffield report circa 1986, which although focusing more on hospital, was making the same point, how to actually utilise pharmacists' knowledge for the greater good of the NHS. 


Leon The Apothecary, Student

Pharmacy does seem to be stuck in limbo. I would speculate that because GP and pharmacists are set up funding-wise to be in competition with each other, you end up with them being in competition with each other!

Sounds tautological, but as I said previously, fundamental change is required.

Chemical Mistry, Information Technology

Bloody hell I remenber all them reports done by pen pushers which produced sweet FA, wish I could get roles like reinventing the reports every 10 years.Also forgotten is that need to get the public on board and accepting pharmacists and their role as part of the MDT rather than all wanting to see the GP all the time. Finally would be better to have prescribers in the community able to prescribe out of stock meds and people who have ran out medication during the weekend rather crap 111


Job of the week

Support Pharmacist
Queen Elizabeth Hospital and Heartl
up to £47,500 dependent on hours (30-40 hours flexible)