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GPhC proposes ‘shining a light’ by publishing inspection reports

Duncan Rudkin: Analysis of aggregated inspection reports should be available online
Duncan Rudkin: Analysis of aggregated inspection reports should be available online

The General Pharmaceutical Council (GPhC) has proposed “shining a light” on community pharmacies by publishing their inspection reports.

As part of a 12-week consultation – which it expects to launch “before the summer” – the regulator will propose publishing the reports of individual pharmacies on a new website, as well as “examples [of pharmacies] that demonstrate both good or excellent practice…and examples where standards are not being met”, it said in council papers this month (April 12).

“We believe that publishing inspection reports will strengthen the assurance we give to the public that pharmacies are providing safe and effective services and care,” the regulator said.

“It will also help to drive continuous improvement within pharmacies, by shining a light on the outcomes of inspections and sharing information that will help the sector to learn and improve.”

The GPhC will be given legal powers to publish the inspection results for the first time “shortly”, when the Pharmacy Order 2016 legislation comes into force, it said. This will be a “significant change for both patients and the public and for pharmacy owners”, it added.

Rudkin: “An incentive to make improvements”

Speaking to C+D exclusively last week (April 18), GPhC chief executive Duncan Rudkin said publishing the reports would “provide a very important incentive for pharmacy owners to make any improvements that are needed”.

“[Contractors] will be aware in future that those issues with the pharmacy will have been published to people in their area, to competitors, to people involved in commissioning and also to their staff.”

For “some” contractors the reports would be “an important motivator in terms of public accountability…to sort things out where they need to”, he said.

The consultation document, which has not yet been finalised, will include examples of how the reports would be published, Mr Rudkin added.

Alongside the reports of individual pharmacies, the GPhC will publish aggregated information with “analysis, reflection, searchable resources online – so that people can slice and dice the findings from inspection reports in different ways”, he said.

No advance notice

In its papers, the regulator also proposed making inspections “unannounced as a general rule”, a major shift from the current policy of giving advance notice of between four and six weeks.

“This would provide additional assurance that the outcome of an inspection more accurately reflects the extent to which a pharmacy is meeting the pharmacy standards on a day-to-day basis and the experience of patients and the public,” it said.

Outcome of inspections “met” or “not-met”

The consultation will also seek views on narrowing down the range of inspection ratings – from “excellent”, “good”, “satisfactory” or “poor” – to just two possible outcomes: the pharmacy has “met” or “not met” the standards.

However, for each of the five principles within the 26 standards, pharmacies would receive one of four ratings: “standards not met”; “standards met”; “good practice”; or “excellent practice”, the GPhC explained.

It proposed including “a summary report, that will contain a link to the detailed report that contains the evidence of what was found and examples of notable practice”, the GPhC said.

The changes are being proposed because stakeholders had raised “concerns” that there was a “lack of clarity” in the current system, it said.

If the outcome of an inspection for a pharmacy was “not met”, a “mandatory improvement action plan” would be put in place, the regulator added.

The GPhC also proposed new inspection model made up of three types of inspections – “routine”, “intelligence-led” and “themed” (see more below).

Mr Rudkin said: “Pharmacies are diverse and getting more so – we need to make sure that we've got a range of inspection tools that serve slightly different purposes in the way that we've started to outline in the draft.”

The three types of inspection proposed

Routine inspections

“We will continue to carry out routine inspections of every pharmacy so the public are assured that a pharmacy is continuing to meet our standards and to help the pharmacy identify how it can further improve the services it provides to patients.

“We will improve our approach by moving to a programme increasingly informed by risk indicators to identify which pharmacies we should inspect first. We will use a pharmacy’s previous inspection rating as a proxy indicator of risk along with other relevant information we may hold, such as scale and complexity of services provided or change of ownership.”

Intelligence-led inspections

“We will ring-fence some of our existing resources to conduct inspections that are quickly initiated in response to intelligence that we have received from others, to make sure we are able to rapidly address risks or concerns raised with us.”

Themed inspections

“We plan to take forward a programme of themed inspections which will involve visiting a selection of pharmacies to focus on specific themes or issues, enabling us to better understand the underlying issues, their causes and effects. Composite reports will be published to inform the sector on the issues and risks that have been found, and to inform discussions on how to continually improve pharmacy services in these areas.”

Source: GPhC council documents, April 12

What do you think of the proposed changes to pharmacy inspections?

Phillippe Togers, Academic pharmacist

Can we continue to shine this "light" by publishing an in-depth report about what the GPhC are (supposed to be) doing, and what they are deliberately ignoring? And why they may be ignoring certain matters but clamping down on apparent trivialities?

Or is it one rule for us and another for them?

There's enough information on the internet to direct an "intelligence-led" inspection about what is going on at Canary Wharf. UK pharmacists should wake up and look at how the GMC operate.

Leon The Apothecary, Student

The rating system definitely needs changing, it doesn't mean anything to those without a vested interest. The common layman is just going to think It's 3 out of 4 for a good rating.

Reeyah H, Community pharmacist

Well with all the cuts, the inspector can expect to arrive in a busy pharmacy with frazzled skeleton staff. We can’t ‘afford’ to run it like we want to. Why are all these changes happening now?!! 

Jonny Johal, Pharmacy Area manager/ Operations Manager

I believe these reports, if published, are of little value. They are heavily concentrated on the 'coal face'. I believe they can exert more influence by being transparent about how they consult the superintendents of the multiples to agree on an inpection regime, and start inspections/validations on the performance of the superintendents. Afterall, most of what happens in our pharmacies are the results of policies handed down from above.

A Hussain, Senior Management

The inspectors don't even know how to apply the criteria (if there are any).  Or things such as innovation making you excellent rather than good.  What a load of tosh.  You could be innovative in that you do all of your dispensing before the prescriptions arrive.  Innovative, yet dangerous and illegal!

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