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GPhC chided one Boots branch for target pressures since 2013

Boots: Took immediate action to address issues raised

Only one Boots pharmacy out of more than 1,000 inspected by the regulator has been reprimanded over targets or incentives

General Pharmaceutical Council (GPhC) inspectors have only criticised one Boots pharmacy in relation to the targets it sets its staff, the multiple has claimed.

Boots “took immediate action to address the issues raised” by the GPhC, it told C+D yesterday (April 21). The pharmacy in question was one of the 1,135 branches visited by the regulator since it updated its inspection model in November 2013, Boots added.

The health and beauty giant made the comments following allegations by the Guardian last week (April 13) that managers encourage pharmacists to abuse medicines use reviews (MURs) for financial gain. Boots told C+D at the time that it “doesn’t recognise” the newspaper’s claims, and stressed it has reminded its pharmacists of its MUR guidelines.

However, it since admitted that a single branch inspected by the GPhC over the last three years was found to require improvement on measures relating to incentives and targets".

Boots would not disclose the details of the branch or when it was inspected.

"Clear professional standards"

Boots takes reports that its pharmacists are being put under “undue pressure” very seriously, it said yesterday. It has “clear professional standards” that it adheres to, and trusts the “professional judgement” of its pharmacists, it added.

“If we find any issues of undue pressure from managers, we always seek to rectify them,” Boots said.

The GPhC revealed last week (April 14) that it is "liaising" with the Pharmacists' Defence Association (PDA) over material the organisation shared with the Guardian from an unpublished survey it claims was taken by more than 600 Boots employees.

C+D will be hosting a debate on Twitter, to discuss MURs, patient safety and targets  today (April 22) at 2pm. Join in and share your views by following @ChemistDruggist and using the hashtag #MURabuse

 

Have you ever felt under pressure to carry out unnecessary targets?

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

 

34 Comments

N O, Pharmaceutical Adviser

How many branches were inspected?? Or it was just a case of a board room tea(it is a drink right) that they decided to sacrifice one honest pharmacist?? Questions remain

Sharon Povey, Community pharmacist

I work for Boots as a store based pharmacist, and like many I have read the media reports and comments generated. I don't feel I'd have much to add that hasn't been said already, except to comment on how a minority of pharmacists view those of us who work for Boots. I ended up with Boots by chance through a series of mergers. I didn't choose to work for them and actually never wanted to, but to my surprise a change of ownership made no difference to my worklife. But I have found that now that my payslip has a different company name on it, some pharmacists view me differently. Have I deskilled? No. Have I become dishonest? No. Do I care less for my patients than I used to? No. We all need to work , and if no one worked for Boots there'd be a huge employement crisis and a patient crisis with closed pharmacies. So if a Boots pharmacist calls you to see if you have a split pack of an item in short supply to meet a patient need, please remember the patient and ignore that the healthcare professional calling you works for a company that you may not want to work for yourself. I'm constantly surprised by the attitude of some pharmacists as soon as I say I'm from Boots. I even had one customer come to me to ask if we had an item that another pharmacy owed them, and when I said I did have some and I called the other pharmacy to offer them the stock they refused to take it from me. Where is the patient care there? In the end the patient got a new script so that I could issue the item and they became a regular at my pharmacy (as they were rather appalled that the other pharmacist was happy to leave him with no medication for three weeks for no good reason). So please remember that those of us who work for Boots are pharmacists first, Boots employees second. We trained at the same universities as everyone else, and have the same patient focus as everyone else. We work hard for our customers the same as every pharmacist does. Don't allow your feelings for the company to cloud your judgement of the individuals within it.

Farmer Cyst, Community pharmacist

I agree you may have it rough, but entirely anecdotally I have found there to be a real...lickspittle attitude from the Boots and Lloyds Pharmacists I have met in my life. They are MUCH more likely to have stayed with the same company for their entire careers, and almost seem oblivious to the fact that they are playing their little part in destroying the profession, and often have been with a smile on their face for two decades.

Mike Jarrett, Community pharmacist

Hi Sharon, I've retired now, but completely agree with your sentiments. All the major multiples are the same. Pressure is put on, and you can only do your best. I worked for a small company latterly that was a pleasure to work for. They've now been bought out.           Unfortunately many pharmacists make life more difficult for themselves by not getting    stuck in and working with staff to get the jobs done. I certainly would not be enjoying getting phone calls demanding this and that, and in the past have told non pharmacist  managers that the Pharmacy could not operate with out me being present. Having said all  that ,the use of required MUR's is a good thing and is of benefit to patients, but please don't kid ourselves that there hasn't been massaging of figures from all branches of retail pharmacy

Perhaps the reason that only Boots is being targeted at this stage is because of Mr Pessina and his creative wealth creation. But they are all at it, as we all well know !! 

I worked for Boots from 1966 to 1982 , then ran my own business until 1996, then did locums for all the companies until 2007 then for a small independent until 2016 early, then Well until Dec 31st . So if anyone wants to have a go at my views,fine, but don't just comment from limited experience! 

Pill Counter, Pharmacy

The down votes sums up the make up of the profession I'm afraid Sharon. Boots get away with it all but you the individual has to carry the can.

David Sarabowski, Locum pharmacist

The GPhC is a toothless inefective talking shop. I recently made a formal complaint to them about precisely this matter, and was completely stonewalled. The situation was this;

I arrived for a one day locum booking to find a newish part time counter assistant as my only help. The pharmacist manager had left the company a few weeks earlier and the only other full timer, the dispenser, had suffered a stillbirth about a week earlier and was not going to be back for several weeks or even months. No one at head office could supply a password to get the computer going. A part time dispenser from another branch arrived to work 9.30 to 3 but had almost no experience in that store. It was nearly 10 when the part time dispenser 'phoned with the password. There was a backlog of 4 days prescriptions waiting to be done, and then head office called to remind me to get my 2 MURs done. I stated it was not going to happen today. I then recieved a second call from a presumably more senior person, which just resulted in a shouting match. This was followed by a third call from the owner insisting  that it was a condition of employment for me to do 2 MURs and that the agency knew that. This is despite the fact that I have worked for this company many times and have done innumerable MURs for them. 

I finished that day without doing any MURs but cancelled the booking for the following week. I wrote to GPhC, the CCG and NHS Northwest. GPhC said it was a financial matter between me and the company, and the other two each referred me to the other and did nothing, even though I clearly stated that the condition of the pharmacy and huge backlog of work was putting patients at risk. 

Apparently a professional's complaint of unprofessional behaviour carries less weight than a newspaper's.

Bharat Rajpra, Primary care pharmacist

Shocking replies!

Hadi Al-Bayati, Locum pharmacist

The GPhC already knows pharmacists are under pressure to deliver targets, as the pharmacists they have reprimanded for falsifying MURs have told them that this is the reason for doing so.

As for the superintendent he/she will always be a puppet and will always get a chunky pay off if their FTP came into question from this as Boots have made their money. They can always say "We changed the superintendent"

Mumtaz Jivraj, Community pharmacist

Why should the GPhC not hold the contractors especially large multiples, in charge for this undue pressure on pharmacists/managers, just because the hierachy (area managers etc) are non-pharmacists, How is this fair? Could this be the reason why pharmacists cannot voice their concerns, when they are put in undue pressure?

Mumtaz Jivraj, Community pharmacist

Can't we all pharmacists address this together as one unit, to challenge these companies to address undue pressure at work, jeopardising all parties (patients, pharmacists & staff ) safety.

Mumtaz Jivraj, Community pharmacist

Why does it require the regulator to ignite the undue pressure, elements on pharmacists? Most multiples have these pressures on their staff and no one to challenge this. All pharmacists have professional obligations, and need to voice out concerns such as undue pressure without any fear, only then can the pharmacists give exceptional patient care. 

Concerned pharmacist, Community pharmacist

Absolutely,

Speak up; don't be afraid. This is the opportunity to return to professional autonomy. Be responsible. If every single pharmacist wrote to their Superintendent spelling out their concerns then there is a chance to eliminate the target culture. The problem lies with the Phamacy contract which has created this culture. PSNC have the opportunity to address this but appear to be suggesting changes where targets will flourish. We need to grasp this at grass root level and force a rethink. Please write to your Superintendent today; there is no personal risk if we all act as one.    

Q

Sue Per, Locum pharmacist

The regulator is simply not fit for purpose, From the evidence submitted by the PDA and the overwhelming response received by the observer article, this indicates that the inspectors are either incompetent at their job, or their remit in inspecting the likes of Boots and Lloyds differs from that applicable to the rest. With the overwhelming evidence (I believe) the Regulator has no choice in the matter, but take the allegations seriously, and take some sort of action. In this case, I believe the suprintendent of Boots is vicariously liable for the actions of the managers under his command, and should face the F.T.P. If this is not the case then he has allowed his authority to be compromised by the company, which he should have challanged, and in the worst case scenario resigned.

As for the R.P. regulations they are a complete farce. The authority of the R.P. is undermined on an almost daily basis, and if ever a complain is made to the GPHC, they simply dismaiss the complaint, by saying, it is a contractual issue, as if to imply that we would have agreed to such a clause in our contract.

The GPHC has no interntion of ensuring that standards are maintained in the pharmacy.

Some of the pharmacies i have works in the MCA have not even embarked on the MCA Couse, or even achieved their accrediton after 2-3 years.Some can barely communicate in english a sensible manner, to convey important advice and message!! 

The [P], meds are sold with gay abandon, purely for profit.

Complaints regarding Pharmacists servies, suah as refusal of sale etc., are handled by Non Pharmacy Store managers, and usually results in termination of contracts. 

Suprevison is a complete nonsense, as it has been for the past few years in busy pharmacies, with high volumes of scripts, other NHS & Private services,  with a single pharmacist in charge!! 

The GPHC, refuses to look into this matter, adjudiacte on the minimum standards of skill mix per pharmacy.

The list is endless., Now that this scandal has broken, pressure shouold be piled on the regultor directly or indirectly via the newspapers, to bring about a radical change, and restore the balance of Power.

Get in touch with the Daily Mail, and Observer Now.

Shaun Steren, Pharmaceutical Adviser

Sue, you speak the truth that many people within pharmacy don't want to hear.

Paul Miyagi, Information Technology

Brilliant Sue . You can maintain anonimity with the media, if you state that is how you wish to proceed initially . So yes more pharmacists should contact the media , it by- passses the corporates lawyers and makes it more transparent so the GPhC can't " cosy up to Boots, etc".

Pill Counter, Pharmacy

According to Mr Hussain, PM and others if you're anonymous then your opinions on workplace pressure cannot be true.

Eleftheria Shingdia, Community pharmacist

The sad part of the story is that working in any community pharmacy, as a Locum or as a manager, you are judged by the quantity of services you provide and not the quality. No multiple cares about the patient outcomes in your community, all they look at are the figures!

Arun Bains, Community pharmacist

Why does the GPhC seem unable to deal with large multiples? And why do they do so little to protect pharmacists from these companies?

Meera Sharma, Community pharmacist

Definately a question that C & D should ask of GPhC!

Harry Tolly, Pharmacist

Have you seen C&D ask tough questions ?

Pill Counter, Pharmacy

They're very busy but I'm sure they'll get round to it.

Pill Counter, Pharmacy

I'm very proud of the brave men and women at GPhC.

Meera Sharma, Community pharmacist

One branch was held to account & Boots “took immediate action to address the issues raised” by the GPhC - please enlighten us, what action & how was it taken? We are in 2016, and this practice is endemic in the stores. So, is there going to be a statutory committe investigation/hearing/remedial plan - there shouldn't be one rule for pharmacists who end up on the wrong side of the GPhC and another for large organisations!

I would also urge a lot of the pharmacists to respond to the consultation on the new pharmacist standards being proposed by GPhC - yet again, no mention of pharmacy owners/companies. Where are the standards that they should be held to account over?? Or have we not learned anything from this recent media reporting?! 

N A, Non healthcare professional

I think many Boots staff don't see the issues. They get brainwashed by the company, despite years of the same rhetoric (or maybe the newer employees believe the rhetoric because they haven't heard it being recycled before).
 

Arun Bains, Community pharmacist

Epedimic is a prefect choice of words.

Harry Tolly, Pharmacist

"""However, it since admitted that a single branch inspected by the GPhC over the last three years was found to require improvement on measures relating to incentives and targets".""""

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BUT THE same target and incentive CULTURE surely applied to ALL branches then the criticism would apply to ALL Boots branches. Is Boots saying only that one branch was subject to targets and incentives ???????  How did GPhC ensure that this was not happening across the whole of Boots ??? What Inspections or additional Investigations did they carry out ?? Did they write to all Boots managers asking them to come forward confidentially ?? Did GPhC choose NOT to understand the scale of the problem ?????

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What would be interesting would be if the GPhC asked  Boots to take actions to stop this happening agian at ANY Branch. What action (if any) did Boots say they would take and how did GPhC moniter this. Did GPhC merely accept assurances ??  How did GPhC check that Boots was not doing what it said it would not ?????

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Did GPhC write to the Boots superintendent and what actions did he take to prevent this target culture ????? The superintendent is after all accountable by LAW to ensure the safe operations of all the pharmacies under his control.

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We need lots of answers from the chubby boys at the GPhC. Hiding under the desk is NOT an option.

N A, Non healthcare professional

Pharmacies have to respond to FOI requests as well as the GPhC, so as Paul said you could get some of that information from either the GPhC or Boots. FOI requests should be used a lot more in pharmacy, perhaps the C&D should submit some. Just a matter of using your imagination.

Harry Tolly, Pharmacist

Paul,  As far as I know C&D has never persued any FoI requests. Press releases are much more the style here.  Some interesting information here if you understand.

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https://www.pharmacyregulation.org/about-us/who-we-are/gphc-council/gphc-council-members

Paul Miyagi, Information Technology

Harry, if you make a Freedom Of Information Act request , your questions will be answered ( eventually if you don't get too bored of waiting ) .. Incidentally , has anyone looked up the meaning of the word "corrupt" lately to see if globalization has changed its meaning ???

Mr Pharmacist!, Pharmaceutical Adviser

The analagy follows the conservative government making noises about tax avoidance and failing to act on large offenders but targeting the "easy fish" of small offenders. There is a lot of posturing and rhetoric about attacking tax avoidance, but we rarely see large offenders being held to account. The same can be said about the GPhC that it really only targets the "easy fish" small contractors but fears the larger operators.  Again they are skillful in rhetoric but when it comes to the crunch they seem to lose their bite.  Surely this narrative puts our profession into disrepute and more importantly risks patient safety, perhaps the GPhC should be referred to its regulator.....if they have one!...or are they are a law unto themselves, like our MP's in parliament.  In conclusion, a discgraceful state of affairs.  Perhaps it is time the GPhC is legitimately criticised and challenged to improve it for generations to come. This is why there must be equality of standards, transparency, honesty and decency within our regulatory body.

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