At the start of December I had the honour of representing the Guild at the American Society of Health-System Pharmacist mid year conference in Anaheim. This is the first time I have attended in a representative role, which due to the meetings included outside the programme means you meet some DoH and the President’s of other European delegations as well as senior hospital pharmacists from the US, but I have attended two previous mid-years with colleagues from my base trust. The changes that I noticed from attending my first nearly ten years ago reflect very much the situation here in the UK. There is a desire to take the pharmacist (and pharmacy technician) out of the dispensary and into a more clinical bedside and direct care role. There is also a push to standardise and regulate even possibly through state registration of pharmacy technicians to support that role. As an outsider looking in I always feel challenged in that some areas of practice seem so advanced – advanced specialisation, automation and computerised decision support - yet others - such as delegation and basic clinical pharmacy - seem so far behind UK practice. For example I attended a session on remote supervision only to find that is was about observing through webcams technical staff working in isolators making up CIVA and other patient specific injection including measurement sign-offs rather than have direct observation and personal oversight by the pharmacist. They particularly seem very constrained by the plethora of standards and protocols that seem to stifle innovative practice. I came back determined to return next year with some colleagues particularly junior colleagues from Sunderland.
The other advantage of the week away was the time difference gave me lots of opportunities to catch up on some background reading both hardcopy – when my luggage caught up - and on the internet, including the on-going proposals by the MHRA on medicines legislation and particularly an NHS proposal on s new system for providing bursaries for NHS staff undergoing undergraduate education. Whilst this largely applied to NHS rather than HEFC funded courses there appeared no logic, particularly as we consider a potential integrated 5 year course, why pharmacy was excluded yet medical and dental education was clearly included. Importantly we also got the support of the Royal Pharmaceutical Society, as this is another way of potentially, addressing the on-going vacancy problem with junior pharmacists.
The MHRA response we submitted on reducing regulatory burdens reflected other pharmacy organisations concerns in relation to wholesaler dealing. It also gave us a chance ahead of the formal consultation to outline our view on amending sections 64 the so called “decriminalisation of dispensing errors. We fully supported the proposal to only have a proportionate response to pharmacists and/or other health professionals who have been involved in a dispensing error. This is an urgently required amendment as we feel that the Medicines Act has no connection with wilful intent or negligence and the pursuance to criminalise pharmacists (and others), who have made dispensing errors through human error, is totally unreasonable. In our view the relevant sections of the legislation largely taken from previous Food Acts are about deliberate adulteration of medicinal products and/or clear misrepresentation of those products to the public and they should have no connections with the dispensing process. If a health professional commits a deliberate or wilful act of negligence there is sufficient existing law dealing with health and safety and/or criminal negligence to address this aspect of human behaviour. Hence we remain clear that it would be inappropriate to continue to seek to prosecute those pharmacists who have committed an offence under Sections 64 and/or 65 of the Medicines Act, as acts of wilful intent or through negligence are already covered by other legislation, although we would accept the outline proposal is at least an improvement of the current in our view total misapplication of the current act with its strict liability provisions.
The other consultation we responded to this month include the professional bodies draft regulations, where we raised the need for upper limits on expenses such as second class travel, the need for electoral colleges especially for candidates in restricted seats representing minority groups. If groups like academia, hospital, primary care or even community pharmacy are to feel and be truly represented by colleagues who reflect their views - rather than those of the body of the collective membership who already a majority of each of the boards then this is an essential requirement going forward. It is still possible to have an election fought on a single ticket election platform but it enhances the chance of a wider multi-sectoral view prevailing. Finally the change back to President rather than assembly chair is in our view a retrograde step in promoting a new and changed professional body freed from the mistakes and constraints of the past.
As December is not a Council meeting month we had a brief teleconference mid way through the month. We had an update on the information in relation to on-call including agreeing to move the background support materials for members into the open section of the website. We discussed the associated presentations confirming the extended position with PLI to cover pharmacy locums and support information for primary care members. We also discussed rumours that NHS employers are likely to propose a freezing of increments for 2 years. This is fundamentally different to a pay freeze in that increments are part of each member’s employment contract and can only be varied with due process and agreement. We also discuss the publication of the Institute for Employment Studies report into recruitment premia and the robust response by GHP/Unite to their lack of support for its extention to hospital pharmacists.
Finally the year appeared to turn full circle as I was involved over the festive period like my predecessor 12 months earlier on daily teleconferences with the DoH England and other pharmacy colleagues in Community and Hospital Pharmacy in relation to the on-going flu issue and the supply of antivirals and vaccines. Also similarly to Richard Cattell I finished 2010 by drafting my part of the Annual report before sending to the Organisational Lead Vilma Gilis to co-ordinate ahead of distribution to members later in 2011. I won’t repeat my short report here apart from perhaps to re-iterate my gratitude to all on GHP Council for their hard work particularly the Chairs and other executive members and highlight what I feel are three main areas of progression in this year. These are the appointment of Barry Corbett to cover the professional secretaries role, the clarification of PLI with its extension to cover pharmacy locums and also of particular interest to junior members the re-iteration of the need for a recruitment and retention premium by the National Pay review Body for band 6 and band 7 pharmacists.
David Miller
GHP President