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Pharmacy defends against report highlighting unsatisfactory medicines advice

Practice Pharmacy leaders have defended the profession against a Which? consumer report that found that two in five pharmacies are offering unsatisfactory advice on medicines.

Pharmacy leaders have defended the profession against a consumer report's claims that two in five pharmacies are offering unsatisfactory advice on OTC medicines.

Pharmacy Voice and the Royal Pharmaceutical Society (RPS) said an undercover Which? investigation of 122 independent, multiple and supermarket pharmacies did not reflect the sector as a whole.

However, the General Pharmaceutical Council (GPhC) warned that the findings – which revealed that 43 per cent of pharmacies were giving out unsatisfactory advice by failing to ask necessary questions to check patient safety – included "some troubling results".

The GPhC and the RPS would be meeting pharmacy representatives and Which? in July to discuss how to improve the advice that patients receive in pharmacies, the RPS said.    

GPhC chief executive Duncan Rudkin said the Which? findings included some "troubling results"

More on pharmacy standards

Which? report: How pharmacy companies faired and        their responses

Deliver on quality to fend off competition, pharmacy       leaders warn

The Which? scenarios – what would you have done?


Which? mystery shoppers visited pharmacies over the course of a month, asking the pharmacist or a member of staff for the heartburn medication Pantoloc Control or the migraine drug Imigran Recovery, or complaining of persistent diarrhoea.

The shoppers gave the advice they received a satisfactory rating if the pharmacist or member of staff offered the minimum quality of advice to keep the patient safe, a good rating when more advice and explanation was given, or an unsatisfactory rating if insufficient questions were asked to check patient safety.

The 43 per cent of interactions rated unsatisfactory was nine percentage points higher than when Which? carried out a similar investigation in 2008.

Across all the pharmacies visited between January and February this year, two thirds of visits handled by members of pharmacy staff were unsatisfactory compared with a quarter managed by a pharmacist, according to results published today (May 20).

The report found that 58 per cent of the 48 independent pharmacies investigated gave unsatisfactory advice, compared to 34 per cent of pharmacy chain and supermarket branches.

The 12 supermarket pharmacies received the highest ratings. Of the 62 branches of large pharmacy chains, Lloydspharmacy received the highest rating and Rowlands Pharmacy received the lowest.  

The IPF branded the findings "disappointing", but Pharmacy Voice chief executive Rob Darracott argued that the sample size was "not enough to make any meaningful comparisons between pharmacy groups, or types".

RPS president Martin Astbury said the results did not reflect the pharmacies he knew. However, he wanted to understand the "underlying reasons" for the results and "improve consistency of the advice the public receive" when they purchase medicines from pharmacy.

GPhC chief executive Duncan Rudkin said the investigation shone a light on "both good and bad practice in pharmacy" and included some troubling results about the quality of advice given on some visits.The GPhC's inspection standards, to be introduced this autumn, would help make sure standards "designed to safeguard patients are being met", he added.

C+D put the scenarios that Which? used in their investigation to our own experts – what would you have done?

Find out how supermarkets, multiples and independents fared in the Which? report and how they responded.

What do you think about the Which? report's findings?

Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook


Super Locum,

How does this affect self selection?
Well it just goes to show the current sytem is not working.
Some places are not even offering basic advice or even asking basic questions.

I am not surprised independents come out worse in this survey. Many are just after the sale in the till. Sad really.

Those venemently opposed to self selection are probably the one who give the most unsatisfactory service. Oh the irony!!!

Small Pharm Owner, Other pharmacy staff

As an independent pharmacy owner these results are worrying. However it does seem absurd that we refuse to sell Bonjela to an under 16 to which the response is a frustrated customer who walks across the road and buys it from the post office, the supermarket, the newsagent..... Or the individual who we advise they shouldn't be taking Lemsip and paracetamol together who normally buys them from the pound shop or the petrol station. If we are to maintain high standards the profession needs to be taken seriously, OTC medicines need to be taken seriously, we should not be competing with businesses that have no standards to adhere too while we are heavily regulated. All it is doing is forcing profit and competitiveness into an equation where it doesn't belong. The answer is to continue to train staff but allow them to feel empowered by ensuring they are not undermined by non qualified yuppies, perhaps then they will feel less pressure to bow down to customer demands and make better decisions knowing the profession is held in high esteem!

Badger 75, Community pharmacist

Many of the 'unsatisfactory' pharmacies were deemed such for failing to highlight a supposed interaction between pantoprazole and warfarin. What is this interaction? Are there any case reports of adverse events? (There aren't in our 7th edition Stockley). This branch of the study would have been more useful if there was a genuinely significant clinical outcome at stake, only then would it be fair to suggest a failure to protect the public.

Syed TTR Abdulla, Non healthcare professional


Carl Schneider, Academic pharmacist

There are no surprises here. The vast majority of the simulated patient/mystery shopper research in the UK as well as overseas support the Which? findings. Rajive Patel says it right with "the worst reaction is definitely denial".

S S Locum, Locum pharmacist

I am a locum and somehow i fully agree with the findings ( even a larger sample would probably have produced a similar level of findings) , especially in the independants. When people argue that this is because of financial pressures, lack of time etc , i believe it boils down to not enough checks being made on the standards of pharmacy TEAM. It is so easy to become a counter assist or a disp assist or an NVQ (even a complete failure at school could acheive this).
The answer is - more checks on standards by GPHC and less putting of your head in sand by the profession !!!!!

Rajive Patel, Community pharmacist

S be fair you cant paint this on solely on the independents. There is clearly a structural problem with the labor pool. Financial pressures are abundant across the spectrum of pharmacy contractors, whether that be a single handed or a multiple. It is an issue for the work force, not a multiple or independent. All pharmacists should be trained to the same level, and if not, they need to be distinguished accordingly e.g. Consultant Health Adviser; Nursing Home Medicines Optimization Adviser etc.

To this end, perhaps there needs to be a new level of accreditation. I am just throwing some idea's around. However, by making comments like "even a complete failure at school could achieve this" devalues your points and brings a slant of arrogance to your post. Perhaps, with less arrogance and blame culture, all stakeholders can come to together to address a problem, that is quite clearly prohibitive to the progression of our role in primary care.

martin gibson, Locum pharmacist

We will fare much worse in the next "Which" hunt once the GPhC have allowed free public access to P meds. This will make our job harder, hamper proper counselling and DECREASE patient safety. Surely, Duncan Rudkin, you don't really want that.

John Alan James Robinson, Superintendent Pharmacist

What does this say about self selection of P meds?

Also, pantaprazole has no effect on kidney or liver function and there were very few and only minor interactions with warfarin (eu license data). WhisltI agree that best advice and practice should prevail , I do wonder about the general case whereby computer generated drug interaction warnings are ignored routinely and not reported to the GP are also a problem.

NHS risk management bodies are keen for us to report safety incidents but we don't.

The same which report criticises us for wasting valuable GP time when referring back.

To me there are lessons to be learnt but I need to know more about the methodology and assessment !

Dr Alan Robinson ,Pharmacist SE England

Career Miss Take, Locum pharmacist

As a locum I find that so many of the branches I work at are really prescription factories.The staff are stretched to the limit,underpaid and are expected to update or learn in their own time. The particular area manager I encounter the most is not fit to work in a 'caring profession and placed the most emphasis on audits and staff wages. If Pharmacists and staff continue to be treated in this way the results will remain unsatisfactory.Given the budget restraints I can only say that under the current circumstances the standards are remarkably good

Gerry Diamond, Primary care pharmacist

CPPE publishes minor illness learning packs and at the minute doing a course with paramedics and nurses on the assessment and management of minor illness which is interesting and more in depth than pharmacists experience.

I think a series of workshops via CPPE on such a topic would assist in boosting community pharmacist standards.

Leon The Apothecary, Student

I would like to see a continuation of this report, or a larger scale about a wider range of conditions, and also to revisit the pharmacies that did score poorly to highlight any improvements that have been made as a result of these findings.

Quite franky, I'm embarrassed by these results. Whereas it does not reflect the sector as a whole, I'm worried that on the larger scale these results would simply be mirrored. Every pharmacy should have the same high standards of care. To not should be seen by the whole healthcare industry as unacceptable.

I look forward to reading at how these shameful deficiences are addressed.

Rajive Patel, Community pharmacist

I know its not an excuse, but could it be the financial pressure is beginning to eat into quality. Lack of time to invest in learning, maintaining standards etc etc. Possibly, multiples pushing pharmacists to concentrate on quantitative output rather qualitative output? Poor morale? Lack of incentivised pay in the realm of public advice? Could be many things.......

When you see things like Day Lewis, devaluing the profession, by creating a bidding market place for professional service recruitment, it only takes time before you piece the pieces of the jig saw together. You pay peanuts, you get monkeys ;-)

Rajive Patel, Community pharmacist

Very patchy findings. On the whole though, bar Lloyds, Superdrug and Supermarkets, a poor rating for community pharmacy in an area pharmacy leaders are trying to champion. Possibly a wake up call? I don't know, but at least it will get the debate started and hopefully we can look at addressing these deficiencies.

The worst reaction is definitely denial.

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