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Hunt responds to concerns about pharmacy supervision plans

Hunt: Supervision discussions will support more agile pharmacy workforce
Hunt: Supervision discussions will support more agile pharmacy workforce

Jeremy Hunt has sought to “reassure” a locum pharmacist about rumours that the government will allow pharmacy technicians to legally supervise medicines supply.

Contractors warned Royal Pharmaceutical Society assembly candidates last month that “many community pharmacists are extremely concerned” that a Department of Health programme board plans to “empower pharmacy technicians to supervise pharmacies” as part of its strategy to “rebalance” pharmacy legislation.

But in a letter sent to Labour MP Hilary Benn earlier this month, health secretary Mr Hunt said “the government has not brought forward any proposals to allow pharmacy technicians to supervise pharmacies”.

The “discussions around the role of pharmacists in pharmacies” are part of a wider strategy to “support a more agile pharmacy workforce”, Mr Hunt stressed.

The aim is to “make the best use of the skills and knowledge of pharmacists”, as well as better integrating them with a range of “other healthcare professionals in other settings”, and “us[ing] their clinical skills to optimise the use of medicines”, he added.

“Diluted” responsibilities

Mr Benn – MP for Leeds Central – contacted the Department of Health (DH) on behalf of his locum pharmacist constituent Ubaid Ur-Rehman, who told C+D he had been concerned his responsibilities as a pharmacist were being “diluted”.

“When I first entered pharmacy, I thought I’d be going into a solid career. But as time has gone on, I am starting to realise that it is not what I thought it was,” Mr Ur-Rehman told C+D this morning (August 21).

“I just want some clarity on what is happening with [the profession].”

In his letter, Mr Hunt said he “agree[s] with Mr Ur-Rehman that adequate governance must be in place if we choose to make legislative changes to the current supervision requirements”.

“Other elements of the rebalancing programme reinforce this, with every pharmacy required to have a responsible pharmacist when it is operating,” Mr Hunt said. “The proposed changes will strengthen the governance provided by superintendent pharmacists and responsible pharmacists.”

Mr Hunt “reassured Mr Ur-Rehman” that “any proposed changes to legislation will be subject to full consultation”.

You can read the full letter from Mr Hunt here.

Are you reassured by Mr Hunt's explanation about pharmacy supervision?

Ilove Pharmacy, Non Pharmacist Branch Manager

As soon as Boots sort out his post cabinet retirement plan supervision plans will be implemented.

Meera Sharma, Community pharmacist

I am reading between the lines here (and happy to be proved wrong), the article doesn't say it is a no - simply states that it is part of a bigger review and also goes on to state that not without full consultation. Why would this even be mentioned if remote supervision wasn't being looked at?? Personally, watch the space - there are too many workforce changes, so who knows!

mark straughton, Pharmaceutical Adviser

I personally don't think there's a problem with remote supervision; or more specifically the notion that a pharmacist doesn't need to be constantly on a pharmacy premises. Look at dispensing doctors, they can run off technicians safely or even look at some pharmacies which have an MDS room separate from the dispensary and the pharmacist spends the majority of an afternoon checking trays (remotely). Yes there will be occasions advice from a pharmacist is needed, whether it's for an OTC advice/ minor ailment/ drug interaction, but the reality is on a large health economic scale this doesn't justify the one for one wages an average pharmacist might expect to receive (eg £40k a year for 40hrs/week).

Bear with me here.............

The biggest con in all of this over the last 15years or so has been the development of the new pharmacy contract mid-2000's which pushed a service driven agenda- a move away from the supply function- but without the sufficient funding (ie the repackaging of funding which introduced cat M and MUR fees- overall the pot of money decreased). There's no incentive to become a service focused pharmacist when the majority of funding still lies with dispensing. A pharmacy (non multiple) would rather increase business by 500 items per month consistently then do any MURs in a year- it grosses more! Hypothetically, a pharmacy with a pharmacist which opperates solely on NHS commisioned and private services will not produce a business model which will not sustain a pharmacist on £40k a year for 40hrs.

Along with this came a huge increase in the number of pharmacy schools which led to increase in the number of pharmacist from 45,000approx in 2010 to well over 60,000 now. Furthermore, there's a fraction proportion number of 'new' pharmacist integration roles whether that's in GP surgeries/ CCG roles.

The question is where are these pharmacist going to work if remove supervision comes into effect? Indeed, I suspect most would be happy to move on from checking prescriptions as a primary role to more clinical roles but the fear and objection to remote supervision is where their job lies afterwards. We've got no credibility from the public or MPs if our arguement is here!! This along with the excess pharmacists and the supply and demands economics/ the corporate drive of the multiples/ the cuts by the DofH/ lacks of unity within our own profession means in the prospects in the medium term for the average pharmacist is abysmal.

Leon The Apothecary, Student

I look forward to seeing clarification on what Remote Supervision even means, definitively. I'm quite outspoken when it comes to RS, but I always believe in the clinical knowledge of a pharmacist needs to play a part in the construction of that prescription, and clear lines of referral are critical.

Who knows? Maybe the comprehensive idea of what RS entails won't sit well with me. It's important to be open-minded to these things.

Ilove Pharmacy, Non Pharmacist Branch Manager

You hit upon the BIG lie which is still being spewed by those with a vested interest(including C&D). So called services. Anyone with half a brain realised from the outset that these simply are not financially sustainable and this is why the likes of Boots and Pharmacy2U concetrate the efforts in stealing your patients and their prescriptions. This is where the remaining money lies in community pharmacy-sheer volume of prescription items.

Leon The Apothecary, Student

I think pharmacy has already seen how sheer volume is being addressed with distance selling pharmacies and hub and spoke dispensing using robotic dispensing methods. Speaking logistically, you don't see Amazon having multiple smaller shops in each town, and financially, the reason is clear.

Ilove Pharmacy, Non Pharmacist Branch Manager

'Clinical' services were made up as a smokescreen to keep pharmacists distracted whilst systematically reducing pay and conditions. To be fair it has worked a treat as now most have woken up it's too late to do anything anyway. Pay and conditions will keep going one way and Boots,the multiples and the government have got what they want.

Dave Downham, Manager

It's not a "no", is it?

Leon The Apothecary, Student

I have yet to see Mr Hunt give a straight answer to anything. Some would say he is the model politician.

Muhammad Siddiqur Rahman, Primary care pharmacist

What more does Jeremy Hunt have to do to convince you guys lol!
Why is this talk about remote supervision not going away yet?

Leon The Apothecary, Student

I believe positively or negatively, it is important to keep talking about it. An unchallenged idea will never be good, nor would an idea that couldn't answer it's critique.

Stephen Walsh, Community pharmacist

Hunt. Reassure. Not words I think I've ever seen in the same sentence.

A Long Serving Pharmacist, Community pharmacist

I do not trust a word Jeremy Hunt says! Be afraid! Be very afraid! 

Christopher Smith, Community pharmacist

You can see a trend here of underskilling, Police community support officers, teaching assistants, both these roles were cost saving at the expense of  the more exspensive and  trained professional!. If  I was at the begining of my career and not the end, I would be very worried.

Pharmacist Pharmacist, Community pharmacist

The saying, no smoke without fire, comes to mind. Remote supervision has been on the agenda for many years. It is the greatest cost saver, because the biggest cost in a pharmacy business is the pharmacist itself. 

The role of technicians have been developed, there are more registered technicians on the GPhC. Does anyone really think the Government is just doing this for no reason? 

The day is not far when there will be remote supervision, I can see it happening before the current Government term is over. 

Mr Hunt is capable of anything, if he wills he can change the current supervision laws and nobody will be able to do anything. It will be pointless protesting, just look at the Junior doctors contracts and so many other changes in the NHS he is responsible for

Leon The Apothecary, Student

I tend to agree, although I also want RS to be challenged and critiqued in every stage. If the government has decided this needs to happen, then I would be happier knowing that RS was made at least the best possible form it could be.

Edward H Rowan, Locum pharmacist

You might not need to worry if you're a "non-pharmacist branch manager". How do you envisage the best possible form of RS?

Leon The Apothecary, Student

An excellent question. My first aspect requires Pharmacy to know, in total clarity and detail, what RS even means.

Rudimentary example does RS mean that a pharmacy can run unrestricted whilst an RP is having a lunch break off site as long as there is a qualified technician, or are we looking at multiple pharmacies within a reasonable distance to be looked after by one RP, or are we looking at a much grander scale where an RP only needs to be connectable at all times.

Three different definitions of RS. Clarification differently important here.

Edward H Rowan, Locum pharmacist

Well who knows? Anyone over 40 will be hoping that they will be well on the way to retirement before any of this has any impact. Anyone under 40 should either train to do something else or emigrate.

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