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  • Resp Pharmacist: A Forum Response?

    www.locumvoice.co.uk :: Index has a member who is going to collate all the members' views on the RP consultation and then send it in as a response from x no. of pharmacists.

    As a member of the EPB my response is being filtered by the board to give a board response.

    If my views do not get put across I was thinking of sending them in purely as C Morris MRPharmS but then I thought how about having a Pharmacy Forum response.

    As I have almost finished my response for the board and possibly my own personal response I am willing to TRY to collate our views into a coherent repsonse so I am going to start a new RP thread just for your views.

    Not guaranteeing I will get it all into one coherent whole but wish me luck.


    Will leave this thread open to pick up repsonses for a week to 10 days. Will then look to get the response together and will post it before sending to DH.

    Please try not to post any back and forth arguments on this thread as I will have enough on my plate trying to get a single response from the many views.

    This consultation is one of the most important to come our way.

    The paper is actually only about 60 pages long (The rest is intro and appendices)
    The Responsible Pharmacist: Consultation on the Content of the Responsible Pharmacist Regulation : Department of Health - Consultations

    Download it, read it and post your comments.

    Succinctly is possible!
    Linnear MRPharmS

    Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.

    In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.



    For handy pharmacy links try
    pharmacistance.co.uk

    If you like my posts or letters in the journal try my books!
    eloquent-e-tales

  • #2
    Re: Resp Pharmacist: A Forum Response?

    Just to get you started my first thoughts are:

    If the Resp Pharmacist is held responsible for everything that happens in the pharmacy then there should be an auditable path for complaints/suggestions made to multiple head offices.
    If there is then a problem with the store and the RP is in trouble he should be able to say "here are the records of when I took this problem to my Supt Pharmacist's office and nothing was done." The responsibility should then rest with HO of the multiple.

    The change in GSL legislation is well received in my book.

    I find it strange that an agricultural show can be held to be an emergency situation whereby a pharmacist can supervise two pharmacies but a pharmacist calling in sick and covering the store until a new one can be found is not.

    Many more ideas fomenting in my little head at the moment but just posted these quick thoughts to get the ball rolling.
    Linnear MRPharmS

    Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.

    In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.



    For handy pharmacy links try
    pharmacistance.co.uk

    If you like my posts or letters in the journal try my books!
    eloquent-e-tales

    Comment


    • #3
      Re: Resp Pharmacist: A Forum Response?

      Good thinking in principle, but i fear that reporting interventions to the Doh en masse would only play into their hands.I Think the idea is that the responsible pharmacist clinically checks (ie makes interventions) the prescriptions, then forwards them to technicians to dispense. So to say we are doing that will appeal to them. My main concern, and the reason I don't use checking technicians, is because there are several drugs that prove lethal (amiodarone/digoxin/lidocaine/peppermint water etc) when dispensed innappropriately, it's that simple. This is a fundamental concept which goes unappreciated by pharmacists. My main reasoning behind kicking up a fuss is that as a profession, we are very frivolous with the phrase 'pharmacy is becoming more clinical'. Clinical pharmacists are worth £22,000 per annum (look at basic grade hospital salaries). The extra that we are paid as standard in community is solely based on the responsibility factor. We are being tricked into thinking pharmacists are experts in warfarin/cholesterol/lung function testing, which we are not. We are being tricked into thinking that prescription volume is too much for a pharmacist to cope with, which it wouldnt be if sufficient number of dispensing technicians were employed. Clinical pharmacy is not feasible in community as (unlike hospital) you cant just walk to a patient lying immobile and clinically investigate their treatment, they turn up when they please, or you call them in. They can't be arsed (as we have found from MURs) coming in for that. When we get one year down the line the government cut funding and we want to u-turn and find our place in the dispensary making easy cash by doing nothing manual, we will be told 'hit the road jack, and don't you come back'. And then we re-train as teachers. GET THINKING GUYS, we have to at the least INFORM every community pharmacist 79 days left

      Comment


      • #4
        Re: Resp Pharmacist: A Forum Response?

        Thanks for the input wooly. (Do all handles now have to have a sheep element? )

        Now I've finished my read through of the document here's my blow by blow analysis.
        Please input your views here.

        Response to Responsible Pharmacist Consultation

        Chapter 1 Intro

        Good if GSL legislation overturned
        Also good if overturn the frankly ludicrous situation where a pharmacist is held responsible for the errors of another pharmacist because it was given out on his shift

        Chapter 2

        Staff training and number of staff need to be part of legislation
        Need pharmacists to be able to report problems without fear of recrimination
        If roles of Resp Phc and Supt Phc are truly separate then RP needs to be able to report probs to Supt Phc and get things done in a reasonable timeframe
        Ensure a Resp Phc for each pharmacy then locums will need to be registered as capable of being RP

        Chapter 3

        Changes need to be made to ensure Supts make changes where needed and can be reported if they don’t
        Staffing needs to be part of regs or HOs could avoid it

        GSL legislation should be changed as should legislation regarding errors made by another pharmacist

        The approach that other matters above those in the regs should be worked out by RP and Supt Phc and owner is fine as long as the pharmacist can get his voice heard at HO/AM level to get things done and can log in that this has been done

        Don’t care what format the records are kept in as long as there is space to record any problems and whether these problems have been raised with HO/AM

        Format doesn’t really matter as we are professionals and as long as there is a means to report badly written ones


        Fine for phcs to sign off as long as there is a means to report unfit procedures etc.

        Reviewing procedures is fine as long as we have power to get something done when procedures no longer up to code

        Locum run branches will have problems with phcs checking procedures prior to taking on shop

        Scenario 2
        If locum thinks there’s a problem and contacts HO then this must be logged so it doesn’t keep happening with HO doing nothing

        Scenario 3
        Where new staff needed or new training again is fine as long as RP has power to put in for training of and/or new staff

        About when reviews are needed:
        Guidance should be fine as we are professionals and we should be able to assess when review is needed.

        Further issues: We need to be able to get to Supt Phc

        “The Supt Phc will enable the RP to exercise statutory requirement relating to pharmacy procedures”
        What if Supt Phc wrong?

        Supt Phc allowing RP flexibility sounds good as long as it happens and Supt Phc is available for comment/complaint

        Roles:
        RP: Day to day running
        Supt Phc: Responsible for whole chain and putting things right beyond control of RP
        Pharmacy Owner: As Supt Phc
        Prof Reg bodies: To set standards and keep register of RPs if experience etc. required

        Chapter 4

        Records:
        There should definitely be spaces for airing problems and complaints and whether this has been passed on up the chain

        No need for registration date
        Reason for absence only if prolonged
        Amendments etc. part of recognised practice i.e. CD reg
        Other staff working only needs to be logged if a perceived problem

        If a major problem this should be recorded especially if short/poorly staffed and a error occurs

        Why would log need to be kept longer than 2 years?

        Chapter 5

        Would have thought 75% of time in premises is not too much i.e. 2 hours out of a normal 8 hr day absent

        I think regs should specify a max time away from shop unless justifiable but I think that 3 hours is too long for that max

        I think that a variable max time dependent on conditions is justified

        Yes we should be able to professionally decide what reasonable promptness means when we have to return

        Yes, Phc should be contactable

        Guidance would be better as each episode of absence would probably be different.

        Can’t see anything wrong with specifing that a 2nd pharmacist be contactable if RP is not

        This Phc need not be eligible as a RP as he won’t be the RP

        Chapter 6

        Is there any proof that newly qualified Phcs are a risk?

        Like the idea of pre-reg and UG courses being changed to reflect new legislation if brought in

        Newly qualified are usually more clued up on latest regs than old hands

        I don’t believe a min period of experience is needed. Prove me wrong.

        If experience becomes part of legislation then needing more experience to be allowed to absent yourself sounds good as experience brings with it abitlity to know when things can be left

        I think that RP should have experience in relevant sector. i.e. Hosp phc shouldn’t be allowed to immediately become RP for COmm Pharmacy

        If Phc has been unworking then should be back at work for 2 months previously or 6 mths in last two years

        If been aware for 3 years or more then there should be an increasing length of time needed. i.e. longer away from work longer return needed before RP status


        Chapter 7

        How can sickness not be an emergency when a horticultural show is?

        Robot dispensing becomes a way for multiples to halve the no. of phcs it employs?

        Regs should include as a condition the RPs capacity to be in charge of more than 1 phy at the same time so multiples can’t squirm by guidelines

        Also should include a regulation on no. of staff in the phy for same reason as above

        These should include ACT if needed, suitable no. of trained dispensers and counter staff dependent on workload

        Only needs to be for the remotely supervised one if this becomes allowed as RP can see staff available at phy he’s in

        I don’t believe that regs should stipulate a timeframe for period where RP is in charge of 2 phys but it should stipulate that it is for the min time and certainly not a whole working day

        If RP in charge of 2 phys then the reg body should be contacted so that multiples can’t keep doing it

        Don’t see why regs need to state that the 2 phys under 1 phc should be owned by same company

        Yes regs should state max no. of phys under control of one phc and it should be 2


        Chapter 8

        Regs should specify the conditions needed to allow a phc to supervise another phy to stop multiples abusing the system

        Chapter 9

        12 months should be OK to bring in new regs and a phased approach would probably be best

        Phased approach hard to comment on as we don’t really know what RP will be responsible for yet
        Linnear MRPharmS

        Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.

        In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.



        For handy pharmacy links try
        pharmacistance.co.uk

        If you like my posts or letters in the journal try my books!
        eloquent-e-tales

        Comment


        • #5
          Re: Resp Pharmacist: A Forum Response?

          Originally posted by Linnear View Post

          Only needs to be for the remotely supervised one if this becomes allowed as RP can see staff available at phy he’s in

          I don’t believe that regs should stipulate a timeframe for period where RP is in charge of 2 phys but it should stipulate that it is for the min time and certainly not a whole working day

          If RP in charge of 2 phys then the reg body should be contacted so that multiples can’t keep doing it

          Don’t see why regs need to state that the 2 phys under 1 phc should be owned by same company

          Yes regs should state max no. of phys under control of one phc and it should be 2
          Can't figure this out - is there a pharmacist at the pharmacy who is not classed as the responsible pharmacist so that the responsible pharmacist can leave the premeses? Where to all the pharmacists who aren't responsible pharmacists go?

          The log of absence should state why the pharmacist is absent.
          Should not be more than 2 hours.
          Reasons for absence should be related to pharmaceutical duties and be planned in advance.

          Still can't work out where it will take us as a profession or how much better off Joe Public will be if the pharmacist is not on the premises when they need to see one.
          47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
          2018 AD : Modern Man : I shopped, I clicked, I collected.
          How times change.

          If you find you have read something that has upset or offended you an anyway please unread it at once.

          Comment


          • #6
            Re: Resp Pharmacist: A Forum Response?

            Most likely, if pharmacist cannot account for every minute of absence, then will not be paid.
            Eg a home visit for an MUR and the pt suddenly not available.
            johnep

            Comment


            • #7
              Re: Resp Pharmacist: A Forum Response?

              Not sure I like the look of this thread any more. Lets look at this from the patients point of view. Patient has a problem (at present) - The Doctor:unavailable,call tomorrow; The nurse:no appointments, call back tomorrow; The pharmacist: in the pharmacy, BONZA! After RPs are created - The pharmacist: is not here at the moment, but you can speak to a tech or you can try phoning them. Hows that for patient centred care? Same old average crappy 'PUBLIC HEALTH', pretty shameful considering the attribute that gives us a professional standing in community is our accessibility. To take steps to allow us to leave is completely irresponsible. MUR's at home? Are we here to save the NHS waste (ie carry out MUR's) or do a professional job?
              The MEMBERS OF THE RPSGB should elect responsible pharmacists-and vote down. That is to say, members would be happy to work beneath them, ensuring quality within pharmacy and self regulation. Pharmacies could then bid for their services. As opposed to an examination accessible to few.
              Beware of allowing newly qualifed pharmacists the opportunity to become responsible pharmacists. This whole fiasco is fuelled by multiples, where profit comes before pharmacy. To say that somebody who hasn't been IN CHARGE of ONE pharmacy can be promoted to being RESPONSIBLE for two is lunacy. Aren't you going to encourage them prove their worth?

              Comment


              • #8
                Re: Resp Pharmacist: A Forum Response?

                I agree with Wooly on some points, but not on others.
                i don't think we should accept the bit about allowing RPs to be away from the Phcy for ANY length of time; Not because staff can't be trusted to maintain a safe dispensary etc..., but because the public has come to rely on it and expects it, as Wooly says. "The scientist on the High street", "Your local health authority": remember those slogans? That's what we're good at, that's our trump card, so we should do everything possible to maintain that reputation. If the new regs allow us to be away for even 2 hours a day, it'll just be the thin end of the wedge, and the multiples will just keep nagging(or lobbying, as it's also known as) to extend that period ever more.
                I don't, however, agree with Wooly's opinion about experience being mandatory in order to assume the role of RP; I share the opinion expressed by Jonathan Buisson in his "Broad Spextrum" article, p496 of last week's PJ (Nov. 3rd), in which he describes the "day 1" phenomenon;"just as pilots are not real pilots until they have flown solo, all professionals, at one point or another, find themselves in charge of a new situation for the first time. New qualifications can be introduced, or the period of supervised experience extended, but this only postpones "day 1". "What [newly-qualified phcists] lack is two things that can only be gained, not taught: experience and, hence, confidence."
                In requiring additional experience, would we not in effect be admitting the inadequacy of the current Pre-reg training?
                Ze genuine Article, present & perfect!

                Comment


                • #9
                  Re: Resp Pharmacist: A Forum Response?

                  Pre reg was brought in to ensure some first hand experience. Similarly in medicine where in the old days a newly qualified dr could find himself in charge of a+e and in those days had to call the consultant directly which was not welcomed. After a few incidents, a pt bled to death on a trolley from an unidentified stab wound, the a=e was reorganised with its own consultant team.
                  Theoretically, a pre reg could be in charge of very busy pharmacy from day one after qualifying. If good staff, then OK. Perhaps we could suggest script volume suitable for a newbie. However, it has been my experience that a 'difficult' script often presented at a quiet pharmacy after pt unable to obtain elsewhere.
                  johnep

                  Comment


                  • #10
                    Re: Resp Pharmacist: A Forum Response?

                    Originally posted by johnep View Post
                    Theoretically, a pre reg could be in charge of very busy pharmacy from day one after qualifying. If good staff, then OK. Perhaps we could suggest script volume suitable for a newbie. However, it has been my experience that a 'difficult' script often presented at a quiet pharmacy after pt unable to obtain elsewhere.
                    johnep
                    Thinking back to my 'day 1' - it was at a well known multiple beginning with "B". In effect I was second pharmacist so there was always a more experienced ph to ask. In fact there were 3 on board, myself, dispensary manager and store manager.

                    On the other hand, a new pharmacist on 'day 1' should be able to call upon ANY other pharmacist for advice on a professional matter.
                    47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                    2018 AD : Modern Man : I shopped, I clicked, I collected.
                    How times change.

                    If you find you have read something that has upset or offended you an anyway please unread it at once.

                    Comment


                    • #11
                      Re: Resp Pharmacist: A Forum Response?

                      My first day working for M-s and i had never used Mediphase. In the end had to 'phone another branch to discover needed to press f6 and f8. After that no problems. My policy now is to visit prior to a locum if unfamiliar with pmr.

                      New shop tomorrow, but is compass and apparently two dispensers. One a man, which is unusual.
                      johnep

                      Comment


                      • #12
                        Re: Resp Pharmacist: A Forum Response?

                        Originally posted by Pharmanaut View Post
                        Still can't work out where it will take us as a profession or how much better off Joe Public will be if the pharmacist is not on the premises when they need to see one.
                        Personally I'm sick of seeing lives fall apart because of a contractual requirement.

                        Jeff

                        Comment


                        • #13
                          Re: Resp Pharmacist: A Forum Response?

                          Originally posted by johnep View Post
                          My first day working for M-s and i had never used Mediphase. In the end had to 'phone another branch to discover needed to press f6 and f8. After that no problems. My policy now is to visit prior to a locum if unfamiliar with pmr.

                          New shop tomorrow, but is compass and apparently two dispensers. One a man, which is unusual.
                          johnep
                          Ah if only F6 and F8 where the answer to everything...

                          What exactly to F6 and F8 do anyway?
                          47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                          2018 AD : Modern Man : I shopped, I clicked, I collected.
                          How times change.

                          If you find you have read something that has upset or offended you an anyway please unread it at once.

                          Comment


                          • #14
                            Re: Resp Pharmacist: A Forum Response?

                            F6 takes you to next item f8 is end of script.
                            johnep

                            Comment


                            • #15
                              Re: Resp Pharmacist: A Forum Response?

                              apologies for the newly qualified comments, my problem is not so much that the new pharmacist will not be able to cope, but the ability of multiples to recruit newly qualifieds/undergrads (via 'training' incentives) to their cause, which will no doubt be remotely supervising pharmacist at no extra cost. Not many people appreciate how much a pharmacist can earn per annum at present. I keep seeing these poor young newly qualifieds working as 'relief pharmacists', earning utterly crap salary packages from multiples because nobody told them otherwise but the multiple took them under its wing (How touching). These guys wont see the salary reduction as I, and others will.

                              Comment

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