The Council of University Heads of Pharmacy Schools - CUHOP
   
 
 

Pharmacists and Pharmacy Technicians Order 2006 : A paper for consultation

Hereunder please find the views of the Council of University Heads of Pharmacy (CUHOP) on the draft Order.

The membership of CUHOP comprises the heads of UK schools of pharmacy which enrol students to read for a Master of Pharmacy (MPharm) degree with the expectation of registering with the Royal Pharmaceutical Society of Great Britain (RPSGB) and registering as a pharmacist in this country. The objectives of CUHOP are, to

1. represent the collective interests and views of the Schools of Pharmacy
2. develop and articulate a vision for pharmacy education in the UK
3. liaise with professional, national and local bodies on matters relating to pharmacy education and research
4. establish CUHOP as a body to be consulted on matters of higher education policy
5. engage with international bodies and at international forums on matters pertaining to pharmacy education
6. work with other healthcare professions to develop educational policy and practice
7. promote UK pharmacy education and research

CUHOP has evolved from and replaces the former UK Committee of Heads of Schools of Pharmacy.

With respect to the draft Order, all CUHOP members were provided with the consultation paper and invited to submit in advance or bring to a full meeting of CUHOP on 15th June their comments. There was lengthy discussion of the draft Order and the comments upon it at the meeting and agreement formally to submit the set of responses that now follows. The responses are to the 22 consultation questions.

Question
Response
Q1. Have you identified any significant elements of the Pharmacy Act 1954 which are not reflected in the draft Pharmacists and Pharmacy Technicians Order? No.
Q2. Do you think the change of name of the register from the Register of Pharmaceutical Chemists to the Register of Pharmacists is helpful? Can you suggest a more suitable name for the register? Proposal supported.
Q3. Do you support the proposal to establish a statutory Register of Pharmacy Technicians for England and Wales to be maintained by the Royal Pharmaceutical Society of Great Britain? Can you suggest a more suitable arrangement for the statutory regulation of pharmacy technicians? Proposal supported.
Q4. Do you think it is helpful for the Society's registers to be divided into two parts to distinguish between practising and non-practising pharmacists or pharmacy technicians? Is there any further division of the registers which might be appropriate? We feel the proposal to be logical but worry about a certain lack of clarity with respect to the status of pharmacists not involved in patient care and more importantly, about no obvious means of protection of patient safety if/when pharmacists change their sector of practice, e.g. from industrial to community pharmacy.
Q5. Do you agree that it is desirable that those who are recognised as practising pharmacists or pharmacy technicians should be required regularly to demonstrate they are keeping up to date with developments? Can you suggest other, or more suitable, continuing obligations for registrants than the ones already set out in the draft Order? We strongly support this proposal in principle. The lack of clarity in the definition of 'practising' mentioned in our response to Q.4 makes for some lack of clarity as to whether pharmacists in academia and industry are to be included or excluded from this measure (see also our response to next question).

We assert that the CPD required of pharmacists should be relevant, proportionate and should constitute real achievement of learning. If it is not, then inevitably pharmacists not needing to be registered as such for their work will quit their membership of the RPSGB, more than would otherwise be the case.

Q.6 Do you consider the definition of practising contained in the draft Order adequate? If not, how would you suggest that the definition might be improved? There is a variety of opinion within CUHOP as to whether the definition of 'practising' in the draft Order encompasses pharmacists and technicians in academia and industry and in other sectors or niches of pharmacy where there is no direct contact with patients or possibly even with other health professionals. The definition seems to suggest that the RPSGB has purview over all pharmacists/technicians that are employed because of their 'professional status' rather than just those pharmacists who are responsible for the supervision of the sale and supply of P and POM medicines but this is far from clear.
Q.7 Do you agree that the proposal to endorse registration certificates with the part of the register on which the registrant is entered provides an element of added public protection? Bearing in mind the penalty/sanctions contained in articles 20 (for pharmacists) and 29 (for pharmacy technicians) of the draft Order, do you agree that public protection considerations are adequately addressed and that the administrative convenience and expense arguments are justified? CUHOP has no strong objections to the proposal in principle but has serious concerns that this approach might be expensive for no great benefit and that other approaches - issue of an individualised annual membership card or referral of enquirers to online Register(s) - might be just as or more effective at lower cost.
Q.8 Do you consider that electronic versions of the pharmacists' and pharmacy technicians' lists which can be updated continuously are better than an annually published paper list? Can you suggest any other more accessible and economic way in which the lists could be presented? Proposal strongly supported. Online Register(s) are far preferable to printed versions. As we have indicated in response to Q.7, they can do away with the need for endorsement of registration certificates.
Q.9 Do you support the proposals for the collection of additional information by the Registrar contained in the draft Order? Do you think there is any other information which the Registrar could usefully collect as part of the registration process? CUHOP regards these proposals as reasonable so long as collection of information is proportionate.

We have some reservations about the need and processes for record-keeping about personal indemnity cover of academic and industrial pharmacists. Personal indemnity insurance is not presently regarded as necessary for workers in the UK pharmaceutical industry and higher education sectors. Indemnity cover could be an unnecessary cost upon these pharmacists and could heighten the possibility of their leaving the profession.

Q.10 Do you think the link between registration as a pharmacist and membership of the Society should be removed from the draft Order? There is a case for the separation of registration and membership; clearly separating the statutory work of the Society from those of a professional body that maintains the interests and standing of pharmacy. . It is desirable in this regard to have sight of and reflect on the outcome of the Foster Review of non-medical professional regulation before coming to a conclusion.

While some CUHOP members accept the RPSGB's position that there should be no change in this regard, a clear majority of CUHOP members is for the separation of registration and membership. There appear to be two main reasons for this, first, the combination of the two always sees regulatory imperatives taking precedence over professional leadership and advocacy; the RPSGB is not regarded as dynamic or strongly visible in its lesser role (this is not good for the profession and in the longer term not good for patients and the public because the profession does not develop as it might otherwise). The second reason is that with membership of RPSGB corresponding with registration, there is no possibility of taking into membership eminent pharmaceutical scientists and other health professionals with a strong involvement in pharmacy, people who could contribute to the advancement of the profession in the public interest.

Q.11 Do you think an express legislative reference to consideration of attitudes and behaviours as part of the process of determining whether an applicant is "appropriately qualified" would be helpful? How would you consider these attitudes and behaviours could best be assessed? CUHOP agrees with this proposal in principle. It does though wonder how well attitudes and behaviours can be defined and particularly how they can be validly, consistently and fairly assessed, judged by us to be very difficult for the RPSGB or schools of pharmacy to do. Furthermore, CUHOP has significant reservations stemming from worries about possible conflicts with principles (and to some degree legal rights) of freedom of opinion and expression, including, for pharmacists in higher education, rights of academic freedom.
Q.12 Do you agree that the emphasis in the draft Order on ensuring that a registrant's fitness to practise remains unimpaired strengthens the public protection function of the Society? Can you suggest a more effective way of fulfilling this objective? CUHOP agrees with this emphasis but with reference back to the response to Q.11., in respect of the cautions in respect of matters to do with attitudes and behaviours.
Q.13 Do you support the proposal to extend the powers of the Society to collect information from other people related to the fitness to practise of its registrants? Are there any further powers you feel the Society should have in respect of fitness to practise issues? Among CUHOP members, this proposal was agreed or attracted no comment.
Q.14 Do you think that reference to a court in these circumstances is the most appropriate approach? Do you agree that 14 days is an appropriate time limit to trigger action? Among CUHOP members, this proposal was agreed or attracted no comment
Q.15 Do you support the proposal to extend the powers of the Society to share information on a registrant's fitness to practise where they feel it is in the public interest to do so? If not, how else might public interest and protection considerations be satisfactorily addressed? CUHOP agrees with this proposal but asserts that sharing of such information must only be in strictly defined circumstances related directly to the protection of the public.
Q.16 Apart from the criteria proposed in article 48 of the draft Order, can you suggest any other grounds on which a registrant's fitness to practise may be adjudged to be impaired? CUHOP has no comment or suggestion
Q.17 Do you support the proposal that the Registrar should be able to refer cases directly to the Health Committee or Disciplinary Committee and ask the committee to consider the issue of an interim order where circumstances dictate the need for such action? CUHOP agrees that in certain cases the Registrar should be able to so refer.
Q.18 Do you support the proposal to replace the current Statutory Committee with the group of new statutory committees? Do you think the right titles have been selected for the new committees? Do you think there is a need for any further statutory committees and, if so, what are your reasons for thinking this? CUHOP is generally supportive of reform of the longstanding present system but has major reservations about the proposed number and complexity of committees. The system is set to be overly bureaucratic and expensive in operation. If this number and pattern of committees is to be introduced, clarity of their roles and responsibilities will be essential.
Q.19 Do you support the proposal to make the Education Committee one of the Society's statutory committees? Do you agree that this will clarify the previous uncertainty about the precise derivation of the Society's education powers The Society's education powers should not be permitted to be excessive, rather CUHOP would welcome the Society as a partner or critical friend in dealing with pharmacist education in higher education. The new Education Committee should allow for rapid developments in the teaching of pharmaceutical science and practice at both undergraduate and postgraduate levels. The Committee should draw heavily on the expertise within academia in order to improve Society strategy and activity in this area.

Relevance and quality demands upon pharmacy education providers that are not accredited for the running of an undergraduate programme should be just as rigorous as demands upon those that are.

Q.20 Do you agree that the functions proposed for the Continuing Professional Development Committee are appropriate? Can you suggest any other functions that the CPD Committee might reasonably fulfil? Among CUHOP members there is a variety of views. Some wonder if there is a need for a separate statutory committee to deal with CPD; CPD might be dealt with by a subcommittee of the Education Committee. At the very least they are looking for clarity in the distinction of its remit from that of the proposed Education, Disciplinary, Investigation and Registration Appeals committees.
Q.21 Do you think that the proposal to have a Registration Appeals Committee is sensible? Do you think it will provide a more efficient route to resolving most appeals or slow down the whole process of securing a just resolution of outstanding registration issues? There is support for this proposal from within CUHOP but there is also a worry that herein lies the potential for additional bureaucracy within the RSPGB and that the Registration Appeals Committee might develop as another step towards the courts rather than as a means of avoiding the courts, slowing down the resolution of cases.
Q.22 Is there anything else about the contents of the draft Order on which you would specifically like to comment? The draft Order brings the possibility, some within CUHOP believe the probability, that the RPSGB will seek to inspect and accredit postgraduate degrees. CUHOP would make the point that UK pharmacy schools have a strong record of working with employers to construct postgraduate programmes. The managed sector (NHS) has given considerable thought to how education and training should be delivered in the future to support both general and advanced practice. This has led to a programme of educational reform which places a clear focus on work-based training and individual competence. Educational governance issues are an integral component of such approaches and informed by Quality Assurance Agency procedures. We would recommend that the RPSGB adopts a watching brief on this process and does not impose an alternative, accreditation approach.

On the matter of pharmacy undergraduate education and preregistration training, possibly the ideal model for students' preparation for practice would be some integrated form of the two; more closely intertwined even than in a traditional sandwich programme (although even that has some significant advantages). Unfortunately, and this is not a matter that the Order can address, the infrastructure for this is simply not present within (or across) the higher education and health sectors. CUHOP will be investigating this possible model for prequalification education and training over the coming months and years.

If any of the above is unclear or you or colleagues would welcome expansion on one or more points, please do not hesitate to contact me or the CUHOP secretary, Dr Robert Dewdney, at the Welsh School of Pharmacy, Cardiff University.