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Fitness to practise

Asian and black pharmacists overrepresented in fitness-to-practise concerns, GPhC data show

Data released by the General Pharmaceutical Council show ethnic disparity between the number of freedom-to-practise concerns raised against pharmacists. 

Asian and black pharmacists are overrepresented in the number of fitness-to-practise concerns raised against them, figures released by the pharmacy regulator show.

Data from 2017, presented to the General Pharmaceutical Council (GPhC) on 13 September 2018, show that pharmacists whose ethnicity is described as ‘Asian — other’ have the highest number of fitness-to-practise concerns raised against them relative to the number of pharmacists on the GPhC register.

‘Black African’ pharmacists are second on the list, followed by pharmacists of ‘Pakistani’ background, and then pharmacists whose ethnicity is not supplied. ‘Indian’, ‘Black Caribbean’, and ‘Other ethnic group’ pharmacists all had a higher proportion of fitness-to-practise concerns raised against them than the proportion of the register they make up.

The GPhC figures show that in 2017, 1,110 pharmacists entered fitness-to-practise proceedings after concerns were raised.

All of the ethnic groups that had fewer concerns raised against them than might be expected for their proportion of the register were categorised as white or mixed race, apart from the ‘Chinese/Chinese British’ and ‘Bangladeshi’ categories.

There were 62 concerns raised against pharmacists identified as ‘Asian —other’ and although they make up 3.2% of the pharmacist register overall, they accounted for 5.6% of concerns raised. The GPhC calculated that this meant there were 77.4% more ‘Asian — other’ pharmacists in the fitness-to-practise system relative to their number on the register overall.

Pharmacists who identified as ‘Black African’ constituted 8.6% of cases but only 5.6% of the population — a 46.7% overrepresentation.

Concerns raised about Pakistani and Indian pharmacists were overrepresented in fitness-to-practise processes by 46.6% and 31.4% respectively, the figures show. 

By contrast, pharmacists who had listed themselves as White British on the register account for 37.4% of the pharmacist population but only 23.7% of those in fitness-to-practise processes – an underrepresentation of 36.6%.

White British pharmacists had the same number of complaints raised against them as Indian pharmacists, despite having more than double the individuals registered.

In its paper, the GPhC said that analysis of the data is “challenging” because of the small numbers of cases which “can make it difficult to draw meaningful conclusions”.

It also points out that there may be wider issues that influence the reporting of concerns to the GPhC in the first place.

Table: Percentage comparison of ethnicity by population of the register and concerns raised in 2017
 Source: General Pharmaceutical Council meeting minutes, 13 September 2018. Available at: https://www.pharmacyregulation.org/sites/default/files/document/2018-09_council_papers_for_website_1.pdf (accessed September 2018)
 Ethnicity% of total register  % of concerns raised % change in population Total number of registered pharmacistsTotal number of concerns raised
 Asian — other 3.2 5.6 77.4 1,80262 
 Black — African5.6 8.2 46.7 3,199 91 
Pakistani 8.2 12.1 46.6 4,712 134 
Not supplied 10.5 14.4 37.26,014 160 
Indian18.0 23.7 31.410,323 263 
Black — Caribbean 0.3 0.4 25.0165 
Other mixed 0.5 0.5 17.2264 
Other ethnic group 2.2 2.4 12.1 1,242 27 
Black — other 0.2 0.2 9.7 94 
White and Black Caribbean 0.1 0.1 9.7  47 
Bangladeshi1.3 1.3 -0.6 726 14 
White and Asian 0.4 0.4 -15.8 245 
White — Other 5.7 4.2 -25.7 3,262 47 
White — British 37.4 23.7 -36.6 21,395 263 
White — Irish 1.7 1.0 -43.0  995 11 
Chinese / Chinese British 4.6 1.9  -58.92,636 21 
White and Black African 0.2 0.0 -100.0 105 
Pharmacist total 100100  57,226  1,110

The paper is part of a more expansive piece of research that the GPhC is planning to conduct over the next year to determine whether its fitness-to-practise processes are effective in guarding against discrimination.

“Over the last few years we have been undertaking analysis of our data and providing high level reports on fitness to practise and equality and diversity,” the paper reads.

“More recently we have been exploring in more depth how we might research and better analyse how effective our fitness-to-practise process is at eliminating discrimination.”

The GPhC said it had not published data on the outcomes of fitness-to-practise cases by ethnicity because of limitations in the data.

Mahendra Patel, treasurer at the Royal Pharmaceutical Society but speaking in a personal capacity, said that while the numbers were small the figures showed “a clear trend”.

“The need to look at this trend is also clear. Questions need to be asked about what is going on here,” he said.

He added that only publishing information on those entering proceedings without any data on the outcome of the fitness-to-practise hearings “only showed part of the picture”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205451

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