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GPhC chief: Stop ‘mis-selling’ degrees to prevent ‘disillusionment’

Duncan Rudkin (second from left) spoke on a panel about how pharmacy can support the NHS
Duncan Rudkin (second from left) spoke on a panel about how pharmacy can support the NHS

The sector must ensure it is not “mis-selling degrees” to pharmacy students or risk them becoming “disillusioned”, the regulator's chief executive has said.

The General Pharmaceutical Council's (GPhC) Duncan Rudkin said he has “lost count of the number of times relatively newly-qualified pharmacists have told me how disillusioned they have become very quickly following entry into community pharmacy practice”.

This happened “because they thought they had been sold a degree and a career which was going to be very different from what they'd encountered”, he told delegates at the chief pharmaceutical officer's conference in London last week (March 15).

Speaking on a panel discussing how pharmacy can support a changing NHS, Mr Rudkin admitted: “It won’t be easy getting the balance right [and] equipping members of the profession for the unknowable future.”

There is a “significant challenge” in “making sure that we don't exclude anybody or create an environment in which we are effectively mis-selling degrees”, he added.

“Flying by the seat of our pants”

Speaking alongside Mr Rudkin, Health Education England (HEE) pharmacy dean Trevor Beswick said that while training programmes for pharmacy professionals to join GP practices and “emerging integrated urgent care” are commendable, the current programmes are for “specific cohorts, for a specific period of time”.

“We can't keep flying by the seat of our pants,” he stressed. “To achieve what we want at scale…we have to put in proper structures.”

If the sector accepts that GPhC accreditation following a four-year degree and one year pre-registration placement is “not enough” to secure certain roles, “it leads to the question: What do you need?” Mr Beswick added.

PSA: “Regulation is too restrictive”

Fellow panellist and Professional Standards Authority (PSA) chief executive Harry Cayton said regulation of the community pharmacy workforce “is too restrictive on the changes that we need” for the future.

“We need to build a more fluid form of regulation that allows us to bring new roles into the system quicker and better,” he added.

“We need to be thinking about what kind of mix of skills we want from pharmacists within the health system 25 years from now.”

The healthcare system will “never” be able to meet demands “if we don’t develop new roles”, he stressed.

In 2016, the PSA proposed the GPhC merge with its dentist and osteopath equivalents to form a “high-street regulator”. The GPhC rejected the proposals at the time.

Main image left to right: Royal Pharmaceutical Society (RPS) faculty and education board chair Peter Kopelman; GPhC chief executive Duncan Rudkin; RPS England director Robbie Turner; PSA chief executive Harry Cayton; Association of Pharmacy Technicians UK president Tess Fenn; HEE pharmacy dean Trevor Beswick.

What skills will pharmacists need in 25 years' time?

Brian Austen, Senior Management

Look at the contract agreed by NHS England with GPs for 2018/2019 and beyond. Then note no contract ready yet for CP. If CP had the BMA representing them things would be very different! Pharmacy has been failed so many times by its representative organisations it no longer has any leverage and is too weak to recover.

Gerry Diamond, Primary care pharmacist

A significant element of community pharmacies have over many years sapped the dispensing service dry with unethical practice. The lack of community pharmacist to be flexible and adapt in terms of the job role has also made a monolith with a static inertia which has eventually overwhelmed it and beached it like a dead whale.

Gerry Diamond, Primary care pharmacist

Too many schools of pharmacy, too many graduates, all this was predicted years ago and we are in the state we find ourselves. Community pharmacy is dead in the water.

David Miller, Hospital pharmacist

Duncan Rudkin according to article said sector not Unis were mis-selling degrees 

NB been on register for near 40 years - not disillusioned with pharmacy and wish was young enough for another 40 so much potential for pharmacy professionals now increasingly in the hands of individual pharmacy practitioners

How High?, Community pharmacist

I didn't realise you had to be newly registered to become disillusioned. Been on the register 30 years and been disillusioned 30 years. What's changed?

Reeyah H, Community pharmacist

What about the free MDS we dish out to elderly patients with dementia? Or the free delivery service (the multiples are to blame for that!). Oh and apparently we can run a business without having staff to pay. 

Clive Hodgson, Community pharmacist

Duncan Rudkin said he has “lost count of the number of times relatively newly-qualified pharmacists have told me how disillusioned they have become very quickly following entry into community pharmacy practice”.

Universities, of course, should take some blame but as they are in the business of selling it is only natural for them to talk up the prospects for the Pharmacy (or any other) degree. Caveat emptor.

No, almost all of the blame for this disillusionment comes from within Pharmacy itself I believe.

For many years now, we have had pharmacy ‘leaders’ eulogising about the glorious, progressive, clinical services driven future that awaits community pharmacists. In this future, individual pharmacists will be highly sought after, well paid, respected professionals. How many newly qualified pharmacists graduated believing this would be their future because this vision came from within pharmacy itself? 

And more. What about the real concerns of an oversupply of pharmacy graduates? No oversupply according to the RPS…..just a little underutilisation that will be easily sorted out tomorrow.

The reality of community pharmacy is so very different as they quickly discover.

They have beeen lied to by their chosen profession. No wonder they are disillusioned.

Paul Samuels, Community pharmacist

Agree 100%--oversupply/poor quality degrees/universities accredited- not fit for purpose---I can go on ad nauseum.Main concern --workplace pressures increasing for less reward equates to a very unhappy working environment


Ben Merriman, Community pharmacist

Is that a lie made by the profession?  RPS do want the "progressive, clinical services driven future that awaits community pharmacists".  That is what we are trained for and what we want to do.  Our problem lies with those at NHSE and DoH (I do prefer that to DHSC, just seems, right...).  It is these people that obviously don't want community pharmacy to do this.  

How do I know this?  Answer these and then ask me again...

Why are such brutal cuts being made to the CPCF/Global Sum?  Why are we solely seen as those who "dole out" medicines?  Why is the fee paid to us  (establishment fee) being reduced to nil?  This fee is intended to cover the costs of us just being there.  What we you get paid for reassuring a father that his 2yo girl doesn't have meningitis?  What do we get paid for advising a surgery what licensed liquids/dispersible formulations are available for a patient with dysphagia?  What do we get paid for the patient just unsure as to where else to go on a Saturday/Sunday when their GP is shut?  I'll give you a clue, if you take the number of times the letter "x" appears in my name and subtract that from the number of Concordia price hikes that have been justified, you get a total of zero.  Nil.    Null.  нуль.  Niente.  נול.  Naught.  零.

Why are those at the top not forcing (but instead politely asking, if it isn't too much bother for) local commisioning of the basic, proven cost effective services such as EHC and smoking cessation.  How, in 2018, there are areas in Egland that DON'T have a pharmacy led EHC service genuinely baffles me.

Why is the "Clinical" pharmacist programme being rolled out (a scheme I'm all in favour of in principle) seen by even our MPs as an alternative for the cuts to community pharmacy?  Whenever questioned about the cuts first announced in December 2015, the almost standard answer involved "clinical" pharmacists. (For the record, a nurse, paramedic, non GP physician working in a surgery is are not a "clinical" nurse, paramedic, physician.  Why is such a demeaning term being used?)

How on earth can community pharmacies of any size (in fact why on earth WOULD they?) provide the "progressive, clinical services driven future" given they're struggling to just do the basics?

I look forward to your reply...

Told Youso, Pharmaceutical Adviser

We won't be paid for telling a surgery what licensed products are available when the DOH know that the surgery could look it up itself... we won't be paid for telling a patient where to go on a Sat/Sun when their GP is shut as there is google for that for free... and we certainly won't be paid for reassuring a parent that his child doesn't have menigitis until the degree course is radically altered so that there is far less stereochemistry, chromatography, gram staining and molecular biology and more pragmatic clinical teaching which will allow graduates to be able to tell a corn from a verucae , the difference in appearance between a strep throat and tonsillitis and the differential diagnosis of non-blanching rashes such as those of
septicaemia, meningitis, Ehlers Danlos, pseudoxantoma. 

Clive Hodgson, Community pharmacist

Hi Ben, I am in agreement with much of what you say.

The point I was trying to make is our ‘leaders’ still seem to be peddling a hopelessly optimistic future for community pharmacists.

Funding cuts, the oversupply of graduates, the powerful commercial interests of the large multiples with their overseas shareholders, extreme workplace pressures and the generally low esteem for CP held by DoH (or whatever) are all conspiring against community pharmacists. Newly qualified pharmacists are indeed becoming disillusioned when they realise this is reality, not what they were told.


Ben Merriman, Community pharmacist

However, I am impressed that I can post Cyrillic, Yiddish and Japanese characters that our esteemed trade magazine allow you to make when posting.  I shall endeavour to find one that isn't allowed and put as much energy into forcing you to change your discriminatory policies as I do in deriding the "clinical" pharmacy programme and the hiking of debrtanded medicines combined, Waldron!!!

***This post will more than likely be edited to comply with C&D community principles***

Nat Mitchell, Community pharmacist

Ben are you OK hun?!

Ben Merriman, Community pharmacist

Yeah, thanks, sugar x

Just reeling after category M prices

Arun Bains, Community pharmacist

Disillusionment comes when you realise you wasted 4 year on a degree but end up as a glorified shop assistant being ordered around by people with two GCSE’s between them.

Beta Blocker, Primary care pharmacist

Exactly the same reason why I left community pharmacy after 5 years.... I think most pharmacists who go into community are sold a lie.

Steven Marley, Community pharmacist

Me in 2008 - Four long years and pre-reg placement ahead of me. Won't be easy, but they say it will be worth it.

Me in 2010 - Half way there. Don't like what I have been hearing about what is happening to the profession I am going to enter. I am sure it is all exaggerated. It will be ok. Half way there.

Me in 2012: Thank God it is over. Just get this pre-reg done and I will be on easy street. I am sure things will work out, despite what I am hearing.

Me in 2013: Uh oh

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