The 37^th General Assembly (GA) of the European Association of Hospital Pharmacy (EAHP) was held on the 8^th and 9^th of June in Tallinn in Estonia.  The Guild was represented by Anthony Oxley (President of GHP) and Bob McArtney (Acting Lead for Education and Development).

EAHP is an association of the associations that represent hospital pharmacy from across Europe; and the GA is a 2 day meeting where representatives from these associations get together to discuss items of common interest related to professional practice, European legislation and directives, and the running of the Association itself.  The association has a president (Jacqueline Surugue from France), a Board of Directors, and is supported by an Executive Director who is a non-pharmacist but understands EU legislation!

EAHP is possibly most recognised in the UK via the European Journal of Hospital Pharmacy and the Congress held in February/March each year. A question we are frequently asked is “am I a member of EAHP?” - basically from a GHP perspective – if you are a Guild member then you are a member of EAHP.

This year over 20 countries attended with apologies from 4 others, and the associations of two new countries Serbia and Turkey were approved for membership. 

The agenda is a challenging one with some 26 items ranging from the progress report from the Board, the structure and organisation of the association itself to matters such as EAHP collaboration with the European Medicines Agency (EMEA).

Major items this year included a re-write of the statutes of the organisation (the rules governing the organisation).  GHP has been arguing for this revision for some years.  It has allowed the Board to be expanded so that members can join the Board without a formal portfolio of responsibilities.  This should allow them to understand the working of the organisation before moving into a more formal role (if they so wish). We hope that this will significantly improve the workload of Board members, and support succession planning which has previously been non-existent.  Another key change was to limit the overall term that a Board member can serve.

EAHP is also keen to have a definition of hospital pharmacy and a mission statement for hospital pharmacists – partly to support the concept of specialisation – “hospital pharmacist” is an important and protected title in a number of European countries. One reservation I have about the proposed definition is that it is very much about “4 walls do a hospital make”.  We shall be discussing these issues at the next Guild Council meeting in September.

The concept of “specialisation” with the protected title of hospital pharmacist is something that has never been successfully translated into the UK. Major discussions were held some years ago about expanding the concept of specialisation within pharmacy of which the Guild was broadly supportive, however, the concept has always been opposed by various bodies within the UK – and by the RPSGB representatives in particular. What the Guild has not supported has been the “protectionist” approach that some countries have taken in preventing “hospital pharmacists” from one country being prevented working as such in another, because they have not completed that country’s formal training plan.

Other issues discussed included;

• a proposal to demand that bar codes are present on individual doses of a medicine
• directive on professional qualifications* and the specialisation in hospital pharmacy
• EU consultations on information to patients both on a general basis and specifically on medicines – the major concern expressed over the latter is that it could open the door to direct to patient advertising by the pharmaceutical industry
• The EAHP survey on hospital pharmacy that is circulated to all hospitals every few years – there are issues around the type of data that is collected as it is not easily translated from the routine data that is collected in the acute hospital portfolio and all the other surveys/inspections that we have to contribute to in the UK
• A report on the future role of hospital pharmacists in managing/handling gene therapy ( V’Iain Fenton-May will be reviewing this on behalf of GHP)
• A presentation on the Council of Europe report on medication safety, with respect to packaging and labelling
• And finally, the development of Electronic Health records/reports across Europe and the role of an organisation called Integrating Health Enterprise within this work.

*You will have seen in the Pharmaceutical Journal of 18^th August (p172) that the Royal Pharmaceutical Society, along with other UK regulators such as the General Medical Council, has written to the Department of Health (DH) expressing concerns about certain aspects of the new Directive, which as to be put into UK law this year.  The Guild’s response, jointly with the Unite-Amicus health sector, to the DH consultation on putting the Directive into UK law can be viewed on the Guild website, “Policy and Practice” and “Guild response to Consultations”.

On a final note of collaboration across Europe, the Guild spent some time discussing Agenda for Change with our colleagues from the Irish Hospital Pharmacists Association as they are undergoing a review of their career structure.

If anyone wants more information on the workings of EAHP, then the web address is www.eahponline.org

Bob McArtney
Chair of Education and Development
August 2007


Regulation of health professionals: the future

The government set out its proposals to “strengthen” the regulation of all health care professionals in the White Paper of February this year “Trust, Assurance and Safety-The Regulation of Health Professionals in the 21^st Century”.  We are all aware from the White Paper of the proposed split of the Royal Pharmaceutical Society into the General Pharmaceutical Council (GPhC), the regulatory body, and another body to represent the profession, possibly akin to a Royal college.  But what of the other proposed changes and how can we influence what might happen to us?

The Department of Health (DH) has set up a programme of work to implement the government’s proposals, the Professional Regulation and Patient Safety Programme.  I attended a briefing and feedback session in June on behalf of the Guild.  There was strong feeling from the participants that the changes should be fully discussed and consulted upon to ensure systems set up are robust, and not introduced in a rushed manner and subsequently be found not to work.

Seven working groups are being set up to look at various aspects of the changes.  Organisations such as Unite-Amicus are being asked to nominate members to these working groups.  The Unite-Amicus health sector sent in their nominations in August.  The working groups will cover the following areas:

Medical Education and Revalidation
Non-Medical Revalidation
Tackling concerns locally (this is mainly about medical staff)
Tackling concerns nationally
Enhancing confidence in healthcare professional regulators, covering the governance arrangements for the regulatory bodies
Health of health professionals
Extending professional regulation (for those professions who do not currently have to be registered to practise)

The Professional Regulation and Leadership Oversight Group, already set up by the DH to oversee the formation of the GPhC (see Pharmaceutical Journal 21^st July), will link in with the work of the group on “enhancing confidence” chaired by Niall Dixon, Chief Executive of the Kings Fund.

Three of the other working groups are of interest to pharmacy.  The Non-Medical revalidation group is to be chaired by Dr Jim Smith, former Chief Pharmaceutical Officer at the DH, and its output will affect all practising pharmacists in the future, as the government is committed to introducing revalidation for all health professionals.

The Tackling Concerns Nationally group, chaired by Sir Ian Kennedy currently the chair of the Healthcare Commission, include discussions on two aspects which will affect pharmacy regulation.  A central list of approved potential panellists is to be set up, to adjudicate in fitness to practise hearings for all regulators except the General Medical Council (for which there will be a separate independent body), so that adjudication is independent of the investigatory process.  However there is a need to ensure that there is always a real specialist available for the registrants area of practice and this will need to be built into the process.  The other aspect is the introduction of the “civil standard of proof” in these hearings ie that the registrant would be deemed “guilty” of misconduct on the balance of evidence, rather than “beyond all reasonable doubt”, the criminal standard of proof currently used.  The Royal Pharmaceutical Society already uses the civil standard of proof in their hearings.

The last group whose work will affect pharmacy is the Health of Health Professionals Group which will be looking at how support and rehabilitation can be provided for all health professionals where appropriate.

It is expected that the output from the groups will be circulated to all the other participants of the June meeting, who in turn should be consulting their members as time allows.  Where we receive any such requests the documents will be put on the members’ forum so that members can make comments if they wish.

Jean Curtis
Professional Secretary
29.8.07


Terms & Conditions update, August 2007

2007/8 Pay Offer

We are extremely disappointed that the recent 2.5% pay offer recommended by the Pay Review Body (PRB) is to be implemented unequally across the UK, where at the Treasury’s insistence in England only, the full 2.5% will not be paid until 1^st November.  Whilst welcoming the fact that the new pay offer in part addresses the position of lower paid staff such as pharmacy assistants and dispensers, the contribution towards professional fees is also inequitable in that it has stopped at band 8a.  The £38 for professional retention fees, whilst contributing around 50% of the fee to most of the staff groups covered by the PRB, most of whom who are regulated by the Nursing and Midwifery Council (NMC) or the Health Professions Council, does not cover even 50% of the increase in fees for pharmacists in 2008.  However that is an issue that will be addressed elsewhere.  The Guild issued a press release on the pay offer on 13^th August.  This can be viewed on the Guild web site www ghp.org.uk.

The continuing implementation of Agenda for Change throughout the UK has begun to reach its conclusion.  However, this has not meant an end to the work by GHP on Terms and Conditions for Pharmacists.  We have continued with the support of Unite, our parent Union, to seek a National recruitment and Retention Premia (RRP) for Pharmacists, address the 2007/8 and 2008-09 pay claims, (the latter may be a multi-year arrangement), and deal with the outstanding issue of out-of-hours working, including unsocial hours and on-call.

The work on a National RRP particularly focused on the junior bands 6 and 7.  The limited evidence available shows that there are on-going vacancies and high turnover of staff in these bands.  In the 22^nd Report of the Pay Review Body on Nursing and other Health Professionals for 2007/8, (now simply called the NHS Pay Review Body), it stated:

“With regard to pharmacists, we believe that the case for a national RRP warrants proper investigation and have asked the parties to consider jointly undertaking further research and to involve our secretariat.”

In the last 6 months we have begun that work with NHS Employers and the Office of Manpower Economics (OME) to obtain robust data on the current employment picture.  As part of this process we have highlighted:

Vacancies – including information from a series of NHS Education & Development surveys on vacancy rates and this will be supplemented by NHS Employers data and a separate OME survey that in part focuses on pharmacists

Annual turnover – High staff turnover is a measure of pressure on posts.  We have requested information on turnover from the Electronic Staff Record, that now covers over 60% of NHS staff by Band point, as our hypothesis is that most lower bands will only use first few points before moving on to other posts due to retention issues and market forces on pay.

Pay Drift – There is a concern that in some difficult to recruit sites, rather than seek local RRP payments for recruitment or retention purposes, managers are moving staff rapidly through AC bands.  This is a return to what was known as Whitley grade drift.  Whilst it may be advantageous to some individuals, it distorts the pharmacy career structure and undermines the concept of equal pay through job evaluation.

As part of this joint working there will be a confidential survey to identify for purposes of comparison, levels of remuneration and remuneration packages in community pharmacy in the major multiples at 3 levels, newly qualified, 3 years qualified and pharmacy managers.  This should be available in time for this years review in November.  The questions will seek to determine: 

• level of basic pay and salary scales;
• additional earnings and benefits, such as overtime, pension, holiday entitlement, sickness benefit, other benefits (e.g. staff discount, company car scheme);
• any overtime requirement or requirement to work during unsocial hours (e.g. 7pm-7am Monday to Friday, at weekends or Bank Holiday) and the level of overtime paid for such hours;
• the hourly rate of pay, both mean and median;
• rates paid for locums; and
• whether there are any regional variations in any of the above.

Unsocial hours.  The situation on unsocial hours is currently out for consultation.  The key point for pharmacists is that hours that are within the member’s normal 37.5 hour week that are worked between 7pm and 7am and worked at weekends and bank holidays, will be paid at a supplementary rate, which is an additional 30% of the hourly rate on a weekday and Saturday and 60% on a Sunday and Bank Holidays.  This will probably come into effect from April 2008.

On-call.  No discussions on on-call have yet taken place although it is the aim of Unite, supported by GHP, to protect the current interim agreements for another four years to allow appropriate discussions.

What can members do to help?

1. We would appreciate information from members of any examples of local RRPs either being paid to pharmacists or which have been refused and on what basis.

2. There is little national data on Agenda for Change outcomes.  We have the impression that relative to many other staff groups Pharmacists, sometimes following a review, have achieved satisfactory outcomes, and this is supported by the limited information obtained by regional members.

We would be grateful if you would update us on either of these issues.

You can contact your regional member via the About the Guild section of the website.

David Miller, Chair of Terms and Conditions Committee