English Pharmacy Board meeting: 31 January 2019

The Royal Pharmaceutical Society’s (RPS’s) English Pharmacy Board (EPB) held its first meeting of the year on 31 January 2019, at the Society’s London headquarters. Present at the meeting were Paul Bennett, chief executive of the RPS; Ash Soni, president of the RPS, respectively; Ravi Sharma, RPS director for England; Robbie Turner, RPS director of pharmacy and member experience; Gail Fleming, RPS director for education and professional development; Harvinder Sondh, RPS director of innovation and enterprise and Gino Martini, RPS chief scientist.  

Guests at the meeting included RPS members Aditya Aggarwal and Cathy Cooke; Nicola Gray, RPS regional liaison pharmacist; Sue Kilby, chair of the RPS Industrial Pharmacists’ Forum; Fatema Mamdani and Abigayle Meikle-Roche, RPS Ambassadors; Priya Modha, clinical fellow at the National Institute for Health and Care Excellence (NICE); Rahul Singal, RPS Hospital Expert Advisory Group representative and Martin Wessels, RPS Sussex.

2019 work programme and campaigns

Sharma set out the three campaign priority areas for England in 2019 — mental health, diabetes and system leadership. Board members then broke into small groups to brainstorm plans for each of these three campaigns, focusing on what the RPS can do to support members and the profession with resources and guidance, education, events and communications. Milestones and metrics for these campiagns will be established in February, Sharma said, with delivery starting in March or April 2019.  

Adele Mott, the chief pharmaceutical officer’s clinical fellow at the RPS, said that a NICE-accredited designated prescribing practitioner (DPP) competency framework should be completed by the end of 2019.  

As of early 2019, pharmacist independent prescribers (IPs) with experience will be able to supervise other pharmacists undertaking an IP training course. “The DPP is ultimately responsible for signing the new prescriber off, so it’s important that they have the skills and experience to do that”, Mott said, highlighting the importance of the framework. A stakeholder group will meet in the next few months to develop the framework, and a consultation will go out in the summer.  

Falsified Medicines Directive

In a discussion on the Falsified Medicines Directive (FMD), which was still yet to go live at the time of the meeting, Bennett said he had heard concern from the other national pharmacy boards about the level of preparedness, and the expense of compliance to pharmacies and the NHS itself. The point had also been raised, he said, that FMD might be short-lived in the event of a hard Brexit. “Not under question is the role of the pharmacist in medicines safety”, he emphasised.  

Kilby said that the RPS should consider its stance on what it wants “if we have a hard Brexit,” and suggested supporting the Medicines and Healthcare products Regulatory Agency to “do something if we can’t link to the EU Hub.” Pharmacists at the “coal face”, Kilby added, feel like they are not getting much support and information from large multiples” and are concerned about how they will manage pharmacy inspections. Bennett said that, according to the UK FMD working group for community pharmacy, the regulators would be “pragmatic” in this regard. Board member Martin Astbury said he would like the RPS to be clear that while pharmacists in pharmacies should fulfil their legal obligation regarding FMD compliance, the legal onus — and risk of prosecution — should fall on the owner, “not the person on the day”. 

It was agreed that Bennett and Soni, together with board chairs, would establish conversation with regulators and while the RPS would not call for a delay to FMD, they would expect regulators to be mindful that “members in all settings are unsure and using their best endeavours in uncertain times”.  

Professional standards for community pharmacy  

Wing Tang, head of professional standards at the RPS, said that two of the three evening workshops had now been held to discuss the Society’s plans for a set of professional standards for community pharmacy. The third event was scheduled to take place in Cardiff on 7 February 2019. The RPS is looking at existing standards for community pharmacy from around the world to see what can be learnt from the international community while identifying any gaps in those standards, Tang said. The steering group will meet on 13 March 2019 and will begin drafting the standards after that, with a view to going out for consultation in September 2019. Publication, Tang said, is scheduled for March 2020, “subject to views we get along the way”. 

Online pharmacy 

Heidi Wright, English practice and policy lead at the RPS, introduced the latest draft of a GB-wide RPS policy on online pharmacy services. Both the Welsh and Scottish pharmacy boards, she said, had agreed that online pharmacies should publically identify their responsible pharmacist. After discussion, the EPB agreed ith this point. Other points discussed included the audit trail for home delivery of medicines, services provided from outside the UK to patients in the UK, and whether patients buying pharmacy medicines should need to be identified.  

Feedback from all three national pharmacy boards regarding final edits will be collated and returned to Wright for inclusion in the final version of the policy.

Science and research  

Martini said that the science and research functions of the RPS had now been combined into a single science and research directorate, reporting to Bennett.  

Martini had observed chimeric antigen receptor T-cell (CAR-T cell) therapy preparation during a visit to the Royal Free Hospital on 29 January 2019: a therapeutic development that he is “really excited” about. “A large part of the T-cell washing process is being done by pharmacists in hospital”, he said, adding that “CAR-T therapy is now a blood service and is being delivered by pharmacists”.  

Martini also told the board that a draft paper on cannabis oil and cannabidiol products had been put together, and the RPS will release further communications on this paper in due course. 

Brexit planning  

John Lunny, public affairs manager at the RPS, said that much had happened since the last board meeting in the area of Brexit planning. Sibby Buckle, vice chair of the EPB and Martini had held a roundtable with Lord O’Shaughnessy in October 2018, and in November 2018 the Department of Health and Social Care’s (DHSC’S) medicines team met with Bennett, Soni and Sandra Gidley, chair of the EPB, to discuss contingency plans for a no-deal Brexit. Conversations with the DHSC are ongoing, Lunny said, as are discussions with the Pharmaceutical Services Negotiating Committee, National Pharmacy Association and others. 

Bennett said that Bruce Warner, deputy chief pharmaceutical offcer for NHS England, was leading on the delivery of the serious shortage protocol (SSP), and described it as the element of “Brexit contingency planning that will affect pharmacists most”. Bennett and other RPS representatives had joined a conference call with Warner on 30 January 2019 to discuss current progress. What is not yet ready, Bennett said, is the operational guidance to go alongside the the protocol. “I understand Jill Loader, [head of pharmacy commissioning for NHS England], is leading on that, and will engage with us on developing it”, Bennett told the board.  

The SSP, Bennett said, will be “very tightly controlled, and will need line of sight of the current supply chain”. The protocol can only be used for existing prescriptions, not for emergency supply, he added — and it is likely to have little relevance in secondary care.  

New GP contract  

Gidley announced that details of the new GP contract had been published the morning of the meeting. Turner said that it included plans for 20,000 more healthcare professionals (HCPs), including pharmacists, who were likely to be biggest group. Funding for these HCPs would be 70% backfilled, he said. Sharma said that the plan included “good news about state-backed indemnity”, and will help pharmacists in care homes and the across primary care network. It brings opportunities to integrate the workforce cross all of primary care, he added, but noted that the “workforce numbers are big”, and it is important to ensure the future supply of pharmacists. 

• The date of the next RPS EPB meeting was set for 11 April 2019.