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Pharmacies can supply meds without responsible pharmacist in emergency

Pharmacy staff must have access to a pharmacist by phone or video link

Pharmacies left without a responsible pharmacist or locum cover will not have to shut their doors during the COVID-19 outbreak, pharmacy regulators have said.

During these “highly challenging circumstances”, pharmacy staff might need to depart from established procedures to care for patients, General Pharmaceutical Council (GPhC) CEO Duncan Rudkin and Pharmaceutical Society of Northern Ireland (PSNI) CEO Trevor Patterson said in a joint statement published yesterday (March 18).

Where the responsible pharmacist “unavoidably has to leave the pharmacy at short notice part-way through the day” because they are “unwell and need to self-isolate”, patients should still be able to collect their medicines, the regulators agreed.

“Where no locum cover can be secured at the pharmacy, and recognising the potential effects of the current pandemic, it would be in the patient’s best interest for medicines already dispensed to be supplied from the pharmacy rather than not supplied at all, even though this may not be in strict accordance with the law as normally understood,” Mr Rudkin and Mr Patterson wrote.

A GPhC spokesperson told C+D today (March 19) that it would not be necessary for pharmacists to notify the regulator if they had to leave the pharmacy without a locum cover first being found.

Support and directions

The GPhC and PSNI said that in such circumstances they “expect there to be access to a pharmacist by phone or video link to provide direction for the remaining staff in the pharmacy”.

“The pharmacy regulators will support pharmacy professionals in the front line making this judgement in patients’ best interests,” they added.

No other option

The regulators specified that this solution “should only be adopted for a short time period, where other options have been exhausted”.

“Except in such exceptional circumstances”, pharmacies must make arrangements for a pharmacist to be at the premises, “even in the current pandemic situation”, the GPhC and PSNI added.

The GPhC announced earlier this week that it has suspended all routine inspections to help pharmacy staff deal with the consequences of the virus.

It also said it will still fulfil its role of regulator by moving to a “supportive phase”, answering queries and providing support to pharmacy owners and staff.

24 Comments
Question: 
Do you welcome the regulators' announcement?

Industry Pharmacist, Head/Senior Manager

The end of community pharmacists was written on the wall years ago. If Covid-19 isn't the final nail in the coffin, then it'll be Amazon. Wake up, smell the coffee and change jobs quickly.

Leon The Apothecary, Student

Pharmacy will change, pharmacy must change.

Kevin Western, Community pharmacist

We are truly now the Invisible Profession. Ignored by the NHS, Blanked by GPs, only noticed by the DoH as a means of saving money by closing us down, never mentioned in the media, No effective representation, No voice and disappearing rights.
It's only right that shortly even our patients, who at least appreciate us, won't be able to see us as we won't be there.
I can see how this emergency ruling will help some patients in a few cases. The knock on effect will be huge. Anyone who thinks that it won't be abused after the dust has settled is far too naive to be let out alone.

ABC DEF, Primary care pharmacist

''patient appreciate us''?? You gotta be kidding me.

Noel Wardle, Senior Management

This seems like a sensible approach, but have they checked with the MHRA (which is the regulator that would ordinarily police unlawful supplies of medicines) that it will also turn a blind eye to supplies in these circumstances?

Chris Locum, Locum pharmacist

The only reason for them to be absent (if not ill) is to buy food before the hysterical public empty the shelves. There are enough pharmacists. Why do they want to work in these conditions?

The public will turn their attention to pharmacies very soon with Easter approaching. If surgeries are actively avoiding patients for most consultations already, then dwindling numbers of pharmacy staff will present a significant problem.

There is a threat of violence on the premises. A range of supermarket staff has told me how idiotic everyone is acting.

Community Pharmacy is not exempt - best wishes to those in the trenches. Stay safe.

David Kent, Community pharmacist

With a 19% increase in pharmacists on the register this year there is no need for any dispensing to be undertaken without a pharmacist present.

John Boey, Community pharmacist

This can only be realistically done by large multiples or corporate. Small independents only have one set of staff working full time (maybe up to 1 1/2). If the RP gets quarantined, everyone else in the shift he is in may have to depending on how the RP was exposed.

This announcement is both precise and vague at the same time. Ok, RP has to isolate because he got called by the Health Dept to do so. What can the staff do, continue dispensing? Continue GSL and P sales? What if you have no senior staff then? What about Methadone/subutex supervised consumption for pts who have yet to come even though everything is already preped earlier in the morning? Hell, CD dispensing in general.

Dee dee, Community pharmacist

There is an abundance of pharmacists. This is an opportunistic reaction to a problem that does not exist. It is also quite clearly illegal. The regulator has disgustingly taken advantage of a crisis to (illegally) usher in remote supervision. Where is the evidence base that this step was required? The multiples will be rubbing thier hands with glee, seeing this as an opportunity to increase the bottom line at the expense of patient safety.  Also, who takes responsibility for errors made or fatalities caused? Absolutely reprehensible decision. 

 

David Kent, Community pharmacist

This further debases the worth of the pharmacist.  Many employers will be very pleased not to look for locums and let dispensing assistants to take charge whicch, of course, costs them less.

 

Reeyah H, Community pharmacist

Still vague. What about scripts not checked off yet? Or urgent antibiotics script with a walk in? I would check it off by FaceTime. The patient comes first. End of. 

Leon The Apothecary, Student

Technically, for the sake of argument, what would be the issue with clinical checking or accuracy checking over a digital medium?

Gary Choo, Superintendent Pharmacist

We are all human. We can get the virus too. Even managers for multiples! Owners cannot afford to self isolate.

Michael Mustoe, Community pharmacist

Please stop whining. It's pitiful to read. Pull together, give the best service possible and go above and beyond. Please

Leon The Apothecary, Student

Every other healthcare professional has shown a far greater extent of professionalism than what I read about pharmacists, in my opinion. I am honestly embarrassed.

ABC DEF, Primary care pharmacist

The big chains have finally got what they wanted for years - to get rid of pharmacists while being able to keep pharmacies opened! This gonna get abused MASSIVELY by the multiples (especially the shoe company) and locum rates insta crashing! 

nawaz mohamed, Locum pharmacist

A slippery slope. When they mean 'supply', do you they mean hand out checked prescriptions, or an ACT/dispenser clinically checking and handing out fresh prescription? Under no circumstances, including this, should a pharmacy be without any link to a pharmacist.

Leon The Apothecary, Student

There is no reason why clinical checking cannot be done remotely.

For accuracy checking, you don't need someone with a degree to play spot the difference.

Azim Ashraf, Locum pharmacist

However ensuring standards are being met in the Pharmacy does require someone on site.
I.e. if people are actually following procedures in work flow, for example
are scripts actually being clinically checked and are supplies having both a dispensing and accuracy check,
Are the support staff appropriatly trained for the jobs they are doing and are they actually doing it correctly e.g. counter assistant WWHAMing or not, or does a certain member of staff seem "not with it" jeopardising the safety of the public in branch?
Are there enough staff for a safe and effective service?
To be there to be there to answer patient questions to improve compliance/ counter diagnose conditions.
Are the fridge temperatures being checked.
Are other SOPs being followed.
Is safe custody rules of CDs being followed (would legally need as pharmacist for this), and I don't think many people in the public would support laymen suddenly have unfettered access to class A drugs.
To answer GP and other professional queries e.g. stock shortage and clinical advise.
Amongst many other things that clearly would be near impossible to do in other business (e.g. retail shop/ cinema factory business management are never asked to move their job remotely) but evidently elements with pharmacy and some pharmacists too believe keeping companies profitable is more important than keeping the public safe.
Pharmacist seem to forget key element of their job we are not the to tick clinical and accuracy check boxes, we are there to supervise safe & effective running of a pharmacy and ensure management of CDs within the drug supply chain (including diversion), and also to be an easy port of call of accurate scientific (particularly medical) advise (like the apothecists your name alludes to from our professions history).
I suggest you develop some respect for the profession you chose to study for so many years, and also to truly understand your role.

Leon The Apothecary, Student

With respect Azim, there is very little of what you described that requires a pharmacist to be in-branch. For your SOP-related points, these are set guidelines that any senior person can follow and enforce. They do not require a pharmacology degree. That is the job of a branch manager.

You mention retail would be impossible to do remotely. To this, I respond with a single word: Amazon. Cinema? Netflix. We don't tend to make things by hand any more, we use machines, so we have already undertaken optimisation in that sense to reduce the number of people needed to perform a task in both business and manufacturing.

​Legality is an interesting point you raise. You quite rightly note there is legislation to follow, and for good reasons such as patient safety. These are simple solutions. You also speak of unfettered access, yet there is already existing technology employed in other professions in regards to the safe control of scheduled drugs.

Training is also a point where I would concede that is would be more difficult to assess training on, except this can already be done by a technician. You also mention advising patients, and I agree that a pharmacist would be the best person to provide this information. But does it need to happen in a dispensary? We are already seeing a shift with the creation of GP pharmacists.

When we talk of respect for the profession, it is important to understand the scope of practice and to think of that scope on both sides. Some tasks are beyond our abilities, and others beneath. Just because we can do a task, is it appropriate to do it?

I don't see a strong reason for pharmacists to physically be in a dispensary ultimately.

David Kent, Community pharmacist

Ridiculous suggestion.

Freelance Chemist, Pre-reg Pharmacist

cue .......the multiples and owners to abuse this

Andrew Nicholson, Community pharmacist

Don't tar every pharmacy contractor with the same brush!

Freelance Chemist, Pre-reg Pharmacist

i dont mean all independents....

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