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RPS clarifies stance on remote supervision after pharmacists’ concerns

RPS: Exceptions to the responsible pharmacist supervision rule should happen “only in emergencies”
RPS: Exceptions to the responsible pharmacist supervision rule should happen “only in emergencies”

The Royal Pharmaceutical Society (RPS) has clarified its position on remote pharmacy supervision following backlash from pharmacists on Twitter.

In its response to a government consultation on the “roles and responsibilities of pharmacy owners, superintendents and responsible pharmacists” – which closed on Tuesday (September 11) – the RPS said it was in favour of allowing regulators to make exceptions to the rule that responsible pharmacists can only be in charge of one pharmacy at a time.

“Being the responsible pharmacist in charge of one pharmacy at any one time should be the norm,” the RPS said. “We expect any regulator to make this clear but to allow exceptions for emergencies where patient care would be compromised, such as extreme weather or a pandemic situation.”

Following the RPS statement on Wednesday (September 12), pharmacists raised concerns on Twitter that the society was condoning the running of pharmacies without a pharmacist present.

Community pharmacist Sham Kiani said the RPS’s statement was “remote supervision via the back door”, while Tohidul Islam, founder of The Pharmacist Cooperative, said he was rethinking his membership as the society's “tacit approval of remote supervision…doesn’t represent me or the majority of our profession”.

Further clarification

In a further statement issued yesterday (September 13) afternoon, RPS president Ash Soni stressed: “The RPS has always been clear that every pharmacy should have a responsible pharmacist.”

Both the organisation’s policy summary and its latest medicines, ethics and practice guide “clearly” reinforce its view, Mr Soni added.

The RPS said that a responsible pharmacist should be allowed to supervise more than one pharmacy “only in emergencies”.

“We will be challenging the General Pharmaceutical Council to make sure there is a defined and specific description of the ‘exceptional’ circumstances where pharmacists, not employers, would use their judgement to make sure patients have access to essential medicines,” Mr Soni said.

“We recognise there is a spectrum of views and will make sure members have opportunities to shape this work.”

Read the RPS’s response in full here.

How did the other pharmacy bodies respond?

In its consultation, the Department of Health and Social Care board set up to ‘rebalance’ pharmacy legislation asked: Do you agree that the pharmacy regulators should have the power to make an exception to the general rule that a responsible pharmacist can only be in charge of one pharmacy at one time?

The National Pharmacy Association (NPA): Consultation “rationale is unclear”

“The NPA policy does not support remote supervision, for example for the responsible pharmacist to be in charge of more than one pharmacy at one time.

“It is unclear from the rationale outlined in this consultation as to the criteria that would be presented in order for the regulator to make an exception to this rule. The NPA asks as to whether this would be in routine circumstances or in exceptional cases such as adverse weather conditions or a ‘major incident’ situation.”

Read the NPA’s response in full here.

The Company Chemists’ Association (CCA): Change rules only in “rare force majeure exceptions”

“Overall, we continue to support the principle of ‘one pharmacy, one pharmacist’ because to remove this would be to materially change the role and nature of the responsible pharmacist.

“However, we agree in principle that pharmacy regulators should have the power to make exceptions to the rule that responsible pharmacists can only be in charge of one pharmacy at a time.

“We could particularly envisage that there may be some rare force majeure exceptions where the responsibilities of the actual or intended responsible pharmacist could be temporarily taken on by a pharmacist already fulfilling the duties at another pharmacy.”

Read the CCA’s response in full here.

The Pharmacists’ Defence Association (PDA): Patient safety is at risk

“This would create an unacceptable risk to patient safety and expose pharmacists unfairly to criminal and civil prosecution and regulatory sanctions, in working conditions that at present are poorly regulated, and for activities that occur in pharmacies in which they are not even present.”

Read the PDA’s response in full here.

The Twitter reaction
What do you think about the RPS's statements?

Harry Khan, Pre-reg Pharmacist

a slap on those pharmacists that still subscribe to an overated organisation, that only seems to be interested in its self preservation, one of these reasons the pharmacy is in state that its in is is because of RPS , when they were RPSGB, didnt give and still dont give a damn about the profession!!

CAPT FX, Locum pharmacist

I have never been and will never be a member of the Royal Pharmaceutical Society. I do not know what their purpose is and more importantly nothing they have said or done since their creation affected me in any way.

This was once again an occassion where they were at odds with conventional thinking in the profession. Our livelihoods in this warped profession depend on the one Pharmacy, one Pharmacist principle. Anyone adopting a permisive attitude in this regard does not understand our situation. Remember we are in this unacceptable situation not out of choice. We trained as Professionals but somehow we ended up ticking and signing boxes. This was a massive concession on our part. So for anyone to come up now and try to review this is tantamount to destroying our profession. So for the RPS to issue such a permissive statement is tantamount to collusion with those who want to destroy our livelihoods.

If anyone wants to reform Pharmacy, dont tamper with the one Pharmacy, One Pharmacist principle, you will have your fingers burnt. For the RPS , continuing with this permissive stance thinking this is reform is dangerous. You are quietly paving a highway to oblivion. My question still is that why respect the opinions of a moribund organisation which is barely respected or does anything tangible for the Profession.

To the Pharmacy owners, if you feel employing Pharmacists is beyond your means, lobby and convince Government that you can provide the same quality service with Technians and other staff who barely passed GCEs. Dont hide behind us.

Peter Sainsburys, Community pharmacist

I think the only people who joined the RPS where people whose employers paid the fee, and I'm sure that even they are disappointed with their impotent behaviour, money would have been better spent elsewhere.

Benie Locum, Locum pharmacist

There are actually jobs outside of community pharmacy. Better pay, more respect and less responsibility. Non contractors should seriously consider them.

John Smith, Academic pharmacist

What happens to pharmacists' jobs if this goes through?

It's hard to believe people could be so naive as to think the big multiples won't exploit the exceptions as far as they can to the letter of the law, or that pharmacists will be free to make professional decisions in some fairytale wonderland. I reckon if people who say that are not naive then they're lying.

Pharmacist was late? Emergency. Planner couldn't find a pharmacist? Emergency. Locum wants an extra £1 an hour which we're not prepared to pay? Emergency. Who's going to police it? Some pharmacies already deliberately open without a pharmacist and know they'll get away with it. Then in a few years time they'll say 'oh look at all these emergencies, how about pharmacy technician supervision'? Maybe even remote pharmacy technician supervision? etc

Not only do I see this as a gross error of judgement from the RPS, but I think they've shown disdain for pharmacists. One senior person seemed to be saying concerned pharmacists were trolls and they seem to be trying to fob pharmacists off with ambigious waffle like "one pharmacy one RP" (omitting to mention the exceptions they support and that the RP might be working remotely). Many elected board members are saying nothing. Does the RPS force them in to silence, and if so why do they agree?

We need the role of the pharmacist to evolve but they're trying to build the house without any foundations, using cowboy builders and without talking to the future tenants about what they want. Oh yeah, there might not be any future tenants.

Maybe pharmacists should look for an alternative to the RPS. They can't put up with this any more.

R A, Community pharmacist

Excellent points raised I have tried to discuss these issues with many pharmacists. The response I have received range from being aware of the issues to indifference or ignorance. Most people who are aware of the issues are retiring whilst the individuals who are indifferent are financially tied to the job.

One thing I will say is that I am interested to see how Pharmacy Schools will spin this to prospective students?

Peter Sainsburys, Community pharmacist

I wouldn't be surprised if the multiples have already completed projections to predict how much money they can grab when remote supervision comes in. Of course, none of the pharmacy staff will ever see any of that money. Being able to reduce the number of pharmacists you need by 50% is a dream come true for them!

DM X, Locum pharmacist

"tacit approval of remote supervision…doesn’t represent me or the majority of our profession”. I would argue and say that the toxic environment created by the cooperative and its telegram groups are not representative of anyone.

Muhammad Siddiqur Rahman, Primary care pharmacist

"We oppose the remote supervision of pharmacies, we oppose not having a responsible pharmacist physically present per pharmacy and we oppose any deviation from one RP per pharmacy." That's what Pharmacists want to hear from the RPS and The GPhC and kill the threat of remote supervision completely.

Cathy Cooke, Hospital pharmacist

Agree with Stephen Eggleston, it’s hardly going to be an opportunity for employers to make it the norm.  The responsibilities and accountabilities for superintendent and responsible pharmacists is proposed to be changed to make the SP more accountable and the RP accountability more reasonable (from what I could see).  It would be up to the RP what elements of service they would be happy to oversee remotely.  Highly limited, I’d suggest.

Peed Off Superintendent, Superintendent Pharmacist

An 'emergency' is having a pharmacy open without a pharmacist. RPS have clarified that they support remote supervision in these cases. This is a non article......If you are a locum you are stuffed!  good luck!

R A, Community pharmacist

Exceptions to the responsible pharmacist supervision rule should happen “only in emergencies” like closing the store or using a non-pharmacist to operate the store on a day to day basis.

Given the fact that the government is indifferent to the contribution the pharmacists make to patients healthcare I guess they won't kick up a fuss.  

Peter Sainsburys, Community pharmacist

The big chains say that pharmacists only self-check in exceptional circumstances. But the reality is that you have to do it every day.

The same will happen with being the RP for more than one pharmacy. Mark my words.

"Exceptional circumstances" basically means that it is allowed and the big chains will capitalise on this massively. Get ready for no locum shifts and massive wage cuts.

If you're a pharmacist in the UK under the age of 35 or have other skills/interests that you can capitalise on you should be running away. FAST!

By the way, the RPS is about as much use as as ashtray on a motorcycle.

Benie Locum, Locum pharmacist

Agreed except I’d remove the age bar. If you want a good healthy life consider alternatives.

Chris ., Community pharmacist

Why 35 may I ask?????

Stephen Eggleston, Community pharmacist

Won't the willingness of the individual pharmacists to oversee more than one pharmacy act as one of the checks. I would also expect permission to be required before allowing one pharmacist to oversee more than one pharmacy, in addition to there being appropriate records of any occurences.

Mike Hewitson, Superintendent Pharmacist

I'm not sure that holds Stephen. There is always someone willing to do something which others object to. Then there is potential pressure which can be brought to bear on an individual e.g. performance reviews, bonuses, continued employment. 

Then you have the malign attitude of NHS England/DHSC which only seem to care about money which can be liberated from pharmacy. I can see the argument now. "We've changed supervision to allow you to reduce your cost base, so we're going to reduce funding for pharmacy". Whether or not anyone is using the 'opportunity' created will be irrelevant to the bean counters. Companies could be forced to adopt a reduction in pharmacist cover out of economic neccessity. 

For me supervision and one pharmacist = one pharmacy are an essential component to a level-playing field. Allowing desperate people (as many contractors are right now) to cut this particular corner will only lead to a race to the bottom on cost. The USP of community pharmacy is ready access to a pharmacist, we tinker with that at our peril. 

Interleukin -2, Community pharmacist

What in your honest opinion will happen to the bookings of any poor locum who has the the proffesional integrity to refuse the remote supervision of say methadone in some distant store during a so called emergency in one of the big chains? Am assuming you are here with us in the real world?

Leroy Jackson, Community pharmacist

Just like supervising pharmacists - someone will do it no matter how poor the governance or safety. And if they kick up a fuss and God forbid ask the board running the company to consider safety or ethics then guess what..... We'll put in a consultation that SPs do not need to be board members in the corporate structure. Makes them easier not to listen too......

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