I was very fortunate to start October with an invitation from the College of Mental Health Pharmacy (CMHP) to be a guest at their annual conference at Hinckley Island on the first weekend in October. We feel CHMP is very much a partner organisation as we have an agreement that they provide Mental Health representation to GHP Council, currently Trudi Hilton. For me it was a great opportunity to speak to a group of pharmacists, both young and old, newly qualified and experienced outside my normal working area on the benefits of GHP membership. My only regret was that I missed the session provided by Roy Lilley, who I must admit is required reading for me with his regular blogs on Nhsmanagers.net
After returning from the weekend at Hinckley I travelled to London on the Monday for a meeting with Unite Head of Health, Fiona Farmer and Section Secretary Kevin McAdam on ways we can take forward the issue of differential tax treatment of private and NHS suppliers of outpatient pharmaceutical services and how we could further improve the professional contribution to pharmacy with Unite support. We also took the time to meet with the underwriter to discuss how we clarify for member the coverage provided by the Unite PLI policy. It was agreed we would write a joint letter as Unite Head of Health and GHP President to members at the next appropriate mailing confirming the position and coverage for pharmacist when working for an employer either as a direct employee or self employed locum.
Details of the policy are avaiable on the website and members who wish to partake in the additional policy can complete the documentation those who are unsure whether they have taken up a policy need to contact their regional district offices (http://www.unitetheunion.org/regions.aspx), who have a list of policy members.
The next day I attended a stakeholder group at Lambeth with a number of other key stakeholders, representing the broad breath of hospital pharmacy, to discuss the professional standards for hospitals. As previoulsy discussed the standards will provide, encompassing high level professional standards that are consistent with regulatory standards and medicines legislation. They will provide a single framework that covers patients from admission through to discharge across multiple care pathways, that can include, for example, outreach care and home care services. It is important that these standards are informed by specialists in all fields but they are applicable and deliverable by the whole profession primarily meeting the needs not of those who deliver the services but the recipients thereby delivering even safer and more effective healthcare.
After 4 days away I returned to the day job in Sunderland for a meeting with Pharmatrust and discussions on when and how we are likely to implement a remote dispensing machine. Our plan is to use the machine in a small Eye Infirmary, mainly in relation to the dispensing of eye drops. The pilot has been delayed as we are awaiting a machine with an integral fridge unit.
For many people it is the changing of the clocks and the move away from British Summer Time (BST) marks the sign of the forthcoming winter for us at GHP usually is the start of a series of face-to-face and telephone conferences on how to address flu. The first stakeholder meeting of this 2011-2012 season took place in London and Graeme Richardson and Trudi Hilton attended on behalf of GHP. Issues raise included better communication between groups, appropriate utilisation of the suspension by restricting it to 1 years and under, more advice and access to IV antivirals, seeking ways of informing the hospital service that prescribing of antivirals is not dependent on CMO letter or NICE guidance and providing stakeholders outlines of future plans.
This was the total of face-to-face meetings this month, but a number of teleconferences were also undertaken in October. GHP is involved in Modernising Pharmacy Careers with Immediate Past President Richard Cattell being a member of the Steering Committee, but in addition to this input a number of stakeholder groups are updated by the chairs of the various workstreams on the on-going progress in relation to undergraduate, postgraduate career development and workforce planning. The two other teleconferences were with GHP Council members, providing updates on a wide range of the meetings attended and issues arising as discussed in this report. The second teleconference was with members of UKCPA further fine-tuning the programme for next year’s joint conference in Belfast starting 18th May.
The main topic of conversation at the GHP teleconference was NHS pensions both to finalise our response to the NHS pension consultation. We commented that the NHS scheme is currently over £2 billion in surplus, there has only just been a negotiated increase in staff contributions with an agreed cap on employer contributions ensuring that future deficits would be met by increased staff contributions combined with an increase in the retirement age for new members to 65. We were also concerned that increased contributions may lead to people leaving the scheme as they are unable to afford the cost or due to the current pay freeze retire early reducing the members in the scheme and creating a future imbalance. The other discussion point was what would be our advice to members in the forthcoming ballot on industrial action. We, as employees, are particularly angry at the unilateral action taken by the Coalition government in relation to NHS pensions. We, as professionals, are particularly concerned to ensure patient safety and the minimum delivery of a bank holiday service is designed to ensure that safety. Finally we recognised that some pharmacists, myself included are very senior managers in their organisation and consequently these Chief Pharmacists may decide to attend work on November 30th to ensure from a management and accounability perspective that safe and essential services are delivered. That dilemna is recognised by GHP Council and we can support this position. Personally as a senior manager I have agreed, on this occasion, to attend my place of employment on 30th November to ensure the pharmaceutical service maintains patient care, but I also recognise many other NHS staff including pharmacists will try to encourage the Government to enter negotiations by making a sacrifice of their day’s salary and take industrial action. Hence I will ensure that I will either personally will not take any salary for that particular day or donate to a recognised supported charity.
As Scotland has devolved powers for health there was a separate consultation on pensions and it is to be noted that similarly the NHS scheme in Scotland is creating a surplus as shown in the latest available figures (2009-10). The scheme received contributions of £884.5 million paying out in pensions in the same year of £660 million. Currently the contributions are 34% higher than the sum paid out and if the Governments proposals go ahead in Scotland this will rise next year to 42%. Colin Rodden, GHP National Secretary for Scotland will respond on behalf of GHP members before the closing date in November.
Returning to GHP professional activities Colin also responded to Scottish Executive consultation on Adults with Incapacity (Scotland) Act 2000 – Consultation on Certification of Incapacity for Medical Treatment under Part 5 Section 47. Roisin O’Hare Chair of Education led on a response to a technical consultation from the Department of Business Innovation and Skills on a new-fit-for-purpose regulatory framework for the Higher education Sector. Finally Graeme Richardson and Trudi Hilton responded on a MHRA consultation on consolidating the Misuse of Drug Regulations 2001.
We also began discussion on GPhC additional detailed guidance to the existing core standards. Although this is not a formal consultation we were specifically identified to provide our input on whether the guidance is appropriate and useable. There are four areas of expanded guidance that is intended not to be prescriptive but assist professional judgement.
Consent: promoting understanding of both legal and professional standards in relation to securing appropriate consent from patients when providing pharmacy services
Confidentiality: promoting understanding of both legal and professional standards in relation to patient confidentiality
Raising Concerns: recognising that a key part of any effective health delivery organisation is appropriate mechanisms to raise concerns on practice which affects patient safety
Maintaining professional boundaries: reflecting on some of the complex issues pharmacy professionals face in maintaining appropriate boundaries with colleagues and patients
You may have seen the employers have already provided evidence to the Pay Review Body (PRB) that a national recruitment and retention premia for pharmacists was not required following the completion of the national Staffing Establishment Survey. We had already agreed at the NPC meeting in July, that we were not pursuing the national RRP claim for junior pharmacists this year since the vacancy figures have improved significantly from when we started making the claim 3-4 years ago. The current rate is now at 11% for both band 6 and 7 pharmacists, which is obviously a big drop from the 22% in 2008. However we would still maintain that we are concerned over the patient safety issues this vacancy level potentially raises particularly when research shows an increase in medication errors in hospitals occurs as the workload increases. In those departments that are still suffering a high level of vacancies, this will undoubtedly lead to increased workload for those in the department and hence possibly an increase in the number of medication errors.
We always said the shortage was a short term issue that would resolve over the coming 3 years or so (from 2008) and we have been shown to be correct. We worked with the Department of Health on the task and finish group and in the medium term this will (and has) help. However our members had to persevere through difficult times when staffing levels were dangerously low and this could have been resolved earlier if the RRP recommended by the PRB 2 years ago had been implemented. We still worry that this may come back around again with the introduction of large tuition fees and a potentially longer and possibly unfunded 5 year degree course.