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Regulation

'Worrying' proportion of minority ethnic pharmacists suspended or struck off GPhC register

Mind the gap logoExclusive: Data obtained by The Pharmaceutical Journal show nearly half of pharmacists suspended or removed from the register over a three-year period were from a black, Asian or minority ethnic background.

The chair of the General Pharmaceutical Council (GPhC) has admitted he has concerns over the proportion of black, Asian and minority ethnic (BAME) pharmacists who are suspended or removed from the register, compared with white pharmacists.

The comments came as The Pharmaceutical Journal obtained data — requested under the Freedom of Information Act — which show that over three years, up to 199 pharmacists were suspended or removed from the register after a fitness-to-practise (FTP) hearing*.

Of those, around 47% were BAME pharmacists, 35% were white and 18% did not provide their ethnicity. This compares with 45% of pharmacists on the GPhC register identifying as BAME, 45% as white and 10% with no ethnicity given.

The differences are even starker if those with no ethnicity given are removed from the analysis, with 57% of pharmacists removed or suspended who identified as BAME, compared with 43% who identified as being of a white ethnicity.

Nigel Clarke, chair of the GPhC, said the numbers of pharmacists going though the FTP process were small and so it was not possible to identify any trends, but that they were “worrying”. He said: “It is difficult to draw conclusions safely, but the numbers are worrying enough to cause us concern about how we’re working.

“We might exclude 20 people from the register in a year; when you’ve got around 260 concerns being raised every month that is relatively small, but if it is disproportionate then we need to understand what’s going on.”

The comments came after the regulator released data in September 2018 that showed BAME pharmacists were overrepresented in the FTP concerns raised. At the time, the regulator promised a “proactive enquiry” to ensure that the GPhC’s FTP procedures met its legal requirements to ensure equality and diversity.

Clarke admitted that the GPhC is behind other healthcare regulators in looking at discrimination in pharmacy

In an official statement, GPhC chief executive Duncan Rudkin said that the regulator would be carrying out an “equality impact assessment” of its FTP processes in the coming year.

He said: “In our FTP processes, we already use a variety of mechanisms to assure good decision making, including eliminating discrimination from decisions. This includes unconscious bias training for decision-makers and using decision-making guidance at each stage of the process for both our investigative staff and independent panels. We also quality assure our decisions, both during the investigation and after the final decision. We are continuously working to make sure that our processes are free from discrimination.“

Clarke admitted that the GPhC is behind other healthcare regulators in looking at this, but they would be exploring what needed to be done in the light of the figures, perhaps including some “independent work on whether we can see whether there’s any kind of common threads.”

Pharmacy leaders and other experts have called for an independent review of GPhC FTP processes.

Ash Soni, president of the Royal Pharmaceutical Society (RPS), agreed that more work needs to be done to identify and understand the potential reasons for the differences found in the GPhC data.

He said: “The figures are concerning; however, it is important to determine the factors which are contributing to the number of minority ethnic pharmacists being suspended or removed from the register. The RPS supports the efforts of the GPhC to investigate the matter further and looks forward to reading the outcomes of the independent review.”

It would be completely unacceptable for a regulator to ignore evidence which suggests that BAME staff are more likely to be brought before their professional conduct committee

Aneez Esmail, a professor of general practice at the University of Manchester who is recognised for his pioneering research on discrimination in the medical profession, said that these data should be investigated.

He said: “It would be completely unacceptable for a regulator like the GPhC to ignore the emerging weight of evidence which suggests that pharmacists from ethnic minority groups are more likely to be brought before their professional conduct committee.” Esmail added that the GPhC need to investigate their processes and reassure the profession that discrimination is not associated with the observed differentials, or the decision to bring certain individuals before FTP committee hearings.

Mahendra Patel, professor at the University of Bradford and member of the RPS English Pharmacy Board, urged caution as BAME pharmacists have been categorised together, but he added: “Even if those who did not supply their ethnic origin were supposedly white, a stark differential would still exist. In contrast, if some of these (if not all) supposedly fell into the BAME group the figures would be further amplified and consequently even more worrying in real terms.”

He recommended that the GPhC provided more detailed breakdown of the BAME figures: “This would allow for the appropriate support systems to be implemented and directed towards individual groups who are most in need of it.”

The data provided by the GPhC is shown in the Table. This is the first time that the regulator has released data on the ethnicity of those undergoing FTP hearings. It took more than six months, following a request made under the Freedom of Information Act in June 2018 for data broken down by invididual ethnicities.

The GPhC initially argued that the numbers were too small and there was a risk of “misleading the public” if they were published, but agreed to supply a limited amount of aggregated data after The Pharmaceutical Journal made an appeal to the Information Commissioner.

Fitness to Practise Committee hearing outcomes Ethnicity2016  20172018 
Table: Fitness to Practise Committee hearing outcomes by ethnicity

Advice

White

0

0

0

Black, Asian and minority enthnic (BAME)

0

0

<5

Not supplied

0

0

<5

Conditions

White

<5

<5

<5

BAME

<5

6

<5

Not supplied

<5

<5

<5

Fitness-to-Practise (FTP) committee — facts proved (e.g. no misconduct)

White

0

<5

<5

BAME

0

0

<5

Not supplied

0

0

0

FTP committee — facts not proved

White

0

0

0

BAME

0

<5

<5

Not supplied

0

0

<5

No case to answer

White

0

0

0

BAME

0

0

<5

Not supplied

0

0

0

Not Impaired — no further action

White

0

<5

<5

BAME

0

<5

5

Not supplied

0

0

0

Removal

White

6

12

3

BAME

12

12

13

Not supplied

<5

<5

<5

Suspension

White

24

13

12

BAME

19

19

18

Not supplied

11

7

6

Undertaking

White

<5

<5

0

BAME

0

0

0

Not supplied

0

0

0

Warning

White

<5

<5

<5

BAME

<5

<5

<5

Not supplied

0

<5

<5

Total

 

87

88

83

Notes:

These data are based on outcomes of cases with fitness-to-practise committee principal hearings from 1 January to 31 December each year. It does not include review hearings.

The term “white” includes white British, white Irish and other white backgrounds.

Ethnicity data is provided on a voluntary basis by registrants so there are gaps in the data. There is a category of “Not supplied” where the ethnicity was not provided.

Categories with results of 1–5 individuals are shown as <5. This is to prevent the people in categories where numbers are low from being identifiable. 

Where a pharmacist has more than one case going to a hearing, they will appear more than once in the table.

Source: General Pharmaceutical Committee, after a request under the Freedom of Information Act

*These calculations assumed a group with less than five individuals had a maximum of four in that category.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206192

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