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How did supervision proposals advance so far without a consultation?

"Where was the consultation to decide whether freeing up pharmacists is a priority issue?"

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

Do you agree with Mr Waldron's comments?

Retiring Locum, Locum pharmacist

This has made up my mind for me. After 40 years on the register, I will be retiring at the end of the year and am feeling very relieved to be in a position to do so. The status of a community pharmacist has been undermined and diminished over the years and this could be the final death blow. Perhaps, the protagonists of these proprosals should be forced to work in a busy community pharmacy dispensary to see just how necessary it is to have a pharmacist present at all times to supervise all pharmacy processes.

Zaffar Mohammed,

how is it possible to make a technician legally responsible for clinical check? Can they do clinical checks or for that case faster than a pharmacist? How will they answer technical queries from GP's, nurses and patients? Does their training allow for that?

Its most confusing. DoH wants to make revenue decisions is this the best they can suggest "get rid" of Pharmacists?

donna bartlett, Pharmaceutical Adviser

my understanding of the proposal is that technicians will be able to supervise sales and allow both already checked and bagged precriptions  leave the premises and to remain to check precritipons that have already been clinically checked (as the ACT does now) they will not be performing a clinical check .  In hospital  and at the CCG's technicians already answer technical queires from all profesions but i think the point you make  around training is a good one and these processes need to be looked and and safegaurds put into place. another point to think about is "do community technicans what this responsibily , are is this going to start about debate over increased pay ? The pay gap between community techs who may be expected to do this and hosptial techs who are already doing something similar can be quite large. How are community to fund this when they are already being squeesed for money.

Retiring Locum, Locum pharmacist

There is a world of difference between hospital and community pharmacy. One main difference is that the 'Responsible Pharmacist' on duty in a community pharmacy is held responsible for the actions of all staff, including technicians and ACTs. So, if a dispensing error occurs, it is the individual pharmacist who will be held to account.

M Yang, Community pharmacist

It's funny how the PDA was conveniently excluded from this stakeholder meeting. The implication would be (apart from obvious corruption in the echelons of power) that the government is afraid of the PDA because it's the only organisation representing pharmacists that has the ability to organise the pharmacists to challenge such proposals. Perhaps a judicial review can be sought? The PDA must also reach out to the public, let the patients in our communities know the government is sacrificing everything for short term profit. We need to ask the public if they'll choose between a) health and beauty stores with a dispensing factory ran without the proper knowledge and skill or b) having your prescription needs fulfilled by real pharmacists.

Stefano Pesstaker, Pharmacist Director

"Openness and transparency".  Mmmmmmmmmmmmmmm

Meera Sharma, Community pharmacist

Excellent article - let's see what the DH and associated organisations in this debate have to say.

Anonymous Anonymous, Information Technology

Yeah good luck with that... I know they will have two words to say to us and the second will be "off"

Locum Pharmacist, Locum pharmacist

Buzz off?? Lol. DoH has Hunt and his reputation as caretaker of health is outstanding. Really, second to none. Just ask the junior docs.

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