As most of you in Telegram Cooperative groups know we organised a meeting with Ashok Soni, current president of The RPS, to discuss various locum, community and various pharmacy related issues. First of all we would like to thank Mr Soni for taking the time to see us and accommodate us in his busy schedule. He allowed us a two hour slot which was very generous of him.
The purpose of this meeting was to develop constructive dialogue regarding some of the pressing issues facing Pharmacy and how we can work together to face these issues.
The topics we discussed were the RPS’s role in the Rebalancing board and proposed supervision regulations, integration of Pharmacists in Primary care and some of the obstacles involved, and last but not Least how to introduce new funded services which we can introduce to community pharmacy to tackle both the funding cuts and improve pharmacist role in patient care. Another topic we discussed was about encouraging whistleblowing and protecting Pharmacists that do this.
The Rebalancing Board
We discussed at length about the secrecy around the board meeting and why it took so long to come out. Mr Ash Soni reassured that no agreement in principle exists regarding he proposals, the only agreement is the topics to be discussed. Mr Soni Accepts that Pharmacists are an important stakeholder in these discussions/proposals and the pharmacist viewpoint will not be overlooked.
He reiterated that the RPS position regarding this will reflect the viewpoints of Pharmacists on the ground working as RP on a daily basis.
We discussed about the greater clarity needed for the 2 hour absence window allowed for responsible pharmacists and measures needed to ensure this window is not exploited for financial gain and the window is used to allow pharmaceutical care, e.g allow pharmacists to visit surgery, patients , care homes etc. Currently some of the most well-known companies are using the two hour window to reduce pharmacist hours by asking managers and locums to sign in two hours eary or sign out two hours later but with no extra pay. This has few implication. 1. It is a patient safety issue as the pharmacist is no longer able to supervise the dispensing process as they haven’t even started their shift or has totally left the premises. 2. Legally the pharmacists is now responsible for whatever happens in those two hours. 3. It goes against the GPhC view that those two hours should be used for patient care and not to save a bit of cash.
Mr Ash Soni said that “wherever there is medicine there should be a Pharmacist and this should be beyond just community pharmacy. Carehomes, Primary care, surgery, A&E etc.”. I think this is an important step in the right direction but still requires a lot of work. As for the secret meetings and how this relates to the proposed changes to supervision rules I don’t feel it clarifies my concerns because this statement is still open to interpretation. For example one could say yes we will have pharmacists wherever there is medicine but we just need him/her to be away for a couple of hours and while they are away we would still like our techs to sell P meds and hand out POMs. To me a stronger statement to say The RPS does not support technicians supervising sales of P and handing out POMs would be a far clearer and would alleviate a lot of worries around this issue. Currently 95% of our group members are strongly against the proposals and rightly so. We have seen how the 2009 RP changes has been abused and this will just make things worse. Infact this change in RP regulations could very easily be used to bring in remote supervision which would allow one pharmacist to supervise a few pharmacies while patients have their medicines handed out by technicians, 75% of whom have been grandpatented.
Mr Soni also gave us an update into decriminalisation of dispensing errors and how we can expect major development on this front in the near future. We emphasised the need for a united leadership to fight off these proposals by Rebalancing board or the idea of remote supervision along with anything that harms the interests of pharmacy. We suggested greater collaboration with the NPA and PDA. The PDA have been fighting on the side of pharmacists for a very long time and both the NPA and PDA know a lot about this topic as they insure pharmacists. So to leave these two organisations out is baffling to say the least.
Integration into Primarycare and Overcoming The Obstacles
We discussed concerns about role of pharmacists in primary care beyond the NHS pilot scheme and employability of these pharmacists when the NHS funding runs out. Mr Soni believes Pharmacists are an important asset to Primarycare and have showed good value. He envisions greater collaboration with pharmacists from community pharmacists working in collaboration with surgery’s on a sessional basis.
Regarding the obstacles facing in getting a designated medical prescriber (DMP) to do the IP course, Mr Soni informed us about the new Pharmacy deaneries which will aid pharmacists and even suggested a 2 year post qualification structured programme which allows recently qualified pharmacists to become Independent prescribers and changing the requirement of a DMP to a DPP (designated prescribing person) which enable prescribing allied healthcare professionals to be supervisors.
We agreed that community pharmacy can offer a lot more providing we get appropriate funding for new services. Community Pharmacy is already stretched with the funding cuts.
Mr Soni believes the network of 12k community pharmacy as an alternative to walk in centres would be a great use of bricks and mortar pharmacies, where Pharmacists advice is readily available and we can also provide services such as wound care, first aid etc.
He also mentioned the pilot scheme of having a pharmacist in every A&E. Development of service where pharmacists providing care to carehomes seperate to the dispensing and supply model.
Introducing management of long term conditions in community pharmacy e.g Diabetes, Asthma/Copd, Hypertension etc with appropriate funding.
Mr Ash Soni acknowledged that RPS has not been very effective in communication with its members and non-members. We agreed that RPS needs to reach out and listen to pharmacists working on the frontline.
We discussed how to get more young pharmacists involved in the RPS. He was keen to encourage placements for young pharmacists to visit the RPS in shadowing and Work experience roles to give a better insight if the Work RPS does.
We feel it was a very positive meeting and encouraged dialogue and we ask that pharmacists engage more with pharmacy leadership, be it RPS, GPhC, NPA, PDA or PSNC. The onus is on us to hold the pharmacy leadership accountable as to how they serve the profession. They were elected by us and they work for us. There should be no fear in holding them accountable because if we don’t then what right do we really have to complain when changes happen that have a negative impact on the profession.
This meeting does not make the Rebalancing board proposals go away so it is vital we keep up the pressure and make the right voices hear our views at all levels and highlight the virtues community pharmacy offers.