P3s Carolyn Scott speaks to GPhC’s Duncan Rudkin about professionalism and standards, following the announcement of a new consultation launched by the regulator

The professional standards that pharmacists and pharmacy technicians work to have been updated, and are open for consultation – for review and comment – GPhC has announced. The nine new standards, outlined in “Consultation on standards for pharmacy professionals”, are the result of a substantial project led by the regulator, including an engagement event held last year to discuss issues around “professionalism.”

The review comes now because the current standards in place since 2010 were due for an update, but also to recognise changes in pharmacy, public expectations and new healthcare approaches following the Francis Report and similar inquiries, GPhC’s Duncan Rudkin (pictured) tells P3. The standards are fundamentally important, he says. “This is the deal if you like – the promise that pharmacy professionals are asked to make to the public. So, it’s important that it is up to date and covers all the different issues that people are grappling with.”

It is the attitudes and behaviours of pharmacy professionals in their day-to-day work which make the most significant contributions to patient safety and the quality of care, says GPhC.

Effective working with other health and social care professionals, strong leadership and professional judgement, and the confidence to question when needed, are key themes. The public want health professionals to be working together in their interests, says Mr Rudkin.

“There is an emphasis here on partnership, on working collaboratively as part of a pharmacy, but also a wider health and care team – and particularly on working in partnership with patients and consumers and carers, who are increasingly telling us that they don’t want health professionals to be condescending to them, but to be helping them as patients, service users, to support themselves and manage their conditions.” There is also a strengthened emphasis on confidentiality and privacy, both particularly important to the public, he explains.

The standards need to be met at all times, not only during working hours, says the consultation document. “This is because the attitudes and behaviours of professionals outside of work can still undermine the trust and confidence of patients and the public in pharmacy professionals.”

Leadership is a characteristic that all pharmacists and pharmacy technicians need to show, says Mr Rudkin, and this features strongly in the draft standards. “We are looking for leadership as a key aspect of professionalism – whatever role you are in, and your position in the pecking order managerially. Sometimes that involves being willing to stick your neck out or to say the unpopular thing.”

This could be a pharmacy technician “who’s maybe starting to get uncomfortable about something” or a pre-registration trainee “who sees something with a fresh pair of eyes and wants to ask a question that may be unwelcome,” he suggests. “That decision to ask that question demonstrates leadership, and we want to encourage and support people in living up to that.”

With controversy around whistleblowing high in healthcare services and a range of inquiries that have questioned the quality of NHS care in mind, Mr Rudkin emphasises that being a professional “is not easy sometimes”. Quality care for patients relies on people being able to openly question poor practice if they see it. “We as a regulator, professional bodies, employers, unions, all have a responsibility to help and support people to speak out when they need to,” he says.

It is intended that the standards help pharmacy professionals to uphold their vital standards professionalism at times when they feel under pressure, perhaps when there are commercial targets to be also met, or time to care for an individual patient is under pressure.

The nine draft standards

GPhC says: “The standards for pharmacy professionals describe how safe and effective care is delivered through ‘person-centred’ professionalism. The standards are a statement of what people expect from pharmacy professionals, and also reflect what pharmacy professionals have told us they expect of themselves and their colleagues.” The nine draft standards say that pharmacy professionals must:

  1. Provide person-centred care
  2. Work in partnership with others
  3. Communicate effectively
  4. Maintain, develop and use their professional knowledge and skills
  5. Exercise professional judgement
  6. Behave in a professional manner
  7. Respect and maintain the person’s privacy and confidentiality
  8. Speak up when they have concerns or when things go wrong
  9. Demonstrate effective leadership.

 

“Hopefully, this will helpfully inform people’s decision-making and give them something helpful to use. We need people to remind their colleagues, managers or bosses that they have a professional responsibility that goes beyond their duty as an employee. It’s a key part of professionalism. And the standards can be, and sometimes are, rightly, used in that way.”

The Standards for Registered Pharmacies – that contractors are required to abide by – will also be updated in the course of this year, so that the two dovetail, says Mr Rudkin. The new standards also link well with those for the medical and nursing professions, he comments. “In my view, what we are presenting now as a draft is much closer to the kind of standards that doctors and nurses, for example, are expected to live up to; explicitly, the emphasis on compassion and care as part of professionalism in pharmacy – that is no different from any other healthcare profession.”

It is important that the standards meet the needs of pharmacists and pharmacy technicians working in all areas of the health services, including new roles and support a focus on the clinical role of pharmacy. “I think the draft standards we are consulting on are deliberately designed in a way that we hope will useful be relevant and to everybody, whether they are working in general practice, community or hospital, recognising as well a very wide definition of “clinical” – including people engaging with patients and with carers.”

What happens next?

GPhC is looking for widespread engagement with the consultation, across all areas of the profession. It’s important that the standards receive “the acid test” from pharmacists and technicians, to ensure that they are as useful as possible.

“We’ve done a great deal of work to make this as informed as it can be, but somebody working in practice in a particular scenario might take what we’ve said in a completely opposite way to what we’ve intended. If that happens we need to know about it, so we can manage that risk and eliminate it if we can,” says Mr Rudkin.

And because it’s likely that these are the standards that will be in place when Continuing Fitness to Practice is introduced in a few years’ time, people should review the draft standards with this in mind, he suggests.

“We have a long-standing commitment in using these core standards of professionalism as the benchmark that we will ask people to use, to show that they continue to be fit to practise and remain registered. One of the tests for the standards, therefore, is can people imagine themselves being able to demonstrate how they are meeting these standards? On a very practical level, people will be asked to do that in the future, so it’s worth making that link,” he comments.

The standards need to stand up for individuals who are using them in their professional practice, says Mr Rudkin. GPhC would like people to test the standards with day-to-day practice in mind, and feedback on what they find.

“For me one of the things that would be really fantastic to see, is people in workplaces; in organisations; in different forums, formally and informally, just using this consultation as a talking point themselves, to reflect on their practice and how they are working together with colleagues.”

“If it provokes heated debate, and a little bit of controversy about certain aspects of practice and what professionalism looks against that background – then to my mind, that’s a good thing,” he concludes.

“There will be times when pharmacy professionals are faced with conflicting legal and professional responsibilities. Or they may be faced with complex situations that mean they have to balance competing priorities. We expect pharmacy professionals to consider these standards, their legal duties and any relevant guidance when making decisions. The standards provide a framework to help them with making professional judgements. Pharmacy professionals must work in partnership with everyone involved, and make sure the person they are providing care to is their first priority.”

Consultation on standards for pharmacy professionals

We are looking for leadership as a key aspect of professionalism – whatever role you are in

Review and respond to the consultation hereComments from pharmacy professionals are invited until 27 June 2016.

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