Responsible pharmacists should be allowed to delegate aspects of the preparation, assembly, sale and supply of medicines to appropriate members of the pharmacy team in defined circumstances, a cross-sector group reviewing pharmacy supervision has suggested.
And they proposed that legislation be amended to allow the preparation and assembly of medicines to take place outside of the pharmacy’s opening hours, without a responsible pharmacist signed in.
The group agreed that having a pharmacist physically present in the pharmacy was ‘an important and defining element of community pharmacy’, but members were split over whether this should be encoded in primary legislation, or within secondary legislation, regulatory rules and standards, or professional standards and guidance.
The group did agree that the term ‘supervision’ should no longer be interpreted to mean that the pharmacist must supervise every individual transaction, but instead that the responsible pharmacist (RP) and superintendent pharmacist (SP) must exercise professional oversight of the preparation, assembly, sale and supply of medicines to the extent required in legislation.
When the RP is absent from the pharmacy, the group agreed that delegation and mechanisms should be put in place to enable continued access to the pharmacist and some pharmacy services, including certain medicines. But it said that the two-hour time limit for RP absence should remain.
The group has been meeting since January to discuss how the term ‘supervision’ should be interpreted, with a vision to free up pharmacist capacity to be available to patients and deliver clinical services.
It includes representatives from the Association of Independent Multiple Pharmacies, Association of Pharmacy Technicians, Company Chemists’ Association, the National Pharmacy Association, the Pharmacists’ Defence Association, Pharmacy Forum Northern Ireland and The Royal Pharmaceutical Society of Great Britain.
It has also met with the Department of Health and Social Care (DHSC) to discuss how its proposals align with the government’s proposals for community pharmacy.
Following this, the DHSC and regulators will draft specifically worded revisions to legislation and regulatory rules and standards, which will then be subject to a full consultation process.
Read the full 'Supervision in Community Pharmacy: Recommendations from the Supervision Practice Group' report here, and on each organisation's website.
Comments from those involved:
The chair of the group, Dr Michael Twigg, associate professor of Primary Care Pharmacy, University of East Anglia and head of research design and evaluation at NHS Norfolk and Waveney, described the group’s conclusions as a ‘major step forward for community pharmacy’ that ‘will enable the sector to work in new ways to support their patients and communities’.
He added: ‘It is a report that values the contribution of all members of the pharmacy team and provides a platform for the development of a more holistic model of care.’
And he praised the organisations involved for their ‘honesty’ in discussions and shared ‘commitment to build a positive future for community pharmacy practice’.
NPA Chair Nick Kaye said that the association was ‘pleased to have reached a common position on pharmacy supervision, after months of working collaboratively to understand, respect and accommodate each other’s stance on this important matter’.
‘This report means that when the government proceeds to a full consultation on this matter it will have a clear sense of where the consensus sits within the sector,’ he added.
While Dr Leyla Hannbeck, chief executive of the AIMp, said her organisation ‘will be responding to the government consultation in accordance with our vision for a robust, innovative and thriving community pharmacy sector with a skilled workforce that play a key role in the primary care’.
She added: ‘We have been a big advocate for seeking a level playing field for community pharmacists in line with our GP colleagues and this applies to the rules of supervision too.’
Malcolm Harrison, chief executive of the CCA said that the changes outlined in the report were ‘crucial to realising the increasingly clinical future expected of the sector’ and ‘provide the basis for the greatest evolution in pharmacy practice for 70 years’.
Claire Anderson, president of the RPS said the society was pleased to work collaboratively with the other organisations to contribute to the report, which she said reflected the views of its boards across Wales, Scotland and England.
And she added that the RPS would ‘keep guiding the professions with trusted standards and advice to support the implementation of any future changes into practice.’
Julie Greenfield, manager of Pharmacy Forum Northern Ireland, said that the publication of this report ‘creates a vision and approach that will inform the legislative and regulatory changes now required to deliver future innovation and service development within community pharmacy’.
This would both enable public and patient safety as well as ‘full and appropriate use of the skill mix and expertise of the whole pharmacy team’, she added.
Nicola Stockman, vice president of the Association of Pharmacy Technicians (APTUK) commented that 'the vision of community pharmacy practice described in the report will enhance patient access to pharmaceutical services, ensure high levels of patient safety, and enable further development of the community pharmacy team including pharmacy technicians.'
Why does ‘supervision’ need clarifying?
Current legislation states that the sale of medicinal products must be carried out by a pharmacist or under the supervision of a pharmacist.
Previous case law has suggested that this means that a pharmacist must be physically present for the dispensing of medicines.
But reform to pharmacy legislation is planned for later in 2023, following a 2018 UK-wide consultation on legislation around the role of Responsible Pharmacists and Superintendent Pharmacists.
The consultation found that further clarity around the definition of supervision was needed.
In response, a working group was launched to work with the government to help shape future legislation.