During my pre-registration training many years ago, I would work with a locum who always brought along her latest copy of a pharmacy magazine on Saturday mornings.
This was before September 2010, in the days when the Royal Pharmaceutical Society of Great Britain was our regulator. Once morning coffee was sorted, the locum’s ritual was to read the magazine from back to front while entertaining us with anecdotes from it.
The benefit of reading it this way was that you got the interesting bits first. Job adverts, notices and her favourite – the regulatory determinations.
I only remember the more undignified downfalls: attempts to defraud, selling copious amounts of controlled drugs, and predilections for taking a swig of the morphine tincture as a post-lunch aperitif. In my youthful optimism, I felt perfectly equipped to avoid such downfalls. These days, I’m not so sure.
In November, the Pharmacists' Defence Association published “urgent guidance” for GP pharmacists “following a number of critical incidents”. My initial response was one of dismay that such negativity had been brought upon us, not least because of the subsequent trade and national press coverage.
On reflection, I think this is a hugely significant moment for our profession, an opportunity to consider if we question our competence enough, and if we at times practise with an ill-founded assumption of competence.
With the emphasis on pharmacists' roles becoming more “clinical”, most recently with the Community Pharmacist Consultation Service (CPCS), I increasingly feel anxious that by trying to do my job properly I may inadvertently find myself and my actions investigated.
It seems that those leading the profession and its development don’t want to talk about competence, at least not in any great detail.
During my independent prescribing course there were vague references to making sure you’re always working within your competence – echoes of guidance from the Royal Pharmaceutical Society and the General Pharmaceutical Council.
Colleagues who have completed the Centre for Pharmacy Postgraduate Education’s GP pharmacist training have told me this mentions competence in a similarly oblique way. There’s little support when it comes to how we assert competence, or even how we know that we definitely are competent to offer a service.
Community pharmacists have informed me that they have had no training on the CPCS service. They have just been told which references to use to look up red flag symptoms.
I would urge caution for the future. Pharmacy is in a very dynamic phase and we need to see strong leadership on the topic of competence – otherwise I fear the whole profession will implode in a collective crisis of competence.
The GP Pharmacist is a former community pharmacist working in a general practice