Posted by: Graham Phillips18 JUL 2014
Recently I attended the Alphega Pharmacy conference. The keynote debate was around the General Pharmaceutical Council’s new inspection model for pharmacy premises. There is no simple pass or fail anymore. Instead pharmacies are to be graded poor, satisfactory, good or excellent. The question is why?
The more I learn of the new inspection model the more concerned I become. Mark Voce, head of inspections at the GPhC, explained to the conference that all visits are unannounced and that a report is written to which the pharmacist (or owner) has only 48-hours to respond. If the inspection reveals that there are issues to be addressed, a list of “advisories” is included in the report and the pharmacist is required to produce an action plan and a timeframe is determined within which to address them. Ultimately, in the interests of transparency, the GPhC intends to publish the inspection results.
Sharon Williams, an independent pharmacist and Alphega Pharmacy member, had recently undergone an inspection of her premises. She pointed out that she had passed absolutely everything the inspection required with no “advisories”. It might reasonably be concluded that was “good” if not “excellent” but she was graded merely “satisfactory”, which is the same grading applied to other pharmacies with significant issues to address and action plans to implement. She is now saddled with a “satisfactory” grade for the next three years because the GPhC does not have a plan, or the resources, to reinspect.
Another Alphega-member pharmacy had been visited when a locum was in place. No patient safety issues were identified within the pharmacy but, understandably, the locum had been unable to answer some detailed questions, for example, about the patient questionnaire which is part of the community pharmacy contractual framework. I doubt that any locum would be able to answer questions such as this, nor would I expect them to be able to do so. This left the proprietor pharmacist with just 48-hours to answer many questions and led to another “satisfactory” score.
In fact Shelley Edmonds, GPhC inspector, told the conference that out of 30 pharmacies she had inspected 29 were found to be “satisfactory” with just one “good”. I find it simply unjustified to conclude that only 1 in 30 UK pharmacies is “good”. Clearly there is something wrong with the new inspection model. Worse than this, it is apparently impossible to gain an “excellent” rating because the criteria for “excellence” have yet to be determined.
If the GPhC had set out on a path intentionally to demoralise the community branch of the pharmacy profession it could hardly have done a better job. Now the GPhC will no doubt argue that the new inspection scheme is “new” and needs time to bed in. The various professional bodies and associations are hurriedly and helpfully assembling guidance to help community pharmacies cope with the new model. However nobody appears to be asking the fundamental questions:
1) What is the problem that the new inspection model is seeking to fix?
2) Who asked for it? Certainly not the pharmacy profession.
3) These is no demonstrable patient safety issue and nor is there any public clamour for tougher pharmacy regulation. Survey after survey, including the Department of Health’s own research, prove that community pharmacists are held in high trust. In fact possibly the pharmacy profession enjoys higher public trust than any other. The patient satisfaction questionnaires which community pharmacies are required to complete annually to satisfy the requirements of the community pharmacy contractual framework reveal that the public has astonishingly high levels of satisfaction with the community pharmacy service
4) Surely community pharmacists, as key stakeholders, should have been consulted before this expensive re-engineering of the inspection model?
Community pharmacies are small or tiny organisations. My smallest branch has just two staff members: a pharmacist and a qualified medicines counter assistant. Yet the GPhC has chosen to impose an “Ofsted” style inspection model which, while appropriate for a large organisation such as a school, a hospital, or a residential home, is massively over-engineered and entirely unjustified in the context of a community pharmacy.
I can only conclude that this “bright idea” was hatched by a few people at the GPhC who have little or no understanding of how community pharmacies actually work. We urgently need to challenge this expensive, over-engineered runaway regulatory train before it gathers momentum. If we don’t, it will end up costing the profession (the registrants) a fortune whilst achieving nothing in terms of patient safety or public benefit.