Honesty to be considered in fitness to practise assessments

The General Pharmaceutical Council (GPhC), pharmacy regulator for Great Britain, has issued guidance to fitness to practise (FTP) committees when deciding appropriate sanctions for pharmacists and pharmacy technicians in particular cases. 

FTP committees are being asked to consider whether registrants have shown any remorse when considering sanctions. Any attempt to cover up wrongdoing should also be considered when weighing up what sanction should be set, the guidance states. Sanctions can range from receiving a warning to being removed from register. 

Other factors that should be taken into account include whether the conduct was pre-meditated, or a repeated or sustained action, and whether it took advantage of a vulnerable person, says the guidance, which comes into effect on 20 July 2015 and replaces the ‘Indicative sanctions guidance’ that was issued on 13 May 2011. 

The ‘Good decision making: fitness to practise hearings and sanctions guidance’ is particularly concerned with “dishonesty”, stressing that while it may not present a direct risk to the public, it has serious ramifications in damaging public confidence and undermining the integrity of pharmacy. 

It also says FTP committees should consider sanctions “at the upper end of the scale” in circumstances where a pharmacy professional deliberately avoided being open and honest with a patient or tried to stop someone else from speaking out as well as failing to raise concerns. 

The regulator says registrants have a “duty of candour” and to be open and honest with everyone involved in patient care. It states that expressions of empathy and apologies should be seen as a positive and “will not normally amount to an admission of impairment by the registrant”. 

Hugh Simpson, director of policy and communications at the GPhC, says the regulator wants to be clear “how serious they view cases where professionals fail to be honest with patients and others when things go wrong and therefore additional guidance to the committees about this was viewed as necessary”. 

Mark Koziol, chairman of the Pharmacists’ Defence Association (PDA), says that while the regulator had addressed some of their concerns, including the position that some cases of dishonesty did not demand removal from the register, other issues have not been addressed. 

The regulator “seems still not able to do anything about non-pharmacist area managers” working for the big pharmacy chains who may expect their staff to comply with edicts which go against what is expected from them as a healthcare professional, he says. 

“There doesn’t appear to be any regulatory approach to wrestle with this problem,” Koziol adds.

The PDA has called for a “fit for purpose” test to be applied at the recruitment stage and guidelines on “the sort of behaviour” that should be expected from non-pharmacist area managers. 

“We also have concerns around the duty of candour and raising concerns issue,” he says. “It flies in the face of what goes on in the real world.” For example, says Koziol, pharmacists working for large companies who make a dispensing error are commonly instructed not to make contact with the patient or anyone, but that head office will handle it. “We also see lots of pharmacists raising concerns with their employer who don’t do anything about it.”

• This article was amended on 16 June 2015 to clarify that the GPhC is the pharmacy regulator for Great Britain, not the UK.