Layer 1

‘Remote supervision in pharmacies is a recipe for disaster’

“Pharmacists aren’t trained to hide from patients and give instruction from a distance”

Removing pharmacists from dispensaries to supervise remotely feels like a recipe for patient safety disasters, says Laura Buckley

Community pharmacy prides itself on having healthcare professionals available on demand for the general public. During a time where pressure on the healthcare system is increasing, having a pharmacist on hand to provide advice holds immeasurable value.

So why is it that we find ourselves once again debating whether remote supervision of a pharmacy is appropriate? Pinching pharmacists from their dispensaries to supervise from afar feels like a recipe for disaster.

As a community pharmacist, I lost count of the number of times I was required to intervene or support my colleagues in advising patients. There were times I was needed to acutely manage patients while we waited for an ambulance, and many times where my knowledge as a pharmacist meant that only I could solve this problem or that query.

My patients asked for me by name, and, though my colleagues were fantastic, there were lots of aspects to my role that required knowledge gained through pharmacist training.

A pharmacy without a pharmacist might as well not be a pharmacy at all. To those of us who see the value of pharmacists in the community, it feels like a money-saving exercise at the cost of patient safety and wellbeing.

Pharmacists aren’t trained to hide from patients and give instruction from a distance. We work in a profession that is designed for integration at the heart of the community. We know our patients well and we use our instincts to guide effective practice and provide patient care.

Aside from access to specialist advice from a pharmacist, safety is a key issue in the pharmacist’s absence. Pharmacists are trained to seek out and identify risk. While our colleagues are well trained, the lack of a pharmacist’s presence in an environment where opportunities for errors are rife is worrying.

Reducing the number of pharmacists and squeezing their skills out to remotely supervise multiple pharmacies feels less like progression for pharmacy and more like a means of making money go further.

I think you would be hard-pressed to acquire majority support from the sector in favour of this. I’m fairly sure that most pharmacists value their interaction with patients as a key aspect of their role. If contractors are concerned about the future of pharmacy for patients, they should be seeking counsel for their funding, not claim remote supervision as the solution.

Patients should be central to all and every future plan for the community pharmacy sector. Remote supervision is not a way of working in which I see patient-centred care. It almost feels like the punchline of a bad joke when pharmacists feel the need to justify their presence in their own pharmacies.

It would truly be a sad day for pharmacy if remote supervision became a reality and I lament the necessity to even discuss this topic. It is 2020 and pharmacists have just battled their way through a pandemic and shown every ounce of their worth. Tell me again why remote supervision should even be considered a possibility?

Perhaps we should be spending more time discussing our pay rise, or the distinct absence of it, in the newly-announced wage rises by the government for public sector workers including doctors. Again, pharmacy has been abandoned and left to question whether we count anymore. 

Laura Buckley is a locum and primary care network pharmacist based in Hull

8 Comments

Chemical Mistry, Information Technology

can we change Laura photo now, she looks alot healthier now she is not working in community beside locuming the odd day

Chris Locum, Locum pharmacist

It is a recipe for saving money and the issue won't be going away. However, that does not mean there will not be a hapless pharmacist signed on, physically away from a particular set of premises. A conduit of the blame for any serious catastrophe.

It is clear that COVID was an excuse for some to attempt this informally (while avoiding paying for an RP). Financial attrition will be the vehicle to bring it about in some guise eventually. The central government thinks the nation's medicines can be processed like a biscuit factory, or for peanuts more likely.

In the not so distant future, some clinical community pharmacists will sadly not be practising street medicine. They will be turfed out on it.

David Kent, Community pharmacist

I am a retired pharmacist and any pharmacy where there isn't a pharmacist on the premises will not be getting my custom.

 

R A, Community pharmacist

I think given the alarm rate at which pharmacies are closing down in UK and the government unable to increase funding. Companies will give the government an ultimatium have a pharmacy with remote supervision or have no pharmacy at all. 

In the past government would not have taken this ultimatium seriously. But given how both Boots and Lloyds Pharmacy have closed hundreds of shops in UK, the government realise that the days of peon like community pharmacy is gone. 

My guess is the government will agree to it. This will mark an end of an era for pharmacists because I think pharmacists will be marginalised if not pushed out of the sector completely. 

Leon The Apothecary, Student

Another consideration, whichever side of the debate you stand, there is a need to have a strong evidence base to support the claim that remote supervision does or does not work, and the impact of patient safety.

As it stands, that information is simply not there!

Leon The Apothecary, Student

Then again, if we look at purely the dispensary process, particularly automated ones, more accuracy checking goes on then the traditional pharmacy. With technology such as barcode validation in a closed-loop system, error rates have been proven to be reduced.

I would respectfully argue that, with the exception of clinical checking, a dispensary does not require a pharmacist to be physically present. The skillset of a pharmacist could be better realised beyond the bread and butter of "spot the difference" that constitute the bulk of their workload in community. Is the service-driven focus an attempt of realising that?

There are still several aspects that need to change before, as rightly mentioned previous, such as who retains accountability and responsibility. The legalisation surrounding these would need modernising as well to reflect the change.

Benie I, Locum pharmacist

Money will trump any patient safety issues or anything else for that matter. But on the occasions it all goes sideways the individual pharmacist will be hauled over the coals. 

Leon The Apothecary, Student

I personally think it is unfair for a "Remote Supervising" Pharmacist to be taken to task over something that is happening in a building they are not even in. Whilst accountability is still in question, this will always be an impasse.

Job of the week

General Practice Pharmacist
Armagh, Dungannon, Newry
Up to £40,894