28 October 2021

In the blog post for this edition Carole Auchterlonie, our Director of Fitness to Practise, sets out the how and why of our new approach to managing concerns.

Our current approach to how we manage concerns about pharmacy professionals isn’t delivering for the public or professionals.

The way we investigate concerns about a professional’s fitness to practise can, at times, be adversarial and slow and it can often have an unintended adverse impact on the mental health and wellbeing of people involved. We know many perceive our approach to be punitive and find it difficult to engage with us. We need to be more person-centred in how we interact with the professionals, patients and families involved in a concern and do more to encourage a culture of openness and learning in pharmacy. We also need to better understand why we get a higher number of concerns about Black, Asian and minority ethnic professionals than we ought to expect statistically.

At the same time, we must continue to meet our main objective of protecting the public.

So, what are we doing to address these challenges?

In June this year, following an extensive consultation, our goverrning Council approved our revised approach in Managing concerns about pharmacy professionals: our strategy for change [PDF 156KB]. Guided by our 2030 vision and our commitment to equality, diversity and inclusion, our new strategy outlines a programme for change. It sets out how we will take prompt action to protect patients when needed, while at the same time promoting and encouraging a learning culture that allows pharmacy professionals to deal with any concerns and go back to practising in appropriate circumstances.

There will always be times when things go wrong that can’t be put right – for example, if someone has been reckless or done something deliberately. In those cases, we will always take swift regulatory action. But in many cases, pharmacy professionals can put things right by being open and honest about what happened, showing insight into what went wrong, and taking steps to improve their practice. If someone can demonstrate they’re safe to practise, we think they should have the opportunity to continue to do so. We’ll encourage more concerns to be resolved locally when appropriate, so that we only take forward the most serious cases to keep the public safe and maintain public confidence in the profession.

The strategy also focuses on how to make sure the decisions we make are fair and that we eliminate any discrimination or bias in decision-making. We’re changing the language we use and the way we communicate with people involved to humanise what can sometimes be a stressful process. And we have now launched our services promises [PDF 243 KB], so people know what they can expect from us if they raise a concern or one is raised about them.

All these changes are within the limits of our existing legislation. To go further, we’re working with the government to set out how we can manage concerns in a modern, efficient and fair way through regulatory reform.

We’re committed to making our ambitions a reality for the benefit of everyone involved. We look forward to working with you to implement the strategy, and to ensure patients and the public receive better protection while being fair to pharmacy professionals.

27 July 2021

Nigel Clarke will finish his term as GPhC Chair in March 2022. In this blog post Nigel reflects on his time in the role and sets out the key challenges for the future, as we start the recruitment and selection process for a new Chair.

It has been a great privilege to serve as the chair of the GPhC over the last eight years.

During my tenure we have taken forward significant changes to how we regulate pharmacists, pharmacy technicians and pharmacies to drive improvements in pharmacy practice and protect patient safety.  These changes have included a review of the professional standards themselves, introducing revalidation, starting to publish pharmacy inspection reports and taking forward major reforms to the education and training of pharmacy professionals.

We have also developed our Vision 2030. This is an ambitious ten-year vision which will focus our efforts on the difference we want to make to the way in which the GPhC undertakes its role. 
We are now looking for an inspirational leader to take over as chair, who has the qualities needed to take the GPhC through the next phase of its development and help us achieve our vision. We need someone with the right skills and experience to take on this important role, whatever their background.

Responding to the COVID-19 pandemic

Our vision of ‘safe and effective pharmacy care at the heart of healthier communities’ and the supporting strategy has helped us to meet the challenges of the COVID-19 pandemic. It has guided our response and will continue to direct our work in the future.

We are currently looking at how we respond to the pandemic, build upon our initial work and determine what our future operating model should be. The experiences of the last year have highlighted something of which the GPhC was already aware – that pharmacy encompasses rapidly changing and developing professions with increasing clinical responsibilities and opportunities.

The GPhC needs to be alive to these changes and anticipating how they will impact on patients, as well as the professions and how they are regulated. At the same time, the broader world of healthcare professional regulation is changing. The results of the Government’s recent consultation on regulatory reform are not yet known but could well lead to change, for example moving from the current structure of a 14-member non-executive council to a smaller unitary board. The new chair will need to lead the GPhC through that process.

Shaping the future

The new chair will have the opportunity to help shape the future of pharmacy and of health professional regulation as we plan for change. They will be joining a motivated group of people, including our council members, staff, and associated workforce, with a shared commitment to do our best for the patients and public we serve and the professions that we regulate.

It is important that the GPhC reflects the diversity of the communities we serve and the professions we regulate. We have developed a diversity action plan for the recruitment of our new chair to help us identify the practical steps we can take to attract a broad and diverse range of suitably qualified candidates.

We have convened a panel, chaired by Mandisa Greene, the first Black president of the College of Veterinary Surgeons, to interview candidates for the role and recommend an appointment to the Privy Council.

If you are interested in being part of this rapidly developing landscape and have the qualities and commitment that we need, we would like to hear from you. You can find out more in the Working for us section of the main GPhC website.
 

25 May 2021

On 29 April, around 2600 pharmacist trainees and provisionally registered pharmacists found out the results of the registration assessment which they sat in March. Just over 88 percent of those achieved the standard they needed to pass and were able to move on to the next stage of their career as a registered pharmacist.

Getting to the point of feeling ‘fit to sit’ the registration assessment represents a huge achievement for all the candidates who sat, many of whom have had quite different experiences of training, working and preparing to sit than they may have expected when they started the pre-registration year, before the pandemic began.

The registration assessment was also a significant challenge for us as an organisation, and one of the areas of our work which was most affected by the pandemic. As the process for this cohort draws to a close, we have also been taking time to reflect on how well we met the objectives we set for ourselves and what we can do better to improve the experience of those sitting in July and November.

It became obvious to us very quickly in Spring 2020 that the usual format of several hundred pre-registration trainees sitting the assessment in large venues was not going to be possible under social distancing restrictions. With input from stakeholders including representatives of pharmacy employers, training organisations and students and trainees, we identified key objectives to guide us in putting in place a new pathway to registration, and to help us approach the considerable logistical issues of holding a robust assessment that met our standards.

These objectives included supporting the NHS and all sectors of pharmacy by strengthening the workforce, maintaining standards for entry to the register to protect patient safety and the quality of care, and safeguarding the welfare of students and trainees.

Introducing provisional registration was the first important step in meeting these objectives, and we were able to put this in place relatively quickly, so that trainees could carry on providing patient care, with some important safeguards in place.

The second step was to focus on delivering the registration assessment sittings in a new way. We worked to investigate options to deliver a robust assessment, learn from other regulators and education organisations’ experiences and carry out a procurement process.

We did not have an outcome for some time, and we appreciate that trainees who were waiting anxiously to know what they would be asked to do would have felt reassured by more regular updates, even if those were to say that work was still in progress.

Once we had identified a supplier, we started to put in place the application process and confirm the details of how the sitting would take place. As well as making sure that candidates knew what they would practically need to do, we also needed to make sure that the registration assessment was a robust and accurate test of trainees’ skills and knowledge. If we were to hold an assessment, it was important that we gave candidates a fair opportunity to meet the same standard as previously.

We know that we did not get everything in this process right. Undoubtedly some of the elements, such as the booking process and the arrangements for overseas candidates, contributed to an already stressful and uncertain situation for some trainees. We are sorry for this.

While we achieved the overall objective of holding an online assessment which maintained standards and enabled the majority of eligible candidates to sit, there are a number of lessons to be learned from this challenging exercise. We have carried out a review to identify these lessons, which will be considered by our Council, and we are applying these to preparations for the July and November sittings.

I would like to congratulate everyone who has passed the assessment; it is great to see them being able to move forward in the careers and take up roles providing much needed patient care.

17 December 2020

Preparing future pharmacists for a greater role in providing clinical care to patients 

Over the past year, we have seen pharmacy professionals adapting their professional practice to provide patient care in a wide range of new circumstances, including being involved in public health programmes in new ways. I feel that it’s shown both the healthcare sector and patients and the public just how capable, flexible and adaptable pharmacy can be.

At the same time, following on from a major consultation we held in 2019, we have been working with key stakeholders to take forward major changes to the initial education and training of pharmacists.  These changes will enable pharmacists to play a much greater role in providing clinical care to patients and the public from their first day on the register – the value of which has been so recently demonstrated.

A key step in implementing these reforms is the approval last week by our governing Council of new standards for initial education and training of pharmacists

The new standards introduce a number of important changes to ensure pharmacists are equipped for their future roles. They incorporate the skills, knowledge and attributes for prescribing, to enable pharmacists to prescribe independently from the point of registration.

They also emphasise the application of science in clinical practice as well as key skills needed for current and future roles, including professional judgement, management of risk, diagnostic and consultation skills. These are all key capabilities pharmacists will need to meet the demands of providing care, both now and in the future.

The standards also set out requirements for organisations providing initial education and training and make the fifth year of initial education and training a foundation training year with strengthened supervision and support.

Overall, the standards have a greater emphasis on equality, diversity and inclusion to combat discrimination and address health inequalities.

When implemented, these standards will mean that universities, employers and statutory education bodies will also be working together in new ways to give student pharmacists more clinical experience and provide enhanced support and quality assurance across all five years of education and training.

We will continue to work very closely with all key stakeholders to implement these significant changes and we’ll start by developing a transition plan for implementing the standards in stages over the coming years.

We know implementing these reforms won’t be easy, and full implementation will take several years, but successfully delivering these reforms together will bring long-term benefits for the health service and patients and will help to meet the ambitions of governments and the NHS in each country across the UK.
 

22 October 2020

The last eight months have challenged us all, both personally and professionally, in ways we couldn’t have imagined at the beginning of 2020.

I want to thank all of you for how you have risen to these challenges you have faced so far this year. There is a huge appreciation from patients and the public, from governments and from the health service for everything that pharmacy teams in all sectors have done during the pandemic.

What has been particularly inspiring for us is to see the good practice that so many of you have identified and put in place in response to the pandemic. Our inspectors have identified over 130 examples of good practice during the COVID-19 pandemic which you can read on our knowledge hub. And we have shared some of the examples in this edition of Regulate.

Despite the huge demands you have faced, you’ve often gone above and beyond to provide care and support to your patients. One moving example of this was the response from community pharmacies when we asked them to offer a Safe Space in the pharmacy for people experiencing domestic abuse. This was part of a scheme organised by Hestia, the domestic abuse charity.

Over 1 in 4 pharmacies have already signed up and Hestia has advised us that Safe Spaces in pharmacies have already been used over 3,700 times. We’ve shared the story of a woman who was able to escape her abuser thanks to the Safe Space provided by her local independent pharmacy and who says the scheme has saved her life. Please do consider joining the scheme if you haven’t already.

Winter pressures

As we head toward winter, and with COVID-19 cases continuing to increase, we expect everyone in pharmacy will again face significant pressures. We know that many pharmacists in community pharmacies are already facing very high demand for flu vaccinations. This is a hugely important task to help protect public health this winter and we greatly appreciate the efforts being made by so many of you to help deliver the biggest flu vaccination programme ever.

It is vital however that pharmacy professionals are empowered to provide this service safely and effectively and there are enough staff to support this. In this article we emphasise the importance of making sure that our standards and guidance are met at all times, including when there is very high demand for services.

Learning lessons from the pandemic

In the next phase of the pandemic, our priority will be to continue to do what we can to support you to provide safe and effective care to your patients and communities.

We also want to make sure we learn the lessons from the pandemic. We’ve already identified lots of positive examples as well as areas where we want to improve and strengthen how we work.

We have had to make some very difficult decisions, including to postpone the registration assessment, and we appreciate that some people have faced further challenges as a result. We are working as quickly as we can to reschedule the registration assessment and will have further news on this in the coming weeks.

When the pandemic first started, we put many of the activities we were planning for 2020 on hold so we could focus on supporting pharmacy professionals and the wider pharmacy sector.

We are now moving forward with some of these key areas of work. These include finalising new standards for the initial education and training of pharmacists and consulting on a new strategy for how we manage fitness to practise concerns about pharmacy professionals. Please look out for more details and take part in the consultation if you can.

Thank you again for the part are playing to support patients and the public during this very challenging year. We are grateful to you all for your commitment to your patients and your resilience as we enter the next phase of the pandemic. We will do what we can, working with others, to support you.

2 March 2020

Thank you for the care you give to the people you serve. Providing safe and effective care whilst managing lots of different risks must be a big challenge at the best of times, and never more so than when faced with a novel public health threat (COVID-19) which is dominating the headlines, the airwaves, social media and many day to day conversations. As a vital and accessible public service, pharmacy is in the frontline of public concern as well as patient need.

Just as our standards for pharmacy professionals ask each of you to take a person-centred approach to your work in pharmacy, so too do we aim to take a person-centred approach to our regulatory work. This includes recognising the challenges you face and the sometimes very difficult context in which many of you are operating. This is why we have joined forces with the regulators for doctors, nurses and a range of other health and care professionals in re-affirming our shared commitment to a proportionate and contextual approach to how we regulate, on a day to day basis.

At the same time, in a practical way, we want to support you by providing useful links to key sources of authoritative advice and guidance, which you need to be thinking about when working out how best to uphold your own professional standards and look after your patients, whilst also holding understandable concerns you may have about the safety of yourself, your family and your team. So please read Latest updates on Coronavirus (COVID-19).
 

11 December 2019

The number of pharmacists qualified as prescribers is rapidly growing, as the way in which people access pharmacy services changes, and the roles that pharmacy professionals take in lots of different settings diversify. 
We expect that the current figure of around 15% of the pharmacists on our register having a prescribing annotation will keep on rising – but it’s not just a question of quantity, but of making sure those prescribers always provide safe and effective pharmacy care, in all settings.

We are seeing increasing numbers of pharmacist prescribers working in primary care and in other settings such as online pharmacies, as demonstrated in our recent survey of registered pharmacy professionals.
These new roles and service models can present new challenges for pharmacist prescribers. It’s essential for pharmacist prescribers to be aware of, and work within, their competence and scope of practice, and to make sure that they can always justify their prescribing decisions.

We have recently seen some examples of inappropriate prescribing and have taken action in a number of instances, including referring those involved to fitness to practise, where appropriate. 

Our new guidance for pharmacist prescribers sets out what both pharmacist prescribers and the organisations that employ them should consider, to make sure people receive safe and effective care. The guidance emphasises that pharmacist prescribers must be able to justify their decisions and use their professional judgement in the best interests of the person receiving care, in all contexts.

We want this guidance to provide a useful framework for prescribers and their employers to help make sure that through the services they provide, patients are safely prescribed medicines that are clinically appropriate for them.

19 September 2019

Earlier this week we began publishing pharmacy inspection reports for the first time. This is a significant milestone in pharmacy regulation and will give the public and the pharmacy sector access to a wealth of information that they can use to inform the decisions they make.

Publishing those first inspection reports on our new pharmacy inspections site was the culmination of many years of preparation and planning.It required a change in the law, supported by governments across Great Britain. We then held a public consultation on our plans to publish reports, and what we heard through that consultation really helped to shape our final approach.

Our team of inspectors have been working very hard to get ready for this major change, including making sure that the reports they write after each inspection are clear and useful for patients and the public and for the pharmacy team.

We believe that being able to find out the outcomes from pharmacy inspections will give greater assurance to patients and the public that almost all pharmacies are meeting standards.

Where a pharmacy has not met all the standards, the pharmacy’s improvement action plan will also be published. Members of the public taking part in the consultation told us that they wanted to be able to see improvement action plans, so they could be assured that improvement was underway. They wanted to be able to see what steps the pharmacy was taking to meet the standards, and to know that this was being monitored by our inspectors. Members of the public were also significantly more likely to say they would use a pharmacy that had not met all of the standards if they knew that the pharmacy was completing an action plan, when compared to if they didn’t know an action plan was in place.

Another key priority for us is to help promote improvement in pharmacy practice, by sharing what we have learnt from inspecting pharmacies.

We have published a new report sharing what we have learnt from carrying out over 14,000 inspections covering every registered pharmacy in Great Britain since 2013. Something that came through strongly to me when reading the report was that pharmacies will only perform well against the standards if pharmacy owners have made sure that their pharmacies have the right governance, systems and culture in place, and are investing in their staff. Once these elements are in place, the pharmacy staff are then able to deliver good and excellent practice for the patients and the public using their services.

To support pharmacy owners and the pharmacy team to deliver good and excellent practice, we have developed an online ‘knowledge hub’ for the pharmacy team, with short anonymised examples of notable practice identified through pharmacy inspections. This knowledge hub was developed in response to feedback from the pharmacy sector about how useful they found examples of notable practice shared by the inspectors during inspections.

You’ll see that the knowledge hub highlights examples of excellent, good and poor practice for the key themes identified by the report on our learning from inspections, as well as examples for the standards that have a key role in driving performance and the standards that are most commonly found to be not met. We will be regularly updating the knowledge hub with new examples, so make sure you regularly visit to see what’s new.

We hope you find the new information we are publishing helps you and your team to continually improve the services you provide to patients and public. And we want to continually improve the information we make available, so please do let us know your feedback about the new site. You can do this quickly and easily via the link at the top of each page on the new pharmacy inspections site.

Inspection visit

Aamer Safdar is one of our Council members who joined our Council in March 2019. He recently went with one of our inspectors on an inspection visit as part of his induction. 

Aamer reflects in the blog post below about his experiences and on how inspections can help the pharmacy team:

I recently took time off work and had the pleasure of visiting a community pharmacy with a GPhC inspector to observe what they do and learn as much as I can about the process. The pharmacy that we visit is part of a health centre. It’s very small, with one pharmacist and a couple of assistants.

As all GPhC inspection visits are now unannounced, the pharmacist- who is also the owner- has no idea we are coming. She is initially shocked when the inspector introduces herself, but soon calms down as the inspection process commences.

I observe while the inspector asks questions based on the inspection standards in a conversational manner, which is not what I was expecting! This is not the enforcement style with questions about why standards were not being met that I had anticipated. The approach is very supportive and helpful, even when some of the more important standards have not been met.

The inspector goes through a raft of standards, which include checking of expired medicines, temperature monitoring, standard operating procedures, controlled drug registers and storage of medicines. What pleases me most is the focus on the training of the support staff who are working in the pharmacy. This is an area close to my heart.

As there are times when the pharmacy is busy, the inspector allows the locum pharmacist who takes over from the pharmacist owner to get on with his duties, and I take the time to learn about the role of a GPhC inspector. We discuss a wide range of things in snatched conversations: the pressure that inspectors can feel when discharging their duties, how they write up their reports and how are these are quality assured in preparation to be published. The inspector also explains some of the difficulties, such as knowing what training is suitably accredited and recognised by the GPhC. We even have time to talk about community pharmacist independent prescribing.

I have learnt a lot from this visit as it has given me reassurance that the inspectors are diligent in their work and are focused primarily on the inspection standards whilst keeping patients and the public in the forefront of their minds. They are obviously there to help the pharmacy team as well and do this in a positive and helpful manner.

29 July 2019

I am not a pharmacy professional, so I am not able to register or revalidate with the GPhC. But for my Regulate blog this month, I have nevertheless chosen to write a reflective account. I have followed the revalidation framework and the standards for pharmacy professionals. In lots of ways they are very relevant to my 'practice' as a regulatory professional in a leadership role within the GPhC. I also wanted to test out for myself the revalidation guidance and resources on the GPhC website. 

The typical users of my services

My colleagues in the GPhC provide services for and work with:

  • pharmacy professionals and people preparing to join the professions
  • pharmacy owners, and employers of pharmacy professionals 
  • providers of pharmacy education and training
  • pharmacy representative and leadership organisations and a wide range of other organisations and agencies including government and NHS bodies and other regulators 

Although we work with all these people and more, we operate on behalf of patients and members of the public using pharmacy services, and in their interests.

How I meet the selected standards for pharmacy professionals

This year, the GPhC has asked pharmacists and pharmacy technicians to reflect on one or more of these standards:

  • standard 3 - pharmacy professionals must communicate effectively
  • standard 6 - pharmacy professionals must behave professionally 
  • standard 9 - pharmacy professionals must demonstrate leadership

I have chosen to reflect mainly on standard 3 (effective communication). I have re-read the standards as a whole, focusing particularly on what I can learn from standard 3 and how it applies to my work. Although I do a lot of talking and writing in my job, listening actively and attentively is essential in order to try to understand and empathise with the point of view and experience of people affected by my work. This was brought home to me really powerfully when I met with a number of women whose children had been affected by exposure to Sodium Valproate in the womb. I was really humbled by the dignity and compassion of the women I met, whose response is to work tirelessly to help reduce the risk of other families experiencing the same avoidable harm. Their example has motivated me to keep exploring what more we can do- with others - to achieve that same goal.

Working to try to understand, as well as I can at second hand, the day to day reality of practice for pharmacy professionals, many of whom are experiencing stress associated with workload and resource pressures, is another important communication challenge requiring more listening than talking from me. This was why it was so important for me to attend a round table event we organised to hear about the challenges which individuals and organisations are facing in implementing the guidance we have issued on safe and effective pharmacy team working

Reflecting on these two different listening experiences has helped me see an important connection between them, which is about understanding the obstacles which decent caring professionals can sometimes face in doing the right thing for patients and their families. A constructive regulatory response needs to be part of an ongoing collaborative effort to improve standards of care, in the way that many pharmacy technicians and pharmacists themselves are so passionate about.

We produced information on the safe supply of sodium valproate and sent it to all pharmacy professionals on our register. What we need to do now is understand how effective that was in making a difference to the decisions made by pharmacy professionals on behalf of patients and the public. This is something we can do through our collaboration with organisations who share responsibility for medicines safety and through our analysis of the learning that pharmacy professionals have done as part of revalidation.
 

30 May 2019

We often hear that the way pharmacy services are delivered will change significantly over the next five to ten years - but the pace of change was really brought home to me when I looked through the information about our proposed guidance on prescribing. Since 2016, the number of independent prescribers on our register has gone up by over 4,000 - which is more than double.

Although this is just a number, behind it are many pharmacy professionals taking on different job roles, working in multidisciplinary teams, in a greater variety of settings, and using new technology.

We want to make sure that we understand these changes and are able to respond to them - focusing more on proactively anticipating and responding to issues, and tailoring our responses to get results in the best and quickest way. To do this, we have begun work on a longer-term, ten-year vision and strategy.

As a first step, we need to understand more about how pharmacy professionals work now. To do this, we have commissioned Enventure, an independent research company to ask you to complete a survey about your role as a pharmacy professional as it is today.

This is the first time we have gathered data about the roles and responsibilities of pharmacists and pharmacy technicians since 2013, and we’re interested to see what has changed, and what hasn’t – we’re keen to share the results with you.

We want to get the most out of the information you give us, so we will also be sharing the same anonymised data we receive with other organisations who are responsible for workforce planning in all three countries of Great Britain.

I hope you’ll look out for an email survey invite in the coming weeks.  Your information will help us understand what pharmacy looks like now, and provide a sound basis for our future strategy.