Royal Pharmaceutical Society Of Great Britain Research Articles

Joy Wingfield (1947–2021)

Joy Wingfield, professor of pharmacy law and ethics and a Fellow of the Royal Pharmaceutical Society (RPS), has died aged 73 years. Wingfield qualified as a pharmacist in 1971 and within six years had risen to become an inspector for the Royal Pharmaceutical Society of Great Britain (RPSGB). In 1986, she took up the role […]

PHARMACY LEGISLATION: PUBLIC PROTECTOR OR PROFESSIONAL HINDRANCE?

Pharmacy originates from a background of medication compounding and supply. More recently, this role has developed away from an absolute focus on the supply of pharmaceuticals with, for example, the advent of pharmacist prescribing. Nevertheless, for a majority of the profession, medication supply remains a core activity. Regulation of the pharmacy profession is now the responsibility of the General Pharmaceutical Council, although up until 27 September 2010, this role fell to the Royal Pharmaceutical Society of Great Britain (RPSGB). Before this change, in one of the most high-profile legal cases involving a pharmacist in a professional capacity, R. v Lee, a pharmacist was prosecuted firstly for gross negligence manslaughter, later revised to offences under the Medicines Act 1968, for a single error relating to medication supply, and was given a suspended custodial sentence. Offences against sections 64 or 85 of the Medicines Act are absolute offences and there is no due diligence defence. Prosecution of a pharmacist for the supply of incorrect medication may seem a measured course of action to protect the public from the wrongful supply of potent pharmacotherapeutic agents; however, further analysis of Lee indicates that this approach may be counterproductive. An appeal of the original conviction in the Lee case has resulted in a clarification of the interpretation of section 85(5); however currently, prosecutions under section 64 are still a possibility. Owing to the seriousness of a criminal conviction under section 64, this continuation will potentially stifle the profession's ability to learn from dispensing errors.

Hospital pharmacy education and training

In the 1990s, the Royal Pharmaceutical Society of Great Britain (RPSGB) launched a vision for pharmacy known as ‘pharmacy in a new age’ (PIANA).1 PIANA raised the profile of the...

Pharmacist prescribing in primary care: the views of patients across Great Britain who had experienced the service

OBJECTIVE To evaluate the views of patients across primary care settings in Great Britain who had experienced pharmacist prescribing. METHODS All Royal Pharmaceutical Society of Great Britain (RPSGB) prescribers (n = 1622) were invited to participate. Those consenting were asked to invite up to five consecutive patients who had experienced their prescribing to participate. Patients were mailed one questionnaire and a reminder. The questionnaire included five sections: demographics; you and your pharmacist prescriber; you and your general practitioner; your views and experiences based on your most recent pharmacist prescriber consultation; and additional views. KEY FINDINGS Of the 482 (29.7%) pharmacists who responded, 92 (19.1%) were eligible to participate, of whom 49 (53.3%) consented. Of those excluded, 193 (49.5%) were prescribing in secondary care and 171 (43.8%) were not prescribing. Between September 2009 and March 2010, 143 patients were recruited. Patient response rate was 73.4% (n = 105/143). Consultation settings were largely general practice (85.7%) or community pharmacy (11.4%). Attitudes were overwhelmingly positive with the vast majority agreeing/strongly agreeing that they were totally satisfied with their consultation and confident that their pharmacist prescribed as safely as their general practitioner (GP). Pharmacists were considered approachable and thorough, and most would recommend consulting a pharmacist prescriber. A slightly smaller majority would prefer to consult their GP if they thought their condition was getting worse and a small minority felt that there had been insufficient privacy and time for all their queries to be answered. CONCLUSIONS Patients were satisfied with, and confident in the skills of, pharmacist prescribers. However, the sample was small, may be biased and the findings lack generalisability.

National and local guidance on services for drug misusers: do they influence current practice?— results of a survey of community pharmacists in South East England

Abstract Objective To investigate levels of awareness of national and local guidance about services for drug misusers and their effect on pharmacy practice. Method A postal survey in 1997 to collect data on current involvement in services for drug misusers, awareness of and receipt of key documents pertaining to drug misuse, effects of guidelines and protocols on practice, and influences on decisions to provide services. Setting A random one in two sample (n=1,582) of community pharmacies in the South East of England (North and South Thames regions). Key findings A 65.1 per cent response rate was achieved. Just over half (54.7 per cent) were dispensing Controlled Drugs for the management of dependence, 47.2 per cent were selling clean injecting equipment and 15.5 per cent were offering a needle exchange service. Most respondents were unaware of key government documents, with the exception of “Health of the nation,” and only a small minority had received copies. The most influential factors on current position on service provision were “personal experience,” “local need” and “Royal Pharmaceutical Society of Great Britain (RPSGB) policy.” New local guidelines and initiatives mainly related to supervised consumption of methadone in pharmacies and pharmacy needle exchange. Conclusion Community pharmacies are substantially and increasingly involved in providing*** primary care services for drug misusers. However, there is a disturbing lack of awareness of key government initiatives, possibly due to the lack of dissemination of such documents. RPSGB policy as a key influencing factor points to an opportunity for the profession to take a more influential position.

Session 1C: The Pharmacy Profession 1

From April 2010, the General Pharmaceutical Council (GPhC) will be responsible for the statutory regulation of pharmacists and pharmacy technicians in Great Britain (GB).[1] All statutorily regulated health professionals will need to periodically demonstrate their fitness-to-practise through a process of revalidation.[2] One option being considered in GB is that continuing professional development (CPD) records will form a part of the evidence submitted for revalidation, similar to the system in New Zealand.[3] At present, pharmacy professionals must make a minimum of nine CPD entries per annum from 1 March 2009 using the Royal Pharmaceutical Society of Great Britain (RPSGB) CPD framework. Our aim was to explore the applicability of new revalidation standards within the current CPD framework. We also wanted to review the content of CPD portfolios to assess strengths and qualities and identify any information gaps for the purpose of revalidation.

Posters: Practice Research

In October 2001 the Royal Pharmaceutical Society of Great Britain (RPSGB) decided to make continuing professional development (CPD) mandatory. A voluntary CPD scheme was introduced in 2002 with the aim of a seamless transition to a mandatory system. Appropriate legislation is not expected before late 2004. CPD is “the process by which pharmacists continuously enhance their knowledge, skills and personal qualities throughout their professional careers”, CPD is not the same as continuing education (CE) nor is it a new concept. This study identified community pharmacists’ attitudes and approaches to the RPSGB CPD initiatives and the current uptake and non-participation of CE and CPD.

Posters: Practice research

This abstract assesses the success of teaching first-year MPharm students to use a personal development planning (PDP) template based on the Royal Pharmaceutical Society of Great Britain (RPSGB) continuing professional development (CPD) framework.

Symposium on Pharmacovigilance of Herbal Medicines, London, March 28, 2006

Symposium on Pharmacovigilance of Herbal Medicines, London, March 28, 2006

What purpose does the MPharm research project serve?

In 2004, the Royal Pharmaceutical Society of Great Britain (RPSGB) funded research on teaching, learning and assessment within the UK undergraduate pharmacy degree (MPharm), including the compulsory final year project. Documentary analysis showed that all schools met the project requirement, although there were wide variations in the relative contribution of the project to the final year mark and the degree classification. Interviews with staff revealed that organisation of research projects was complex and time consuming and exacerbated by increasing student numbers and the impact of research ethics. 61% of students, surveyed via a self-completion questionnaire (response rate 50.6%) perceived the research project to be very or fairly important. Whilst 47% considered that they had enough choice of topic and 37% said that their training in research methods provided a good foundation for their project, this suggests scope for improvement. In the UK, there are legislative changes impending which may provide an opportunity to review the future purpose and feasibility of a significant final year project within the MPharm.

Supplementary Prescribing: Early Experiences of Pharmacists in Great Britain

Pharmacists in Great Britain can undertake supplementary prescribing (SP) after training at a higher education institution and completing a "period of learning in practice" in accordance with the Royal Pharmaceutical Society of Great Britain (RPSGB) curriculum. To explore SP pharmacists' early experiences of prescribing and their perceptions of the prescribing course. A questionnaire was mailed to all RPSGB prescribers (N = 518, on June 1, 2005; 30 used in pilot questionnaire). Predictors of pharmacists starting to practice SP were identified in univariate analysis, and significant variables were further tested in multivariate analysis. The respondents (n = 401; 82.2%) were mainly female (270; 67.3%), had more than 20 years' experience as a pharmacist (123; 30.7%), worked in hospital settings (160; 39.9%), and focused on cardiovascular conditions (143; 35.7%) during their period of learning in practice. The median course satisfaction score, on a scale of 3 to 15 (lowest to highest), was 10. Practicing SP was self-reported by 195 (48.6%) respondents, 154 (79%) of whom had written a prescription. Ninety (58.4%) of the first prescriptions were written in primary care settings. Better patient management was regarded as the major benefit by 139 (71.3%) of those engaged in SP, while funding issues were identified by 71 (36.4%) as major barriers in implementing the practice. Lack of organizational recognition of SP was the main reason given (37; 18%) for those not commencing the practice. Independent predictors of those practicing SP included a longer time since registering as prescriber (p < 0.001); confidence of pharmacists in their prescribing abilities (p < 0.001); practicing in a setting other than community pharmacy (p = 0.001); and training in cardiovascular conditions or multiple conditions during the period of learning in practice (p = 0.005). Pharmacists have made progress in implementing SP, which is perceived by pharmacist prescribers as beneficial for both patients and themselves. Pharmacists need more support in terms of infrastructure and integration into the healthcare team to overcome some of the barriers to implementing SP.

Destination, future intentions and views on practice of British-based pharmacists 5 and 10 years after qualifying

The first ever Pharmacy Workforce Census of pharmacists in Great Britain (GB) was conducted in 2002, and repeated in 2003. Both census surveys aimed to gather empirical data on the employment profile of pharmacists to aid the workforce planning process. The aim of this paper is to compare the work profile and employment destination of two graduate cohorts of pharmacists to explore what changes take place in employment practices and how quickly they occur. GB-based pharmacists. A two-page postal questionnaire was sent to 38,000 GB-registered pharmacists in August 2003, to provide various data on employment patterns, intentions to work abroad, and desire to practise pharmacy. The pharmacists were contacted using addresses stored on the Pharmaceutical Register, a statutory record of all pharmacists and pharmacy premises held by the Royal Pharmaceutical Society of Great Britain (RPSGB). A sub-set of this large data set--pharmacists who qualified in 1992 and those who qualified in 1997--was selected for comparison. Sector of employment and strength of desire to practice. A response rate of 75% was achieved for the overall census, while the response rate from the two graduation cohorts was 62% and 58%. Larger proportions of women compared with men, even after only 5 years of working as a pharmacist, are either not working or work part-time. Among the women, these patterns increase significantly for those with a greater number of years on the Pharmaceutical Register. There is evidence that pharmacists move out of the two main sectors of practice (hospital and community) with increasing years on the Register, and some gender differences in job mobility are observed. The School of Pharmacy from which pharmacists graduate appears to have some effect on practice patterns although more research is needed to explore this further. Desire to practise pharmacy is weaker among those practitioners who work in the community sector of practice, and younger pharmacists are more likely to intend working abroad. Part-time work patterns are implemented fairly quickly after qualifying, particularly among the women pharmacists. Given that female students account for over 60% of all intake onto pharmacy courses current supply problems will continue if work patterns continue along this trajectory. The ability of the profession to meet current, never mind extended roles, is thus called into question.

Formative assessment as a learning aid for pharmacy calculations—a theory based design

Deficiencies in basic numerical skills exist amongst the general population and within healthcare professions. This paper shows how an application of education theory can be used to design an assessment tool to diagnose these problems in pre- registration pharmacists. The main component of this research is based on formative assessment, which acts both as an assessment method and learning aid. Theories such as Landa’s Algo-Heuristic Theory and Vygotsky’s Concept of Learning Development are incorporated directly into the tool’s development. The designed assessment tool comprises three papers, developed around a sample Royal Pharmaceutical Society of Great Britain (RPSGB) exam paper. These papers are to be used at various stages throughout the pre-registration training year to aid progression to mastery. Preliminary validation of this research was carried out using qualitative analysis of an academic/practitioner pharmacist consensus group. The analysis showed that formative assessment is perceived to be difficult to implement and understand. It also showed this tool to be a novel method of addressing this important issue, worthy of further research.

21st Century Issues in Pharmacy Education in the United Kingdom

In the United Kingdom (UK) the discipline of pharmacy is clearly expanding, with student intakes into schools of pharmacy more than doubling in the last 20 years. There are currently 16 UK schools of pharmacy, with a combined output of approximately 1600 graduate students per year. To contextualize these facts for the Journal readership, the UK population is 60 million people. The schools deliver the 4-year master of pharmacy (MPharm) program that confers upon successful candidates the right to practice as a pharmacist subject to subsequent successful completion of the preregistration year and examinations. MPharm graduates also enjoy the right to mutual recognition of their pharmacy qualification across the European Union (EU), subject to completion of satisfactory “transition” procedures (normally peer observation). The MPharm is the only qualification that the Royal Pharmaceutical Society of Great Britain (RPSGB) recognizes as suitable for entry into their preregistration year (the equivalent of the United States’ internship) and consequent entry into the register as a pharmacist. Normal practice is for students to take the preregistration qualification after completing the MPharm program; however, 3 pharmacy schools have a gap-year program, which allows the students to spend a year in the field before completing their final year. Currently, 74% of MPharm graduates become community pharmacists, 26% become hospital pharmacists, and 12% go into industry or academia, with the latter group normally also required to hold a relevant PhD. (The 112% total reflects that some pharmacists have two occupations, for example part time teaching/part time hospital pharmacy.) All 16 schools of pharmacy deliver a version of the “indicative syllabus,” a framework of learning outcomes that the RPSGB sets, and with which accredited schools must comply, based upon EU requirements. Until recently, the RPSGB was empowered to dictate the maximum number of students permitted to enter the MPharm programs across the UK each year, effectively controlling the supply of pharmacists. This power has now been removed, making the supply of potential pharmacists deregulated and subject to market forces.

The Relationship of Undergraduate Assessment to Degree Accreditation

From its Charter and the Pharmacy Act 1954, and recognised in European Directives 85 / 432 / EEC and 85/433/EEC, the Royal Pharmaceutical Society of Great Britain (RPSGB) has responsibility and powers for approval of the education and training of pharmacist s registering in GB. An important stage and component of such education and training is the pharmacydegree course. The RPSGB’s approach to the approval of such programmes is a system of accreditation, no less frequently than every five years.

Responsibility for controlled drugs in operating departments.

The difficulties experienced with the recruitment and retention of registered nurses has made it necessary for NHS trusts to review the traditional role of nurses and to transfer some of their duties to other groups of staff in order to maintain services. For example, in the operating department, operating department assistants and operating department practitioners (ODAs/ODPs) are undertaking some of the duties that were previously the responsibility of nurses. This article presents the findings of a survey to determine the extent to which ODAs/ODPs have access to controlled drugs in operating theatres. The survey was initially undertaken by the author in Welsh hospitals during 1998. The mixed responses generated discussion in the Duthie Review Committee (Committee Chairman, personal communication, Royal Pharmaceutical Society of Great Britain (RPSGB), 1999) and led to a collaborative exercise based on a random selection of NHS trust hospitals in England, Scotland and Northern Ireland to obtain a broader data across the UK. Despite a clear legal position concerning possession, the survey showed that practice varied widely and that some trusts may be contravening the Misuse of Drugs Regulations 1985 in order to keep the service running when registered nurses are not available.

A survey on factors that could affect adverse drug reaction reporting according to hospital pharmacists in Great Britain.

Since April 1997, UK hospital pharmacists have been invited to submit reports of suspected adverse drug reactions (ADRs) to the Committee on Safety of Medicines (CSM) and Medicines Control Agency. Three studies have investigated the involvement of hospital pharmacists in ADR reporting; however, they did not investigate the possible factors that could affect ADR reporting. (i) To analyse the extent to which hospital pharmacists think that specified factors could affect reporting ADRs; (ii) to identify any additional factors that could hinder reporting; and (iii) to recommend possible methods to improve reporting. Piloted questionnaires were sent to 548 hospital pharmacists in Great Britain randomly selected by the Royal Pharmaceutical Society of Great Britain (RPSGB) from their computer database. 346 questionnaires were returned and 280 were included in this study. 46% of the pharmacists had identified ADRs that were considered to be reportable according to the CSM criteria in the 6 months prior to the survey. 39% did not report these ADRs either to the CSM or the manufacturers. Only 8.2% reported that their hospitals had a written policy; conversely, 73.7% agreed that such a policy could enhance ADR reporting. Although not statistically significant, the result showed an increasing tendency to report ADRs by pharmacists who had received training. Furthermore, there was an increasing tendency to report ADRs with increasing seniority. The results show that hospital pharmacists say they are more likely to report serious and rare ADRs and ADRs associated with newly marketed drugs. Factors that could reduce ADR reporting included being busy at work, lack of confidence in recognising ADRs and the fear of breaching patient confidentiality. Most common suggestions on methods to improve ADR reporting were to provide ADR training and meetings (34%) and a hospital written policy (24%). ADR training and meetings would be a useful step in improving hospital pharmacist ADR reporting. Therefore, we recommend that the CSM and the RPSGB liaise with regional drug information centres and schools of pharmacy to provide more study days and training programmes for hospital pharmacists. Furthermore, the CSM should write to the 'Drugs and Therapeutics Committee' of each hospital and encourage them to develop a written local policy for pharmacist ADR reporting. Further studies should be conducted to test the recommendations noted here, assessing the response of the pharmacists in terms of absolute numbers of reports made. It would be particularly interesting to study the need for a written hospital policy and education.