After seven months of deliberation the Pharmacy Supervision Review Group has failed to reach a consensus on how pharmacy supervision should be reflected in legislation.

All the organisations on the Group agreed that the physical presence of a pharmacist in the pharmacy was a defining element of community pharmacy. They agreed that the pharmacist should be more accessible to patients as a result of any changes to legislation, regulatory rules and standards.

However, the National Pharmacy Association, Pharmacists’ Defence Association, Pharmacy Forum of Northern Ireland and Royal Pharmaceutical Society felt that primary legislation should be amended to include a definition of “supervision” that required the physical presence of the pharmacist.

They argued that this would not only deal with the outdated concept of supervision and remove any previous case law precedents but, importantly, make it clear to all employers and patients that the community pharmacy is the place in which a pharmacist should be found.

Embedding this concept in the Medicines Act 1968 would inform the nature and style of commissioning going forward. Any future innovation and technological advances could then be developed to support (rather than replace) pharmacists in their face-to-face dealings with the public. Secondary legislation and regulatory rules and standards could still be reviewed and respond to changes in practice and define the exceptions to primary legislation.

The Association of Independent Multiple Pharmacies, Association of Pharmacy Technicians UK and Company Chemists’ Association felt that including the concept of physical presence in either secondary legislation, regulatory rules and standards, and/or professional standards and guidance would be more appropriate.

These organisations argued that if the physical presence of the pharmacist was already a requirement in the Human Medicines Regulations 2012, then an additional reference in the Medicines Act 1968 was not necessary, and if it did occur it could restrict flexibility in the future as making changes to primary legislation would be difficult.

As practice evolves, seeking to amend regulatory rules and standards as opposed to amending primary legislation, felt more appropriate, they said. This more iterative approach would create more opportunities for pharmacists, pharmacy technicians and pharmacies in the future and would bring pharmacists in line with other professionals.

The Review Group did agree that legislation should be clarified to reflect that “supervision” should no longer be interpreted to mean supervising individual transactions. The default expectation should be that a responsible pharmacist is present to ensure the pharmacy is operating safely and effectively.

The Group agreed that any absences from the pharmacy of the RP should be temporary and only where the benefits outweigh the risks. There was a consensus that the two-hour time limit for absence should remain

The Group also agreed that legislation should be amended to enable the preparation, assembly, sale and supply of medicines to be delegated in defined circumstances from the RP to appropriate members of the pharmacy team (including pharmacy technicians).

Legislation should also be amended to enable the preparation and assembly of medicines to take place outside the opening hours of the pharmacy without a RP being signed in, with accountability for dispensing accuracy resting with SP, the Group said.

AIMp Chief Executive Dr Leyla Hannbeck said: “Whilst we have reached consensus on many areas, the reality is that there remain areas where organisations continue to differ. We have been a big advocate for seeking a level playing field for community pharmacists in line with our GP colleagues and this applies to the rules of supervision too. We will be responding to the government consultation in accordance with our vision for a robust, innovative and thriving community pharmacy sector with a skilled workforce that play a key role in the primary care.”

PDA Chairman Mark Koziol said: “The report clearly puts forward a view that the physical presence of a pharmacist in a community pharmacy is essential in providing safe and effective patient care, and while there were differing views on the need for this to be specified in primary legislation, the general point about physical presence was agreed by all. We will now be working with our members to feed into the formal consultation process when that is launched by the government.”

The Review Group has been meeting since December 2022, chaired by Dr Michael Twigg, associate professor of primary care pharmacy, University of East Anglia. The Department of Health and Social Care, the General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland were present as observers.