23 October 2023

Welcome to this edition of Regulate.

We’ve been meeting pharmacy professionals over the past months, including students, trainees, pharmacists and pharmacy technicians at the recent Pharmacy Show in Birmingham. One of the things we’ve heard is that you value accessible and bite sized materials to encourage learning and discussions in team settings. I hope Regulate can help to meet this need.

We’ve taken the opportunity to join in with Menopause Awareness month, and to highlight key information about providing hormone replacement therapy medication to those who need it.

As part of our EDI work, we’ve taken a closer look at the protected characteristics of age, sex gender reassignment and disability, to help you and your pharmacy team to think about more broadly about health inequalities and start discussions about how these may be relevant in your pharmacy setting. We’ll be covering different characteristics in the future, so look out for these.

I also wanted to highlight some key legislative changes about original pack dispensing in case you missed our email last week, and also give a quick reminder about our resources to help you meet your responsibilities in relation to the duty of candour.

You may have seen that the General Medical Council has published a new edition of Good Medical Practice, the professional standards for all doctors in the UK, which will come into effect in January 2024. A theme in this new edition is multidisciplinary working, so in this edition of Regulate, we hear from Charlie Massey - Chief Executive and Registrar at the GMC about his view on how the pharmacy and medical professions can work together effectively.

Charlie talks about the importance of 'positive, open cultures', which are vital in both pharmacy and medicine. Patients from all backgrounds and communities need to feel safe when accessing pharmacy services, so they can place their trust in pharmacists and pharmacy technicians and receive the care they need. This is reflected in our standards for pharmacy professionals, which ask pharmacy professionals to behave in a professional manner. Equally, pharmacy professionals must be able to work in an inclusive environment free from harassment and prejudice.

The standards need to be met at all times, not only during working hours, including when online or using chat groups such as Whatsapp. All pharmacy professionals should be aware of and follow our guidance on demonstrating professionalism online, including the importance of respecting each other and not subjecting others to bullying, harassment or discrimination.

We have these same expectations of our future pharmacy professionals during their education and training. Learning to demonstrate the standards in an education or training context is an essential part of progression towards registering and practising as a pharmacy professional.

Pharmacy employers also have important responsibilities, including the responsibility to create a culture in which staff can live up to their professional and legal obligations.

I hope that these you find this and future editions of Regulate useful, as a quick and concise resource to refer to as part of the important work that you do.

22 June 2023

Welcome to this edition of Regulate, where I get the opportunity to thank all those who’ve joined us at our new programme of engagement events we’ve been running this year as well as highlight key topics in pharmacy that are of interest.

We’ve been hearing your views via our series of regional roundtables that we’re running around Great Britain as part of our commitment to increasing engagement with all those with an interest in pharmacy. The aim is to listen to peoples’ views and experiences to inform our work and build our insights into key issues.

As Chair of the GPhC Council, I find it invaluable to meet people working across the pharmacy sector, as well as organisations representing patients and the public, to really comprehend the challenges people are facing, and how we could help address them as the pharmacy regulator. In this edition you’ll be able to find out about the issues and topics that we discussed at our very first event.

You’ll also see we want to hear from even more people, specifically in relation to experience of fitness to practise. We are looking for individuals who would be willing to share their experience of being involved in a fitness to practice concern (both positive and negative) in order to help inform an independent evaluation of our managing concerns strategy. Read the article about managing concerns about pharmacy professionals to find out more.

Thank you again for those who are engaging with us – we really do want to hear a diverse range of views and experiences of pharmacy so we can learn, understand and ensure these are reflected in the best way possible in our regulatory work.

I look forward to attending our next GPhC Regional Roundtables Event in Wrexham on 4 July, 18:30-21:00. Book your free place now if you want to join us.

24 January 2023

Welcome to this special edition of Regulate, which focuses on equality diversity and inclusion (EDI).

In March 2023, we will reach the end of the first full year of our new EDI strategy, which signalled a major change to the way we approach equality diversity and inclusion at the GPhC. The strategy sets out a clear agenda to use all of our regulatory levers and influence to tackle discrimination and support the reduction of health inequalities, and to be more proactive on speaking out on these issues. This approach is supported by everyone at the GPhC, from our governing Council through to all of our committees and staff.

Some EDI highlights

To share some of the highlights over the past 10 months: we’ve now started to routinely publish diversity datasets for our registers (pharmacists and pharmacy technicians), as well as specific diversity datasets for the three countries that we regulate; we’ve been working to minimise the risk of discrimination and bias in fitness to practise decision-making (with the introduction of several process changes, to identify any potential issues around discriminatory behaviour by the person raising the concern or issues with referrals being used as a retaliatory measure) and we’ve published new equality guidance for registered pharmacies.

In November, we brought together key stakeholders from across the pharmacy sector, to discuss how racism manifests and affects pharmacists and pharmacy technicians, and how this can have a resulting impact on patient care. The report on that event and the associated actions will be published soon. We also launched a discussion paper on our proposal to strengthen decision-making guidance for fitness to practise committees, to help eliminate any potential discrimination in the outcomes of hearings. This guidance makes it clear what we mean by discrimination, bullying and harassment, and how seriously concerns of this nature will be taken.

We published some new advice to help anyone with a disability, mental health or physical health issue, get the support they need and remove or reduce barriers when using our services. For our staff, we developed a new guide and toolkit, to help assess the impact of policies, including how to take an intersectional approach to impact assessment and to use data and evidence effectively. 

We’re continuing to support the Inclusive Pharmacy Practice (IPP) work, which is a joint initiative with the Royal Pharmaceutical Society, the Association of Pharmacy Technicians UK, and a number of partner organisations. Inclusive pharmacy practice focuses on making the workplace more inclusive for pharmacy professionals, with a senior leadership that reflects our diverse communities, to improve health inequalities in the population. Read our most recent contribution to the IPP bulletin on diversity in senior pharmacy leadership.

You can read about all of this work and more in our recent report to our Council, which includes detail about our EDI activities as a regulator and an employer.

Inclusive care for LGBTQ+ patients

In this special edition, we’re also highlighting the crucial role that pharmacy teams play in addressing the health inequalities faced by LGBTQ+ communities including barriers to accessing healthcare, experience of prejudice and discrimination, and poorer health outcomes.

Read our article with the LGBT Foundation, with includes materials for individual or team-based learning to develop knowledge and confidence around LGBTQ+ inclusivity in pharmacy, and how this links to our standards for pharmacy professionals in terms of providing person-centred care.

In this further article, we’re also looking at the important issue of inclusive care for trans and non-binary patients, specifically gender identity services for children and young people who are experiencing gender incongruence and dysphoria and the role of pharmacy teams in this context.

There is growing interest in how the NHS should most appropriately assess, diagnose and care for children and young people who present with gender identity issues. All children and young people deserve safe, timely and supportive healthcare services, and professionals with the training and expertise to meet their healthcare needs. Children and young people with gender incongruence or dysphoria must receive the same standards of clinical care, assessment, and treatment as every other child or young person accessing health services. They must also be able to access the appropriate level of psychological and social support as any other child or young person accessing services for their healthcare needs.

In the article, we look at what pharmacy teams need to consider when providing care in this context, including on a range of important issues from professionalism and professional judgement, personal values and beliefs, confidentiality, consent and effective communication, and partnership working.

Patient Safety Spotlight

We look at managing the risks associated with providing community pharmacy clinical services and what GPhC standards should be applied to ensure pharmacy teams are delivering safe and effective care.

Using an example of a community pharmacy setting up a blood pressure check clinical service, we highlight best practice, and set out the key elements of the standards which should be applied when setting up and providing this service.

4 October 2022

Our Chair, Gisela Abbam, sets out the patient safety issues we’ve identified with online pharmacy services and how we are responding to protect people using these services

Patients and the public are increasingly using online pharmacy services to get medicines and treatment. There can be significant benefits for people in using online services, but the right safeguards need to be in place to protect patients, as medicines are not ordinary items of commerce.

This a fast-developing area of pharmacy practice. As the pharmacy regulator, we need to respond quickly and effectively to emerging issues, to keep patients safe.

In this special edition of Regulate, we take a closer look at some of the issues around online pharmacies, and what actions we are taking to help keep people safe.

Unfortunately, we are continuing to identify patient safety concerns. More than 30% of open Fitness to Practise cases at the GPhC are related to online pharmacies and we have taken enforcement action against 55 online pharmacies since 2019.

Working with pharmacy professionals and owners

We want to work with pharmacies, pharmacy owners and pharmacists to ensure the right environment is created and maintained to deliver safe and effective online pharmacy services.

But we are seeing too many examples of pharmacies which have weak clinical governance and leadership, and are not providing a safe and effective service. Where necessary, we are taking robust action in response to concerns over some online prescribing services in Great Britain and are working closely with other relevant regulators.

In the first article in this special edition, we set out the key themes we are seeing in our fitness to practise cases, the patient safety issues we’ve identified, actions we’ve taken, and what pharmacy professionals and owners need to do if they are providing online pharmacy or prescribing services.

These actions includes making sure the standards for pharmacy professionals are met at all times, and that the organisation or service that you are working for is appropriately regulated in the UK, or is meeting the relevant UK regulatory standards for that service.

Sharing good practice to help drive improvement

We also want to proactively share examples of good practice we have seen in online pharmacies, and make clear to everyone working in this area what is expected of them, to help drive improvements in patient care. We know some online pharmacies and prescribing services are providing a good service that benefits patients. In this article we share examples of good clinical governance in an online pharmacy setting, which have been identified through our inspection work.

For patients and the public, we’re also sharing our guide with top tips to help people make sure any medicine or treatment they get is suitable and safe.

 A safer future for online pharmacy

It is vital we ensure online pharmacy services are safe for the public and patients to use now and in the future. We all need to work together and respond quickly to make that happen.

31 May 2022

Hello, I’m Gisela Abbam and I wanted to introduce myself as the new Chair of the GPhC.

I’d like to take this opportunity to tell you a bit more about myself, why I think pharmacy and all those who work in it are so important, and what my priorities are for the next few years.

Firstly though, let me give you a bit of background on how I got here. Unfortunately, a number of years ago I was unwell and ended up paying for private healthcare for the detection and treatment of my illness. This led to the removal of one of my kidneys due to late diagnosis of severe endometriosis. Fortunately, I am fit and well now - minus a kidney - so I look after my health as a result. 

This experience inspired me to work in the health and life sciences sector, and specifically to become a global health advocate for the prioritisation of health and early diagnosis and treatment. 

My career from that point spanned working in Public Health and being part of the leadership team that set up the Centre for Public Health and NICE, to establishing a global function in over 100 countries for General Electric Healthcare, a global medical technology company. My last position was Chair of the British Science Association.

The importance of pharmacy in public health

The last 2 years of COVID-19 has highlighted the importance of pharmacy in relation to public health. Community pharmacists not only remained accessible during this period but were at the forefront of delivering vital services to keep everyone safe, such as the rollout of the vaccination programme. Furthermore, community pharmacists supported local residents through one of the worst public health crises in decades.

However, in all my national and global work in public health I found that the “voices” of pharmacists and pharmacy technicians were largely missing, despite the important and critical role played in achieving public health for all. 

Why the GPhC?

I believe the role the GPhC plays in regulating pharmacy and the pharmacy profession at large is vital in ensuring pharmacy is an integral part of the healthcare system across all countries in the United Kingdom. I am excited to work with such talented, dedicated and passionate staff led by Duncan, who continued business as usual during the pandemic and adapted to meet the needs of the profession and the public.  

In working towards our Vision 2030 of safe and effective pharmacy care at the heart of healthier communities, I have 4 key priorities:

1.Education and training

With the enhanced clinical services and independent prescribing this is an opportunity for the pharmacy profession to provide more services for the public; but it also has its challenges within the context of the broader healthcare system.

2. Regulatory reform

We share the Government’s aim of ensuring healthcare regulation is faster, fairer and more flexible - so we can further improve how we manage fitness to practise and can be agile and responsive to developments like the expansion of pharmacist independent prescribing.

3. Broader stakeholder engagement to create awareness of the role of GPHC in relation to achieving integrated healthcare

Working with other health organisations through sharing of data, working through issues such as access to patient records to ensure patient safety and quality services for patients and the public.

4. Equality, Diversity and Inclusion (EDI)

Embedding considerations of equality, diversity, and inclusion in all aspects of our work as a regulator and as an employer.

Finally, let me say I feel really privileged to be here at such an exciting time for pharmacy and how much I am looking forward to supporting the great work being done by the GPhC.  

16 February 2022

It has been a tough two years for everyone working in pharmacy. For pharmacy teams and owners, there have been increased work pressures added to potential personal difficulties that we’ve all had to face during the COVID-19 pandemic. I would like to say thank you for all those who have worked so hard and are still doing so during these challenging times.

With the closure of the provisional register on 31 January, I’d like to take this opportunity to personally thank the 4,799 provisionally-registered pharmacists who have used the scheme in order to support NHS services and provide patient care when it was most needed. Professional leadership and representative bodies, education and training organisations and employers all worked together to support provisionally-registered pharmacists to provide safe and effective care to patients.

One area where we’ve experienced particular challenges during the pandemic is in our fitness to practise function. During the pandemic, we received high numbers of concerns, could not progress investigations as quickly as usual and had to rapidly move to remote hearings. Some of the improvements we had planned to make to how we manage concerns about pharmacy professionals started later than anticipated because we needed to respond quickly and effectively to the challenges and pressures of the pandemic.

As we highlighted in our response to the Professional Standards Authority’s recent performance review, it is a key priority for us to make improvements in our fitness to practise processes, to meet the concerns of the public and patients, to ensure fairness to registrants, and to meet the Standards of the PSA.

Looking to the future, I can say that we have clear strategies and plans in place to help us achieve our Vision 2030 of safe and effective pharmacy care at the heart of healthier communities. We’ve learnt how to do things differently and begun making significant improvements to how we regulate.

And to take us forward, we have a new Chair joining the GPhC from March this year.

I’d like to welcome Gisela Abbam to the GPhC. Gisella is bringing her wealth of experience in healthcare to the role. Gisela has worked in collaboration with governments, the World Health Organisation and the United Nations to improve health outcomes for people across the world, and is a former Chair of the British Science Association. I am sure her knowledge and expertise will help the us drive forward our Vision of safe and effective pharmacy care at the heart of healthier communities.

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.