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17 August 2016

I started using social media as a New Year’s resolution a couple of years ago.  Intrigued by the chance to connect with friends, colleagues and strangers alike in a virtual forum, I found these interactions—ranging from short discussions to long debates—intellectually stimulating and even sometimes entertaining.

My enjoyment has waned of late due, in large part, to decidedly unsocial trends emerging in the larger online world. I still feel that social media is a valuable tool to engage on personal or professional matters. But it seems that, too often, social media is being used to upset, ridicule or embarrass, rather than inform or enlighten. 

In my view, it’s the immediacy that fuels the good and the bad in social media. On the one hand, you can post an idea and have it instantly validated or rejected.   You can generate new ideas from an audience as large as your followers and beyond. 

On the other, this immediacy (and imagined anonymity) also makes it too easy for any of us to behave in ways we wouldn’t dream of doing in person.  To act—or more precisely, react—without thinking.   To say things that are not only unkind and uncivil, but unprofessional.

Social media has become an integral and pervasive part of daily life for many of us.  But it can be a difficult thing to navigate successfully for professionals, who face higher expectations than non-professionals for appropriate behaviour online and off.   What’s allowed and what’s over the line?

Over the years we have been asked to produce guidance for registrants to help them navigate the choppy waters and treacherous channels of social media.  Against this backdrop, last month we released a one-page document outlining additional guidance for using social media. Our aim was to offer common-sense tips to help pharmacy professionals continue to meet our standards, and to make it clear that those standards extend to online forums and social media platforms as well as face-to-face interactions.  

We also wanted to prompt a conversation within the profession about what is considered acceptable behaviour.  And that, we certainly did.

Let me be clear—our aim is not to stifle debate or commentary or drive regulatory actions against registrants.  We welcome and encourage lively, provocative thoughts, discussions, disagreements and debates that do not descend into abuse and rancour. And, I have to think that all of us know the difference between constructive criticism and respectful disagreement, and personal attacks.  If not, think: disagree without being disagreeable and criticise the policy, not the person.

We are not the first regulator to issue guidance on social media.  Other health profession regulators, including the General Medical Council, the General Dental Council and the Nurses and Midwives Council, have all issued detailed guidance on the responsible use of social media. Professional bodies like the RPS and NPA have also issued helpful guidance on using social media effectively, which we signposted in our document as additional resources.

The guidance we have issued does not change our expectations of pharmacy professionals, as set out in our standards. Instead, it offers information and advice which registrants may find helpful in their practice. Our approach to standards and guidance is—as it has always been—grounded in the belief that pharmacy professionals do not need detailed, prescriptive guidance in order to exercise judgement and demonstrate professionalism.  

Like all health professionals, pharmacy professionals must take responsibility for upholding public confidence and maintaining the reputation of the profession online as well as offline.  We recognise that this is not always easy, and as the regulator we see our role as helping you to uphold the trust and confidence patients and the public have in you.

15 June 2016

Many of you will have read recent articles in the Guardian and pharmacy media about pressures experienced by pharmacy professionals working in community pharmacies.

We recognise that pharmacy professionals working in a wide variety of roles and settings will experience significant challenges in trying to provide high quality care to patients and the public while dealing with limited resources or other pressures.

Indeed, we never seem to hear of healthcare professionals working in fully optimal circumstances without resource constraints of one kind or another. Some of the challenges facing professionals in NHS organisations, including financial pressures and targets, were recently highlighted again in the latest Nuffield Trust’s Health Leaders Survey, published last week, which warned of poor morale among staff and looming shortages in key areas within the NHS in England.

Pharmacy professionals working in community pharmacy face different pressures as the businesses in which they work seek to generate income and manage their costs. This reality highlights one of the reasons why society looks to professionals to act professionally, counting on them to put patients’ interests above the interests of others (including professionals themselves and their employers). This can be very hard and easy answers are thin on the ground. If these situations were easy we wouldn’t need professionals to handle them.

It’s also true that a range of other people have a part to play. Employing organisations have a responsibility to provide a working environment in which professionals can behave professionally. This requirement is clearly set out in our Standards for registered pharmacies. We as the regulator have a responsibility to set standards for pharmacy professionals and registered pharmacies that promote safe and effective care for patients and the public. And we use our inspection powers to assess how well pharmacy owners are achieving the standards for registered pharmacies. A great deal of the information which informs these assessments comes from responsible pharmacists themselves, and other individual team members. And there are roles for other key organisations and groups too, including educators and professional bodies in providing support to help make sure professionals (including superintendents and responsible pharmacists) are both competent and confident to challenge management where needed, and to raise concerns where their challenge is not heard or acted upon.

We have recently reviewed the survey results shared with us by the Pharmacists’ Defence Association, which had asked its members about pressures they face in the workplace. The survey and accompanying anonymous case studies highlight a number of issues which we and others need to understand better. A wide range of views and comments have also followed, which we also need to get to the bottom of. This is why we are arranging a seminar in October, to be chaired by Professor Nairn Wilson, a distinguished professional leader from outside pharmacy. We want to create an opportunity for all of us – regulators, the NHS, companies, professionals and representative bodies to consider these complex and challenging issues in depth, to inform the work we have to do individually and collectively. Read more on professionalism under pressure.

14 April 2016

Last week we launched one of the most important consultations we’ve ever undertaken, on new standards for pharmacy professionals.    

You may be asking ‘why we are changing the standards?’ What will these changes mean in practice for pharmacists and pharmacy technicians?  What changes in the sector prompted or informed the new standards?   

At first glance the new standards may suggest that not much has changed. But they do represent a departure from those currently governing pharmacy professionals. We’re proposing to reduce the number of standards from 57 to nine, underpinned by guidance and examples of the kinds of behaviours that describe them. 

And in focusing on comparing the existing standards with those proposed to replace them, it’s important that we don’t lose sight of a number of more profound changes in what the standards themselves represent.   An enhanced focus on person centred care; a greater emphasis on professional responsibility and accountability, and last but not least, highlighting the importance of leadership and teamwork.

Against the backdrop of a sector that is changing and maturing, we have written these standards to be flexible and applicable to pharmacy professionals wherever they work. Rather than an exhaustive list of dos and don’ts, we are providing you a framework, with guidance and support, which relies on your knowledge, skills and professionalism to determine the best way to do your job. The draft standards reflect the attitudes and behaviours that you and the public told us were important. They also reflect a call for greater accountability to yourself, to your peers and to your patients.

Amidst all this change, however, there also is continuity. This consultation on standards reflects our ongoing commitment to promoting a culture of professionalism and to improving outcomes for patients and the public. My hope is that this consultation will provide the impetus for you to start a conversation with your peers and other health professionals about your practice and how to work effectively together; and also to consider how you can provide person-centred care. 

And, of course, we also want to hear from you.

Read more about the standards, take the consultation survey and let us know if we have got it right – not just for today, but for tomorrow.

11 February 2016

Photo of chief executive Duncan Rudkin

In this issue, chief executive Duncan Rudkin looks at the significant changes ahead in 2016

We are only six weeks into 2016 and already it has become clear that this will be another year of significant change in pharmacy – genuinely justifying the cliché ‘challenge and opportunity’, perhaps. And I’m conscious that for many of you, especially those of you who work in community pharmacy in England, 2016 may have started off with a great deal of concern and uncertainty about the future. Before Christmas the Department of Health published a number of proposed changes to the pharmacy contract and pharmacy services in England, but it was the proposed reduction in the total funding commitment which has inevitably been the focus of a lot of debate.

I appreciate that is an emotive issue which affects people’s livelihoods. And you may be asking what the GPhC’s position is on the government proposals. Let me emphasise that the GPhC operates independently of governments and of the pharmacy professions and of contractors, and is not involved in making decisions about funding pharmacy. We are here to work on behalf of patients and the public and to protect, promote and maintain their health, safety and wellbeing; our role is not to advocate for the profession, for pharmacy owners or for government.

It is our responsibility, however, to listen to governments across Great Britain, to the NHS and other employers, to registrants and above all to patients and others who use pharmacy services, to be aware of how pharmacy may change in the future. We need to understand these changes so we can ensure that the standards we set are fit not just for today, but for the future. And so we will be holding major consultations in the next 12-18 months on standards for pharmacy professionals, for registered pharmacies and for the education and training of the pharmacy team to ensure that these standards are achievable and appropriate. We will need your input into these consultations to help us understand how you think pharmacy professional practice will and should change (whether or not you see these as the same thing!).

Efficiency and effectiveness

We continue to focus on ensuring we are using registrants’ fees efficiently and effectively. Last week our council approved our budget for 2016/17 and decided to maintain registrants’ fees at the current level for October 2016-17.  We are reducing our operating costs for 2016/17 so we don’t have to raise fees, despite continuing growth in the volume of cases we are having to deal with. It is our intention to achieve greater efficiencies on top of what we’ve already achieved over the past financial year, while continuing to achieve our ambitious aims.

Reserving judgement

It is very important that the pharmacists and pharmacy technicians that we regulate have confidence in us as their regulator and so we carefully consider all feedback and comments from registrants about our work. Recently, some registrants have raised concerns in the media about the actions we have taken so far in a high-profile case involving an internet pharmacy.

My team and I understand the frustration some registrants may feel when they think we should be taking immediate action in a particular case involving an individual pharmacy professional or pharmacy business. While our process may take longer than many would like, our duty is to thoroughly investigate and consider all available evidence before taking action. We aim to provide updates whenever possible, however, it would be inappropriate—and unfair—to discuss ongoing cases; doing so could prejudice any future hearings and the outcome of the case.   It is right that registrants let us know when they think we have not taken the right action. But we are not in the business of arbitrary judgement or trial by comment columns.

New powers for regulating registered pharmacies

Finally, I’d like to add that I’m delighted that the UK and Scottish Parliaments are now considering new legislation which will give us important powers to improve the way in which we regulate registered pharmacies. The order will allow us to publish reports from our inspections and take proportionate enforcement action against pharmacies where necessary. Once this legislation has gone through, we will seek your views later this year on changes to our approach to regulating registered pharmacies.

2 December 2015

Earlier this month we brought together leaders from across pharmacy, students and patients and asked them a question; how do we produce the pharmacy team of the future that will meet the needs of patients and the public? 

We were provided with a multitude of answers but one theme that emerged strongly was that of change - that change is coming and that change is necessary.

On many levels change is already happening. Pharmacy professionals are already taking on greater roles in providing person-centred clinical care and in medicines optimisation. The way care is provided continues to change in order to meet growing demand from an ageing population at a time of limited resources, with care moving out of hospital and into community settings. Relationships between patients and health professionals are also changing, with patients becoming partners in their own care and expecting to make decisions jointly with the health professionals working with them.

It’s important that our standards for education and training reflect all of these changes and prepare tomorrow’s pharmacy team for new roles and new challenges. There was widespread agreement from delegates at the conference that the core skills of professionalism, communication skills and multi-professional working need to be included in the standards for all members of the pharmacy team. And many of those attending told us that the pharmacy team need more interaction with patients in clinical settings and more inter-professional learning during their education and training.

We are mindful that we must not simply build our standards around a core of today’s knowledge. Instead we need to equip the pharmacy team of the future with the abilities to acquire knowledge and skills throughout their working lives – knowledge which most of us are not even able to visualise at this point in time. Education and training needs to be an ongoing process beyond qualification; there needs to be a clear pathway for future education and training.

The responses we received to our recent discussion paper Tomorrow’s pharmacy team also highlighted that there are still gaps in knowledge about the roles, skills and abilities within the team. This needs to be addressed if we are to achieve a truly integrated approach to pharmacy education and training and to pharmacy practice. And as part of that approach we also need to consider how the pharmacy team as a whole becomes better integrated within the wider healthcare team, with the patient always being at the centre.

These are all issues which will be reflected in our future standards for education and training of the pharmacy team. We plan to continue to engage, question and challenge all those with an involvement in pharmacy education and training to make sure that the standards we end up with are robust now and in the future. And we will challenge ourselves and others to make sure that we move this forward with pace. Change is needed now to make sure tomorrow’s pharmacy team have the skills and abilities to meet future health challenges and the needs of their patients. We all need to make this change happen.

22 September 2015

Welcome to our September issue of Regulate. With students starting a new year at school, college or university, now seems a very appropriate time to give you an update on our work to review our standards for initial education and training

Earlier this year we asked you for your views on our discussion paper Tomorrow’s pharmacy team: future standards for the initial education and training of pharmacists, pharmacy technicians and pharmacy support staff. In that paper we set out our analysis of the policies for health, pharmacy and pharmacy education provision in each of the countries of Great Britain. We then drew some preliminary conclusions about what the policies may mean for the future roles of the pharmacy team and the education and training they will need to fulfil those roles. 

And we asked pharmacy professionals, pharmacy students and trainees, employers and education providers and patients and the public if they agreed with these conclusions, particularly the skills and abilities that pharmacists, pharmacy technicians and members of the pharmacy team will need in the future.

Although we’re still in the process of analysing all the responses we received (more than 130 of them), I’m happy to give you an early snapshot of what you’ve told us and how we intend to use what we have heard when developing the new standards.

There was overwhelming agreement with the core skills of the pharmacy team we identified in our paper; professionalism, communication skills, and multi-professional team working.  

A broad range of views were expressed about the core role and core skills for pharmacy technicians and for support staff which require further exploration and discussion. We also received wide-ranging views on what it means to be a professional; an area we’re exploring as part of our ongoing work around patient-centred professionalism and the revision of our current standards for pharmacy professionals.

Overall there was strong agreement around the direction of travel pharmacy education should take and we’re really grateful to all those who contributed to this discussion. We now have a really helpful platform on which to build our future standards for education and training, and we will continue the discussion with all those with an interest in pharmacy education to help identify answers to some important questions that were raised during the listening exercise.

A major focus of our work in the next twelve to eighteen months will now be on drafting the standards.

The first step will be to hold a national conference in November which will bring together key education and training providers, pharmacy professionals, employers and patient representatives from across the UK to discuss how education and training of the pharmacy team may need to change to respond to future challenges. The conference will consider key issues including how to improve trainees’ experiences during pre-registration training; you can read more about trainees’ and tutors’ views of pre-registration training at the moment in this update.

 I look forward to sharing with you some of our thoughts and learnings that come out of that conference in the next edition of Regulate.

Throughout the first half of 2016 we’ll also be running a number of events for the pharmacy team to help us draft the education and training standards before we begin the formal consultation on the new standards.

Thank you once again to all those involved for continuing to help and challenge us as we develop the new standards. Keep watching this space for updates and opportunities to get involved.

13 July 2015

Given the pace of change in pharmacy, what kind of skills, knowledge and behaviours are we right to expect from a newly qualified pharmacist in 2022? Or a newly qualified pharmacy technician in 2019? This simple sounding (but quite challenging!) question lies at the heart of our planned review of education and training standards for the pharmacy team. 

You have only had to look at the news recently to appreciate the pace of change in pharmacy and the growing recognition of the greater role pharmacy can play in supporting patients and the public to maintain and improve their health and well-being.

Last month the Health Secretary Jeremy Hunt MP gave a speech announcing a new deal for GPs in which he recognised the ‘great potential’ of pharmacies and GP practices working together to support patients.  The speech included a commitment to ‘better use’ of pharmacies in primary care and further investment to support community pharmacists with tools and training.

Since then there has been some further detail on how this will work in practice, with the announcement that pharmacists and pharmacy technicians in community pharmacies in England will be given greater access to patient records. This is a move which the GPhC supports because we believe that giving patients the choice to allow pharmacy professionals to access their records can help them to receive better care. 

In the last few weeks NHS England has also announced a commitment to fund 300 pharmacists working in GP practices, to give patients the additional support of an expert pharmacist in their GP surgery. 

In Scotland we have seen the announcement of a major new project on polypharmacy, led by the deputy chief pharmaceutical officer in Scotland and involving organisations across Europe, to address health service provision and sustainable management of medication among the elderly. The Scottish government also said it would allocate £16.2 million to recruit up to 140 new pharmacists with advanced clinical skills training who would work directly with GP practices.

And in Wales there was a similar announcement recently of additional funding to move more care into the community, including by recruiting and training more clinical pharmacists to work alongside GPs as part of a joined-up primary care team.

What’s clear from all of these developments is that the role of pharmacy is evolving rapidly. So too are the expectations of patients and the public about how pharmacy professionals can support them to improve their health and well-being.

We are now in a very different place from even five years ago when the GPhC first came into operation. As the regulator, we need to be responsive to all of these changes, to make sure we regulate in a way that supports and encourages the development of pharmacy and pharmacy professionals to meet the challenges and opportunities ahead.

It’s not our job to specify the shape and size of the pharmacy workforce of the future. But we do need to make sure that the education and training of pharmacy team members equip them for the responsibilities they will be taking on.

This is why we recently published our ‘Tomorrow’s pharmacy team’ discussion paper which will inform our future standards of initial education and training. Those reading the paper will see that it is not a judgement on the quality of current education and training. Instead, we want to use this paper to check our thinking about the direction of pharmacy education should take, and to check whether the conclusions we have drawn are the right ones.

We want to hear the views of pharmacy professionals, patients, students, trainees, employers and education providers in this discussion. And what we hear will help us ensure that the pharmacy team in future has the skills and capabilities to do what the public will expect from them.

It is really crucial that we get this right because any new standards we develop will be educating and training those who will potentially be working in pharmacy for the next 40 to 50 years.

Please join the discussion and help us to shape the future of pharmacy education and training.

13 May 2015

Over the past year policy-makers across Great Britain have made clear their support for developing the full potential of pharmacy.  As the regulator of both registered pharmacies and individual pharmacy professionals, we play an important role in promoting improvement and managing risk across pharmacy and in providing assurance to patients and the public that pharmacies and pharmacy professionals are meeting the right standards.

We will continue to seek some important legislative changes in this new parliament to help achieve this, including new powers to publish reports from inspections and to take enforcement action against pharmacies that are not meeting our standards.

This is just one part of the ambitious programme of work we’re taking forward. And we will need your views and your experience to help shape and inform this work.

I hope you’ve had chance to read the update I sent earlier this week asking you to feed into our discussion on patient-centred professionalism and our evaluation of our new approach to regulating pharmacy professionals. I’m really grateful to all of those who’ve already responded and I would encourage everyone who hasn’t already to get involved.

And thanks also to all those that have responded to our fees consultation; this closes tomorrow so you still have time to share your views on our proposals for small cash increases to our fees.

Over the coming year we’ll continue to ask for your thoughts on some important developments that sit at the heart of what we do as a regulator, including reviewing our standards for conduct, ethics and performance, and updating our standards for education and training of pharmacists and pharmacy technicians.

I know we’re asking a lot from you at the moment in terms of your input into the development of our work. We understand that many pharmacy professionals are already facing increasing demands on their time, but it’s really vital for us that we take into account your views and the views of the public in everything we do. After all, that is the only way we can achieve our vision of pharmacy regulation playing its part in improving quality in pharmacy.

One way you can get involved is by joining our new panel of pharmacists, pharmacy technicians, pharmacy owners, pre-registration trainees and students. We hope you will consider participating, because your contribution will help ensure the way we regulate is proportionate and fully reflects the realities of pharmacy practice today. If you feel you’d like to contribute please do get in touch. Another way of getting involved is by volunteering to test our draft continuing fitness to practise framework. Please email cftp@pharmacyregulation.org to find out more and register your interest. 

We’re not just committed to listening. We’re also committed to learning. One of the things we’ve learned for example is that as an organisation we can get better at sharing some of the feedback we’ve received through our listening exercises and consultations and explaining how this has influenced our regulatory work. So keep watching this space and our website for any updates and opportunities to participate. And thank you once again for your continuing involvement and input. 

5 March 2015

With spring in the air (although I’m conscious that some will be adamant that spring does not start until equinox on 21 March!), I wanted to update you on some important developments in pharmacy regulation and on the work we are doing.

We recently published an update on our new model for the regulation of pharmacies and prototype inspection model. We have been listening carefully to the feedback from pharmacy owners and stakeholders and this paper highlights some of the progress we’ve made. It also sets out where we’ve taken into account that feedback, for example by identifying the need to review our ‘ratings’ system.

We’ve also made significant progress in the drafting of our hearings and sanctions guidance. This guidance is aimed at people involved or interested in our fitness to practise (FtP) hearings and is the main document our FtP committees use to help with their hearings. We’ve had some really useful comments back on the discussion paper we published last year which we’ve reflected in the draft guidance. We now really would like to hear from you whether we got the structure, content and tone of the draft guidance right. 

Following the commitment made by our Chair Nigel Clarke during last year’s Pharmacy Show to review our Standards for Conduct, Ethics and Performance, I can confirm that we’ll be publishing a discussion paper very shortly which will explore the concept of patient centred professionalism. We really want to hear how you show professionalism on a day-to-day basis and what barriers and enablers you think there currently are to professionalism. We’re hoping to launch the paper in the next few weeks so do watch this space.

We’re also looking to publish our final guidance for registered pharmacies providing internet and distance sale, supply or service provision in the next few weeks. Many of you will remember that we published our draft guidance last year and I’d like to use this opportunity to thank all of those who commented.  

Last but certainly not least, we’re consulting on our proposed fee levels for 2016. We’re proposing small cash increases for all registrant categories. Even after these small cash increases, fees for pharmacists and pharmacy technicians in 2016 will still be lower than those charged in 2011. Our fees need to reflect the underlying cost of regulating each registrant group and we need to avoid, where possible, any significant future fluctuations. I’m keen to hear your views, so please download our consultation here and respond directly by taking part in this short questionnaire.

Many of you will also have picked up on changes proposed by government Ministers which would amend existing legislation on inadvertent dispensing errors and would allow us to publish reports and outcomes from our pharmacy inspections. We welcome those proposals and we’ll be responding to them formally in due course. If you want to find out more about the proposals or if you want respond to the consultation directly, you can do so by clicking here.

As you can tell, we’ve got a very busy and exciting couple of months ahead of us. As ever, we really value your input in everything we do, and your involvement is much appreciated. 

10 November 2014

We’re using our new online version of Regulate to give you more information about our review of the conduct, ethics and performance standards which Nigel Clarke announced in his keynote speech at the Pharmacy Show. We are making an important commitment to engage and consult extensively with both the public and the pharmacy profession. Why is this so important? Many within pharmacy are working innovatively to support people and communities to manage and improve their health and wellbeing. We can also see evidence both of the public’s trust in the profession and, at the very same time, evidence that the public are increasingly willing to challenge and, yes, to complain when their expectations are not met. So it’s never been more important to have an honest and open dialogue with the public about the standards society can and should expect of professionals working in pharmacy.

Whether you work as a professional in pharmacy or you work, as I do, in a regulatory body, one thing we have in common is a shared purpose - to serve the public. For you as pharmacy professionals and for us as regulators it’s essential that we put the people we both serve right at the heart of our review of the core professional standards. And we need pharmacists and pharmacy technicians to have their say too, so that the standards which emerge are realistic and achievable as well as principled and aspirational. I think the standards we set as a result of this review process should ideally be a co-production between the public and the profession. I see our role as being much more about hosting the conversation than issuing edicts.  There will be a clear output at the end of the project, in the shape of an up-to-date set of regulatory standards for pharmacy. But it may be one of those times when the journey (hopefully towards mutual understanding and clarity of expectations) is as important in some ways as the destination. 

Have you ever struggled to make sense of what is the ‘right thing’ to do in the face of competing imperatives in a difficult situation when there’s no obvious single best answer?  Or just a least-worst option? Have you had to make a pragmatic on-the-spot call about how best to balance what you regard as the best interests of the person in front of you with what they are telling you about what they actually want? Add in to the mix having to work out where your employer’s legitimate interests begin and end. It’s always seemed to me that managing this kind of complexity on a daily basis is one of the great challenges and privileges of being a professional at all. It’s precisely because there aren’t easy answers that the public need you to be professional, particularly when we all know very well by now that systems and procedures only get you so far. If you want our work on professional standards to take account of your reality and your concerns, as well as your values and ambitions, I hope you’ll make time to take part