Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
I’ve got a confession to make.
I’ve got penalty points on my driving license.
I was ‘caught’ on a speed camera south of Aberdeen slightly over the speed limit in a 50mph zone. The letter that came through the post one rainy Tuesday morning was a complete shock to me. I was completely mortified and quite stressed because obviously I was really concerned about what this might mean for my registration as a pharmacist. I quickly remembered that it would have no impact because the GPhC do not require you to declare traffic offences of this nature.
It felt like a close shave.
I took my money to the police station and paid my fine. The points are set to come off my license this summer. Hitherto I had never broken the law so whilst some reading this may feel this is a minor offence in my naive state and given that I am a pharmacist and all-round honest chap it certainly didn’t feel minor at the time.
And it has really made me think about driving. A wrap over the knuckles with enough consequence to make me really stop and think about how good a driver I was after all these years. Bad habits had perhaps crept in. On reflection, I maybe was becoming a bit relaxed on the road.
Does this incident mean I’m unfit to be a driver?
Should I be banned from driving?
Almost certainly not.
Did it give me a jolt and make me focus on improving my driving?
Yes, of course.
So why do I make this earth-shattering confession that no-one else will likely care about?
Well, as I consider recent events in pharmacy circles it got me thinking. Two things come to mind.
There was a rather rude outburst on Twitter recently involving some aggressive expletives by a ‘leader’ in the profession.
Now folk that know me will agree that I’m very relaxed about most things but we must draw the line somewhere. I really thought this was completely unacceptable and in fact, in previous employment situations, I have been involved in disciplinaries with staff resulting in significant sanction for much less.
Is the behaviour exacerbated if the person in question is in a leadership position?
I think it is. Being in a position of power and/or influence is a privilege, not a right. Let me be clear. It’s a disgrace to our profession to do such a thing in a public forum. I was embarrassed as I’m sure many others were too.
But how on earth does the GPhC regulate activity like this and should it?
I have to admit this is a really tricky task in this fast-paced digital world of passive-aggressive online behaviour and hastily deleted social media posts. The disinhibition associated with operating on social media is clearly too much for some. It continues to fascinate me how the most placid people offline become complete keyboard warriors on social media. Combine this with the binary, combative nature of many social media platforms and the intoxication of a group of like-minded followers cheering you on and you can quickly find yourself in tricky situations.
Which brings me to the second issue I have been pondering.
It will be no surprise to many to read the recent news that the GPhC had fallen short on some of the PSA standards. In case you missed the story the standards not met by the GPhC are as follows:
The fitness to practise process is transparent, fair, proportionate and focused on public protection.
Fitness to practise cases are dealt with as quickly as possible, taking into account the complexity and type of case and the conduct of both sides. Delays do not result in harm or potential harm to patients and service users. Where necessary, the regulator protects the public by means of interim orders.
All parties to a fitness to practise case are kept updated on the progress of their case and supported to participate effectively in the process.
All fitness to practise decisions made at the initial and final stages of the process are well reasoned, consistent, protect the public and maintain confidence in the profession.
For any registered pharmacist these findings should absolutely send a shiver down your spine. If you, unfortunately, become involved in a fitness to practise case you have every right to expect it to be dealt with in a fair and timely fashion. The median time for a fitness to practise concern to proceed from receipt by the GPhC to a final hearing is now 93.7 weeks – nearly two years. The impact on a registrant’s mental health during this period has been shown to be significant.
Whilst none of the cases examined were deemed to have had an incorrect outcome it surely stands to reason that if the process has been found to be poor along the way then the likelihood of registrants to have faith in the process may well be diminished. This may result in further disengagement from the organisation altogether.
If you talk to pharmacists who have been through the fitness to practice process these findings will come as no surprise. I was contacted by someone going through the fitness to practise process last year and that person described the process as “traumatic”.
I have spoken to others who have described exactly what the audit found. Poor communication, significant delays and basically from a registrant perspective a horrible experience.
So how do these two events weave together?
Well, I think the GPhC, like other large organisations, struggle to understand what is happening at the myriad of coal faces in our profession. Incidentally, I feel that the area of pharmacist independent prescribing could be argued to be very loosely regulated at the moment. Let’s be honest, how on earth does the current revalidation process give any indication whatsoever that a registrant is a safe prescriber?
This lack of faith manifests itself I feel in a fear of the regulator. It erodes registrant faith in the organisation and that is not helpful for all parties concerned.
We have found from our published professional dilemmas that the vast majority of unprofessional behaviour will not be reported to the GPhC and if the findings of the audit are to be believed the cases that are reported are often dealt with in a very convoluted problematic way from a registrant perspective.
Blue sky thinking…
Surely the regulator could come up with the equivalent of a speed camera? Some unprofessional activity will automatically meet a threshold of unacceptability for all to see.
And maybe a fine?
It is absurd that everyone can see that certain behaviour is inappropriate and brings our profession into disrepute but nothing happens. Who would want to report someone and therefore put themselves through the regulatory mill even for the greater good?
So the truth is everyone stays quiet and nothing changes.
Some points on the pharmacist’s GPhC license? Repeat the offence and perhaps the formal fitness to practise process could kick in?
The trouble is, as evidenced through (the highly unscientific just for fun) results of our dilemmas is that the threshold for referring to the GPhC is really very high. In our dilemma about a group of pharmacists on a wild night out, 21% of respondents would not refer the pharmacist in question to the GPhC for openly using cocaine at a party.
I am absolutely not in favour of more regulation but I am in favour of effective regulation.
Registrants deserve a regulator that is firing on all cylinders and completely engaged with the profession. Unfortunately, evidence in the market and evidence revealed from the PSA investigation suggests there is still some way to go before we reach this point.
Johnathan Laird is a pharmacist who is now a much more careful driver than he was before.
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.