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The General Pharmaceutical Council (GPhC) has decided not to investigate Boots over allegations that it placed unacceptable pressure on pharmacists to perform medicines use reviews (MURs), a decision that has been met with dismay from the Pharmacists’ Defence Association (PDA).
Details of workplace pressures experienced by pharmacists working in community pharmacies, particularly at Boots, were revealed in a survey by the PDA and covered by The Guardian
in April 2016, leading to questions in parliament. Similar concerns have been reported in the pharmacy press
and have been raised by pharmacists at GPhC disciplinary hearings over several years.
Rather than investigate Boots specifically, the GPhC says it recognises “that these challenges are not unique to pharmacy”, and that it will “work with people and organisations from inside and outside pharmacy to examine and understand workplace pressures across the pharmacy sector, including through a seminar to be held in October ”.
This will include meeting with pharmacy owners to determine how they “support their professional staff to do the right thing”.
Mark Koziol, chair of the PDA, says he is at an “utter loss as to the logic of the GPhC’s argument in declining to take action against those responsible for the unacceptable targeting activities within Boots”.
“The GPhC is essentially saying that because the evidence shows that the unacceptable treatment of Boots pharmacists and patients is also happening elsewhere in corporate pharmacy, then no disciplinary action should be taken against anyone,” he claims.
The role of the regulator must be to protect the interests of patients and to underpin the professionalism of pharmacists, he says, not “to appear to behave like an apologist for large business interests”.
Koziol welcomes the stakeholder event but believes it is “far too little and far too late”.
“It is very important that the public and the profession have confidence in the pharmacy regulator and it is difficult to see how an event in October will underpin that confidence,” he adds.
Duncan Rudkin, chief executive of the GPhC, says: “We recognise that pharmacy professionals working in a wide variety of roles and settings will experience significant challenges in trying to provide high quality care to patients and the public while dealing with limited resources or other workplace pressures.
“It is important that everyone involved works to ensure that a balance is struck that protects and promotes the health and well-being of patients and the public, empowers pharmacy professionals to work with service users to make good decisions about care, and enables companies to pursue legitimate business interests in an ethical way.”
Marc Donovan, chief pharmacist at Boots UK, welcomes the GPhC’s approach. “At Boots we are, and always have been, committed to developing the future of community pharmacy and promoting the professional autonomy of pharmacists. We will support and participate fully in the inquiry alongside all other invited participants,” he says.
In a statement, the PDA said “a significant number of pharmacists”, including some working for Boots, had been struck off by the GPhC “because they buckled under the intense target-driven culture of their employers and falsified MUR figures to relieve some of the unbearable stress”.
“They are referred to the GPhC by the very employers who have pressurised them in the first place. These pharmacists are never given the option of attending a conference to discuss their misdemeanours,” the PDA added. “They expected more from the GPhC.”
The Royal Pharmaceutical Society (RPS) welcomes the GPhC’s intention to understand workplace pressures, but expects the GPhC to “move quickly from words to action”.
The RPS also wants pharmacy trade bodies, such as Pharmacy Voice, and the negotiating organisations across Great Britain to work with employers “to bring about a new covenant between the profession and those that employ them”.
In a statement, the RPS said: “The profession and patients need the GPhC and employers to make the rhetoric of professional autonomy a reality for those that work at the coal face every day.”
Pharmacy Voice, which represents three pharmacy trade bodies, said in a statement: “There is a significant risk that the government’s current approach to ‘reforming’ the community pharmacy sector will serve only to exacerbate the pressures that pharmacy teams are facing, and we urge the GPhC to take this context into account in their review.”
 Chakrabortty A. How Boots went rogue. The Guardian. 13 April 2016. Available at: http://www.theguardian.com/news/2016/apr/13/how-boots-went-rogue