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Rowlands: Embrace and promote new pharmacy supervision regulations

“The new normal is a unique opportunity to improve patient access to healthcare”

Regulations that allow pharmacies to be supervised remotely by a pharmacist are appropriate, says Rowlands' superintendent pharmacist Margaret MacRury

It’s good to see COVID-19 restrictions easing, but the grim reality is it will take years for the NHS to catch up on the backlog of postponed procedures and appointments. We also have the additional pressures of flu season on the horizon, which could put the health service into crisis mode.

Over the last few months, community pharmacy has proven its value as the “third pillar” of healthcare in delivering NHS services alongside GPs and hospitals. When access to the latter was understandably restricted, community pharmacies kept their doors open, providing not only medication, but also trusted professional healthcare support and advice.

When the government looks at the immense healthcare challenges that lie ahead, it must recognise there can be no return to ‘as was’. Instead, it must seize the opportunity to reset how care is planned, commissioned and delivered.

Surely, one of the lessons we can learn from the COVID-19 crisis is that our country needs the community pharmacy network as a critical local healthcare access point. The network needs to be financially viable – currently it is not in England. Who thinks pharmacy closures are a good idea post-COVID? Is the community pharmacy contractual framework (CPCF) in England still fit for purpose?

However, if we expect the government to play its part in supporting the new normal for our sector by commissioning more services and providing sustainable funding, then we too need to be bold and progressive in our thinking.

If the sector wants to encourage the public to think “pharmacy first” when it comes to treating minor ailments, seeking wellbeing advice such as smoking cessation or even COVID-19 antibody tests then we have to change the way we work to deliver an expanded range of services.

We should therefore embrace and promote new regulations about pharmacy supervision that don’t dilute professional due diligence, but are appropriate for the new realities of delivering high-quality patient care.

Given the circumstances, we also need to adopt more efficient dispensing practices such as hub-and-spoke to create the time to provide patient services. In addition, we need to see more GPs refer patients to pharmacies when it is clinically appropriate to do so, but we also then need the capacity to respond to those referrals.

The new normal is a unique opportunity to improve patient access to healthcare with community pharmacy at the forefront of illness prevention, chronic condition management, testing, triage and wellbeing support.

The healthcare challenges that our nation is facing are daunting. Community pharmacy has a critical role to play in meeting those challenges, but we need to adapt our ways of working to reflect the new realities we face in delivering the best possible care for patients.

Margaret MacRury is superintendent pharmacist at Rowlands.

36 Comments

Jacqueline Bradley, Locum pharmacist

This rambling nonsensical article would make you think remote supervision is something Rowlands are pushing for in the future when in fact I have proof that they went ahead all guns blazing remotely "supervising" stores and used the pandemic as justification for their actions. No regard for the law nor patient safety, only profit in the forefront of their minds and Ms MacRury as the puppet. I'm sure her cheeks are still burning and unfortunately for her the article wasn't written on a chip shop wrapper. The internet can haunt for years. The only way is down. 

Leon The Apothecary, Student

This was a painful article to read.

Her incoherence and contradictory statements only serve to dissuade people of her position, and even more to discredit herself as an individual, and the pharmacist profession. She might have had a good point in regards to structuring pharmacies differently to the betterment of customers, however her disingenuous rambling has failed to articulate anything productive.

I hope Rowlands as a company distance themselves from this article, in my opinion that would be the best thing they could do.

Suraj P, Superintendent Pharmacist

Just shows why Rowlands is the company it is to work for when they have such an out-of-touch Superintendent.

Can she show any more ignorance of reality even if she wanted to?

How do people with no gauge or "finger on the pulse" get into such senior positions?

Or is it just a classic case of "I'm in my high tower, I'm safe, let's mess up as much as possible for the worker ants below me".

Beggars belief. What a state.

Rowlands already run hub and spoke so I'm not sure what point this article is supposed to be making. Is she advocating that other pharmacies should use hub and spoke or remote supervison? .They already abandoned ACT training and run branches on minimum staff so I don't know who would be checking prescriptions if not the pharmacist.

Why not go the whole hog and move all repeat dispensing to the hub and only do acute scripts in branch, OTC sales and "clinical" services.

Rowlands were a good company with good ideas once upon a time....

Kevin Western, Community pharmacist

I hope this is the first of many articles by this Person, this is going to be fun!

mark straughton, Pharmaceutical Adviser

If there's ever clear evidence of the push for remote supervision then this arrogant person has just displayed it. There is no mention of pharmacists and their input. She has total disregard for the pharmacists and their profession, more on the 'survival' of community pharmacy.

I'm fed up of criticism of my views on remote supervision and the redundancy of the pharmacist that this piece serves more to my cause. 

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

No criticism from me, Mark. I totally agree with you. The erosion of the pharmacist role is picking up pace all the time and we will have crumbled to dust in the foreseeable future.

A.S. Singh, Community pharmacist

Nothing new here

 

Multiple in favour of remote supervision (increases net profit by reducing pharmacist wage bill)

Amitpal Singh, Community pharmacist

Wow.
How can people not see through this greed. 

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

I think we all do.....

Matthew Edwards, Community pharmacist

How on earth do we provide more clinical based services when the pharmacist is not on the premises to provide them.  Flu is the prime example, needs a pharmacist to do the injection!   This is purely a way for multiples to reduce pharmacist levels (and costs) which is definitely not in the public interest.  If GPs closing their doors as soon as Covid hit and the resultant wave of patients on our doorstep didn't prove a pharmacist is required in branch then someone has not been at the coal face for some time

Angela Channing, Community pharmacist

Thanks Matt, you just saved me a load of typing! Totally agree.

mark straughton, Pharmaceutical Adviser

I think they'll try and push for pharmacy techs to do services, even flu jabs. Or the multiples will come up with some silly scenario where a the 'remote pharmacist' visits a different pharmacy each day of the week to do flu jabs. As you say 'not at the coal face'. This lady here clearly isn't.

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

And then it's just a short step from 'remote pharmacist' to 'no pharmacist'. Ah well. Horticulture here I come!

Chris Locum, Locum pharmacist

It is funny how those calling for remote supervision are never to be found in a dispensary. Community Pharmacy did not go down in flames but it surely buckled under the strain in places.

Just wait for round two. Flu symptoms and Covid-19 symptoms potentially getting confused. Staff staying home wanting a test. Not enough vaccine for potential demand. Many surgeries shutting their doors again. Christmas holiday into the weekend and a bank holiday Monday.

What could possibly happen? A re-run, sickness, isolating staff and more strain on Pharmacy teams. Premises closing for financial or staffing issues. The cure? Removing the pharmacist? Totally illogical.
 

H Saw, Community pharmacist

Hypocrite and greed. That's all I can summarise.

Industry Pharmacist, Director

Wow Margaret! You are really towing the company ethos aren't you? De-valuing the profession by suggesting silly ideas with no real evidence of improvement. 

How will remote supervision help anybody except your shareholders, by saving your company money at the expense of patient safety by not requiring a pharmacist on premises? 
 

Margaret in the Superintendent of Rowlands and has clearly been indoctrinated into the 'commercial' way of thinking rather looking at from a patient safety aspect. If she did look at it with patient safety at the forefront of her mind, why didn't she step in when locums were denied PPE?? Where was her concern then? Obviously, refusing PPE for locums was another cost saving measure at the expense of patient safety. 
 

* This comment has been edited to comly with C+D's community principles*

 

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Funny how there's not a word about the money Rowlands will, just purely co-incidentally, save from remote supervision and hub-and-spoke.

A Pharmacist, Allocation & Distribution

*This comment has been removed for not complying with C+D's comunity principles*

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Oh come on C+D!!! Please treat us like the adults that we are. Look at the thumbs up - the word 'sod' is not precluded by your highbrow 'community principles' (and learn how to spell otherwise you just look silly....)

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Best post I've ever seen on here! Well said!

Shahan Mir, Community pharmacist

 

"When access to the latter was understandably restricted, community pharmacies kept their doors open, providing not only medication, but also trusted professional healthcare support and advice"

Your own quote above advocates for a 'trusted professional' to be onsite and evidence from the pandemic vindicates the physical presence in comparison to reduced GP services. 

The incoherent and contradictory messages are somewhat more worrying as you are reported to be the Superintendent Pharmacist. The role should be to mitigate any potential risks to patient safety and not be swayed by proposals which are quite clearly to provide financial benefits. 

Principle 2 from The GPhC Standards for Pharmacy Premises:

"Staff are empowered and competent to safeguard the health, safety and wellbeing of patients and the public."

Pharmacists undergo extensive training and are experts in medication. There are areas of knowledge which are out of the scope of Pharmacy Technicians and other support staff. I would argue that the 'trusted professional' that the patient has appreciated during the current pandemic needs to remain a physical pharmacist by your own reasoning.

Beyond that, the only reason I can think why Rowlands are trying to reduce the number of RPs would be that there is not enough PPE to go around?

 

 

 

 

Farhad Hotak,

Remote supervision has a negative effect on community pharmacies. when the pharmacist communicate with staff or patients through technology, nonverbal communications and responding to symptoms become less effective and the outcome can be dangerous if any red flags are missed.

Taking a responsible pharmacist away from the premises hinder pharmacist ability to quickly support staff or help patients in urgent situations.

Is it not the time we consider the need for superintendent pharmacist

Dodo pharmacist, Community pharmacist

She is contradicting herself massively in this article. Firstly she wants more referrals to community pharmacy and pharmacies to see more patients, then she wants no pharmacist present in the pharmacies and remote supervision. It is either one or the other, not both. 

Angela Channing, Community pharmacist

How can someone get so high up in a company and come out with such absolute contradictory nonsense?
Send them all to the Pharmacist.....oh hang on, we took them out ! Poor technicians is all I can say, they don't want all the stress for what they earn, they tell me!

Paul Summerfield, Community pharmacist

Having read the article a few times, I agree with the post to which this a reply to. The argument put forward makes no sense and is contradictory. How can there be more clinical referrals to pharmacies when there is no pharmacist on the premises? It makes no sense. What does make sense is that this is the ideal opportunity for cost cutting at the bottom line and therefore increased profits. I also agree with Umer who has replied to the article. How can patient safety be guaranteed when there is no pharmacist present within the pharmacy? It would be extremely difficult to provide a Standard Operating Procedure (SOP) for every eventuality that may be faced in everyday practise. Pharmacists are well equipped to deal with such situations and do so on a minute to minute basis throughout the working day. By physically removing the pharmacist from a pharmacy, you remove an essential and integral part of the patient safety framework. I also highly doubt that the Superintendent Pharmacist who wrote the main article would accept full professional responsibility if anything went wrong and would most likely find a SOP which would shield them from any responsibility. Rowlands brought us the PPE debacle and now they advocate for remote supervision. In my opinion, both are ill thought, unworkable and frankly dangerous not only to pharmacists but to all those who rely upon the pharmacy network to provide a first-class service.

Umer Ayyaz, Community pharmacist

We've just had the worst possible situation there will ever be and we did not need remote supervision, so I don't see the need for it to be brought up ever again. Please do not disguise this ordeal we have all been through to push forward an agenda to cut costs and increase profits! Remote supervision and hub and spoke will be the final nail in the coffin for pharmacy. We need pharmacists to be physically present at all times to ensure the safety of our patients! That is not up for discussion!!!

Caroline Jones, Locum pharmacist

Perhaps then they might effecively tackle the explosion of FTP cases they are seeing and not addressing due to the failure to recognise the phenomenal workload, high staff turnover/ shortages, lack of breaks, poor working conditions leading to intolerable stress across the whole pharmacy team resulting in soaring sickness levels.... Just a thought from the front line.

Caroline Jones, Locum pharmacist

If the GPhc had any professionalism about it, it would be pushing for double pharmacist cover to ensure good oversight in delivery of dispensing/clinical services as well as the additional extra services that we are expected to provide. Surely this would ensure patient safety more effectively than green lighting the remote supervision that the multiples crave and are so adroit at sidestepping the consequences of..... or have Rudkin et al forgotten what they are there for ?????

Benie I, Locum pharmacist

Some believe GPhC to be puppets with their strings are operated by Boots, Lloyds et al

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