The Royal Pharmaceutical Society (RPS) last week revealed that it is now “supportive” of making P-meds available for self-selection, despite previously being opposed to the practice.
But the PDA yesterday (July 23) hit out at the move, branding it “misguided, premature and potentially harmful”.
It said that it is “deeply concerned and holds strong opposition to the RPS endorsement of facilitated [P-med] self-selection”.
Read more: RPS U-turns to new pro P-med self-selection stance
“This position, while perhaps well-intentioned in seeking to modernise access, is fundamentally flawed in its assumptions, lacks sufficient evidentiary support and risks undermining patient safety, professional standards and public trust in pharmacy practice,” it added.
It said that the RPS’s new stance “contradicts its own long-standing professional standards”, creating “confusion among pharmacists and the public” and “weakening the clarity of professional guidance and regulatory expectations”.
And it added that the RPS’s “alignment” with the GPhC’s “misleading” terminology around “facilitated” self-selection “without robust scrutiny is deeply troubling”.
Sales over safety
The PDA urged the RPS to “reaffirm its commitment to the prohibition” of the practice and engage in a “transparent, profession-wide consultation before endorsing any policy change”.
And it called on the membership body to “prioritise patient safety and professional integrity over convenience or commercial interests”.
“Until such steps are taken, the PDA will continue to oppose any model that dilutes the pharmacist’s critical role in safeguarding medicine use,” it said.
Read more: ‘Overwhelming opposition’: 93% of pharmacists reject P-med self-selection
It added that facilitated self-selection and supervision reform could together “create a dangerous vacuum in professional oversight where no one is clearly accountable for ensuring the safe and appropriate use of P-meds at the point of sale”.
And it said that despite an “emphasis on prevention of harm from medicines” in the NHS 10-year plan, “changes in pharmacy practice are emerging that could contradict government policy and that undermine the professional position of pharmacists as guardians of medicines safety”.
The PDA has launched a survey to “understand pharmacists’ awareness and views on facilitated self-selection” including the “clinical and safety implications” and to ensure their “voices are heard”, it added.
“Unacceptable risks”
The PDA stressed that its February report on self-selection presented “overwhelming evidence that any form of self-selection, facilitated or otherwise, introduces unacceptable risks”.
These include inappropriate use and misdiagnosis and increased and avoidable adverse drug reactions due to the “dangerously optimistic” assumption that patients have enough health literacy to “safely self-select”, it said.
Self-selection also “reactively engages the pharmacist after the patient has made a choice”, leading to “resistance, confrontation or even violence” amid escalating tensions in pharmacies, it added.
Read more: PDA slams ‘disingenuous’ RPS as P-med self-selection row rages on
It said that the practice “risks shifting the pharmacy model from healthcare-led to retail-driven, where commercial incentives may override clinical judgement” – with pharmacy owners “prioritising sales over safety, especially in large multiples”.
And it claimed that facilitated self-selection is “at odds” with legislation requiring that P-meds are “sold under the supervision of a pharmacist”, saying that “no compelling new evidence has been presented to justify reversing” its prohibition.
This shift could also “jeopardise future prescription-only medicine (POM) to P-med reclassifications as regulators may no longer trust that pharmacist oversight is meaningfully maintained”, it added.
RPS: ‘Ongoing research’ needed
When approached by C+D for comment, the RPS pointed to its previous statement outlining its new position.
It last week stressed that pharmacies operating this model “must meet regulatory standards” and that all staff involved “must be appropriately trained and supported”.
And it said that the model “may not be suitable to operate in all pharmacies”.
Read more: RPS supports DH move for more POM to P reclassifications
“The responsible pharmacist must have confidence that the processes in place ensure any identified risks are mitigated or minimised and patient safety is maintained” – and that they are “able to appropriately supervise” P-med sales, it added.
The RPS also recommended “ongoing research into the risks and benefits” of “facilitated” P-med self-selection and the implementation of “mandatory training for pharmacy teams operating this model”.
The PDA revealed in February that 93% of over 1,300 pharmacists responding to a “snapshot” survey “opposed the concept of self-selection”.
