We wanted to highlight the responsibilities of pharmacy teams and owners in ensuring that targets and incentives do not compromise the health, safety and well-being of the public or the professional judgement of pharmacists and pharmacy technicians.
We have recently received intelligence about pharmacy teams being set targets or being incentivised by employers to complete a specific number of services or patient consultations within a set timeframe. There is a risk that this may affect a pharmacist or pharmacy technician’s decision-making and compromise patient care. Any performance indicators should be worked with professionally and appropriately and financial interests or targets must not be prioritised over patient safety and wellbeing.
While we are aware of the ongoing pressures that pharmacy owners, organisations and teams may be facing, incentivising or setting targets on performance for employees can put undue pressure on pharmacy teams to deliver services where it may not be appropriate to do so.
We will consider taking fitness to practise action against those who prioritise targets or financial motivation over patient care.
What do our standards and guidance say?
Pharmacists and pharmacy technicians need to provide person-centred care. This includes listening to the person, understanding their needs and providing information in a way that they understand, so they can make informed decisions and choices. There is a risk with targets and incentives that people do not receive tailored and person-centred care to suit their needs. We expect pharmacists and pharmacy technicians to consider the impact of their practice and utilise their professional judgement.
This includes managing any personal or organisational goals, incentives or targets to make sure the care they provide reflects the needs of the person.
We expect pharmacy owners and superintendent pharmacist to provide adequate support to their pharmacy teams and empower them to make professional decisions that support the needs of their patients.
Pharmacists and pharmacy technicians must also speak up when they have concerns or when things go wrong. This means challenging poor practice and behaviours, and promptly telling their employer and all relevant authorities (including the GPhC) about concerns they may have.
Standards for registered pharmacies
Pharmacy owners and superintendents must ensure that their pharmacy teams adhere to Standard 2.6: incentives or targets do not compromise the health, safety or wellbeing of patients and the public, or the professional judgement of staff.
They should not place undue pressure on pharmacy teams to meet targets if there is a risk that this would have an adverse effect on patient care. Pharmacy teams should be able to exercise discretion and their professional judgement when providing services that have targets or incentives attached.
During the inspection process, GPhC inspectors will ask how services are provided and if targets and incentives are set, to encourage delivery of the service. Inspectors will consider the evidence and a judgement will be made as to whether professional judgement is being compromised to achieve targets in favour of providing safe and effective care. Inspectors may fail standards where evidence suggests that safety, health and wellbeing of people and the public is compromised in favour of targets and incentives.
In practice: guidance for pharmacist prescribers
Pharmacist prescribers are responsible and accountable for their decisions and actions. Targets and incentives associated with consultations for prescription medicines can lead to patients not receiving the care they need or receiving medicines which are not appropriate for them.
Pharmacist prescribers must make sure incentives and targets associated with patient consultations or provision of treatments do not compromise their professional judgement. They must make sure the care they provide reflects the needs of the person and does not compromise the health, safety and wellbeing of patients and the public. If they are concerned or things go wrong, they must speak up. This is in line with their professional and statutory ‘duty of candour’.
Guidance to ensure a safe and effective pharmacy team
Pharmacy owners must make sure that their teams can meet their own professional and legal obligations and are able to exercise their professional judgement in the interests of patients and the public.
Managers who have responsibility for leading and managing teams, and for co-ordinating many aspects of the day-to-day pharmacy operations, have an important role to play.
Pharmacy owners and those in management and leadership roles:
- should make sure pharmacy teams are supported and empowered to handle challenging situations confidently and professionally, whether that means having the right conversations with managers or knowing when and how to raise a concern with the pharmacy owner.
- understand how to manage appropriately any personal or organisational goals, incentives or targets without compromising the professional judgement of staff to deliver safe and effective care. This should include providing adequate training and support to help team members fulfil their roles.