The General Pharmaceutical Council’s (GPhC) new premises inspection regime is “working well” but concerns have been raised over whether it will improve service quality in the long term, according to research commissioned by the regulator.
Around 72% of pharmacists and 81% of pharmacy technicians said new GPhC standards for registered pharmacies encourage them to increase their focus on patients, the report of research conducted by ICF International says
GPhC chief executive Duncan Rudkin says the study has given the regulator important insights into how the new inspection model, introduced in November 2013, is working. “It is very encouraging that the majority of pharmacy professionals agree that inspections are helping to deliver real improvements in patient safety and the care people receive from pharmacies,” he says.
A few GPhC inspectors raised concerns about there being too many standards, and some inspectors questioned whether compiling inspection reports and rating pharmacies would bring about “sustained improvements”.
“While reports and ratings tend to act as a ‘wake-up call’, pushing pharmacies towards greater compliance, some GPhC inspectors felt that such changes are not maintained long term, partly because these reports are not yet publicly available,” the report says.
Inspectors support the GPhC’s intention to publish inspection reports, according to the report, published on 28 October 2015, which says: “Reputation and competition with neighbouring pharmacies could be a significant driver of improvement if these reports were published.”
The research — which included an online census of more than 3,700 community pharmacy professionals and follow up in-depth interviews — brought to the surface the profession’s disquiet about the inspection ranking system and the ‘satisfactory’ rating that the GPhC has promised to abolish.
Inspectors said that ‘satisfactory’ ratings are “misleading and demotivating” for pharmacies. And from the perspective of community pharmacists, they also have the potential to undermine patient trust in the pharmacy and confidence in the services it offers.
ICF International recommends that the GPhC considers approaches to ratings adopted by other regulators and that it subjects any new system to public testing.
The survey also revealed that 98% of pharmacy professionals who have gone through the new inspection regime highlighted the importance of inspector feedback to help them improve. Developing action plans to address any shortcomings identified by the inspectors was helpful, according to 95% of those who had to produce one.
A greater proportion of pharmacists operating in multiples were aware of the new standards for registered pharmacies compared with independent pharmacists (46% and 40%, respectively), the report says.
However, Leyla Hannbeck, chief pharmacist at the National Pharmacy Association (NPA), points out that awareness of regulatory standards is not the same as lower standards in practice. “The fact that there is relatively less awareness of the standards among smaller independents is in a sense unsurprising, given the inherent challenges of communicating to a diverse group outside a nationwide management structure,” she says.
The NPA welcomes several of the report’s recommendations, says Hannbeck, including that there should be greater clarity and differentiation between ratings. “This is something we have been calling for from the outset, because the current rating system is misleading and demotivating, as this report acknowledges.”
Jackie Peck, director of Hampshire-based Pharmacy Consulting Ltd, which inspects pharmacies to help them improve the quality of their services, says pharmacy teams often do not buy into their quality systems, do not keep them up to date or do not use robust change and risk management principles. “If the quality system is not led from the top and bought into by all team members, then they may not then find the new GPhC inspections and their reports helpful, nor will they use it to help with their continual improvement,” she says.
The ICF International report comes eight months after the GPhC launched an urgent review into its inspection rating system following concerns from the profession that a ‘satisfactory’ ranking could be misinterpreted by the public. The GPhC also announced at the same time that it intended to publish the inspection reports as well as the pharmacy rankings. However, it has yet to be decided how much of the information will be released, how it will be accessed and for how long it will be available.