Pharmacy owners and regulator must give responsible pharmacists true autonomy

I read with interest a piece by Greg Lawton proposing that the General Pharmaceutical Council (GPhC) uses its powers to set mandatory minimum staffing levels in community pharmacies. Like many others, I wholeheartedly agree with the points made, but I fear it is unlikely that this will ever happen.

What constitutes adequate staffing levels within any pharmacy will always be subject to debate and impossible to legislate. Other pharmacists may not agree with what I deem a safe staffing level; the routine staffing levels I adopt would certainly be deemed overly generous by some pharmacy owners.

Having said this, it is patently disingenuous to suggest that every pharmacy has enough staff to cope safely with its routine workload at all times: crises occur. And, more worryingly, some contractors have always expected their pharmacies to routinely run with staffing levels which, at best, prevent all but the most routine of necessary functions and, at worst, place the pharmacy team under unacceptable pressure and put patient safety at risk. Therefore, it is hardly surprising that the regulator now feels compelled to be seen to be doing something. But there are no easy solutions, and few that would be particularly practical or politically acceptable.

The staffing level situation is now coming to a head with competition between contractors; the need for the multiples to maximise profits by driving down staffing costs; decades of lax regulation; reductions in remuneration; and the dislocation between those who negotiate pharmacy services and those who deliver them. Employed community pharmacists have been papering over the cracks for years, despite an erosion of their professional autonomy and their routine endurance of working conditions that many others would not tolerate.

I can see only one realistic solution in a reversal of this professional erosion — responsible pharmacists (RPs) need true professional autonomy. Some may have difficulty with this idea and it involves a radical change in attitude. If confronted by staffing levels that they deem to be unsafe, or that compromise the ability of the pharmacy to undertake specific services, the RP should feel able to exert the power that should come with their responsibility. If this means reducing the level of service provision, or altering standard operating procedures to reflect the ‘non-standard’ situation in which they find themselves, so be it.

This should be actively encouraged by pharmacy owners and the GPhC on the grounds of patient safety.

Ewan Black, pharmacy superintendent and manager, Greenhead Pharmacy, Dumbarton; Scottish pharmacy board member and Assembly member, Royal Pharmaceutical Society