On Wednesday (April 13), the Guardian published an article accusing Boots of pressuring staff to abuse medicines use reviews (MURs) for financial gain. The newspaper backed up its allegations with references to an unpublished survey conducted by the Pharmacists' Defence Association (PDA), which it claimed was completed by more than 600 Boots employees.
As well as referring to allegations that Boots managers treat the government's 400-MUR limit as a "target", it claimed that more than 60% of Boots pharmacists who responded to the survey said commercial incentives or targets compromise the health, safety or wellbeing of patients – or the professional judgment of staff – half or more of the time. This compared to 52% of pharmacists surveyed by the PDA at other major chains, the Guardian alleged.
The PDA today (April 15) provided C+D with its view on the sector's response to the Guardian's coverage.
Read Boots' denial of the Guardian's allegations here.
Mark Koziol, chairman, PDA:
Here we go again, the profession is in self-denial.
The Guardian feature dealt with a number of issues, and from these come matters about which the profession needs to have an honest conversation.
We can argue about how good MURs are until we are blue in the face, but no matter how many internal memos from superintendents, warnings from chief pharmacists or statements from the regulator there are about the need to avoid targeting, [as long as] volume produces income, then volume will be driven [by income]. As you read this article, a number of non-pharmacist area managers are eyeing up their bonus entitlements from the sales drives that they managed during the last financial year.
The current MUR scheme must be comprehensively re-engineered to enable it to focus much more upon quality and clinical care. Whether this should be achieved through a community pharmacy contract or through a direct contract with the NHS (or even both), and whether there should be a second pharmacist available in the pharmacy to deliver MURs in a more focused and productive way, are all issues that need to be considered.
There is the issue of regulation. The General Pharmaceutical Council (GPhC) has consistently stated that the best way to protect the safety of patients is by underpinning the professionalism of pharmacists.
The PDA has been providing examples to the GPhC about how pharmacists' professionalism is being undermined by employers for years, and yet the GPhC appears unwilling to go after the miscreants, focusing their efforts instead upon individual pharmacists. We need the GPhC to put a lot more vigour behind its efforts to support pharmacists.
Pharmacists join their vocation because they want to look after patients; are we happy that so many community pharmacies now resemble one almighty 'three for two' offer?
Perhaps it is unsurprising that a European Court of Justice ruling in 2009 concluded that a pharmacy owned by a pharmacist is a safer place than one owned purely by a commercial operator. Perhaps that is why, in continental Europe, many countries do not allow the corporatisation of community pharmacy and restrict the ownership of pharmacies solely to pharmacists.
Finally, we need to think about the pharmacists, like the individual interviewed in the Guardian's feature, who are being broken by the culture and business behaviour of their employers. Surely, if we want to call ourselves a healthcare profession, then we must not allow this to happen to our fellow professionals.
As members of the profession, we all know that there are very many excellent community pharmacists working hard every day throughout the whole of the UK to try and look after the needs of patients. However, unless we can address these issues, then community pharmacy will find it very difficult to lift its game and provide an improved service to the public.