Maintaining sexual boundaries

Following the launch of guidance on sexual boundaries from the GPhC, James Bloodworth reveals the key points you need to consider

1. Crossing professional boundaries can damage the reputation of community pharmacy. Patients should have confidence that their pharmacist will act in their best interests. Professional judgement can be affected if you are sexually or romantically involved with a patient and this can have an impact on decisions about a patient's health.

2. Relationships between patients and healthcare professionals often feature a power imbalance. A patient will be sharing personal information with a pharmacist and a pharmacist often has the resources a patient needs. The patient may be oblivious as to what is appropriate professional behaviour. It is your responsibility as a pharmacist to ensure clear professional boundaries are maintained during any interaction.

3. The same principles apply to patients or carers that you have dealt with in the past. If you think it is possible a personal relationship may develop with a patient, you should consider the harm this may cause to the patient and to your professional reputation.

4. During private consultations it's important to be clear with the patient about why you are examining them or why you want them to come into the consultation room. Give them all the information you can and get their consent before proceeding. Ask the patient if they would like another person present with them for the consultation; never assume.

5. If you are attracted to a patient you must remain professional. If you are concerned that your professional judgement may be affected, or if you are unsure about whether you are abusing your professional position, discuss the situation with a colleague or a professional pharmacy body.

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6. If you cannot continue to care for a patient objectively, transfer care to another healthcare professional who is qualified to provide the service to the patient. Ensure the patient does not feel they are in the wrong due to this transfer.

7. If you believe a patient is making sexual advances towards you, it is important to re-establish a professional relationship, possibly by addressing their feelings constructively. If this is not possible, you should transfer the patient's care to another healthcare professional.

8. It's important to be sensitive to cultural differences, as these may affect a patient's personal boundaries and what is appropriate. Always treat patients as individuals in a way that is respectful and maintains their dignity. For example, a patient may prefer to discuss their problem with, or be examined by, a pharmacist of the same gender.

9. A breach of sexual boundaries does not necessarily require an act such as a rape or sexual assault. For example, carrying out unnecessary physical examinations or enquiring about the sexuality of a patient when it is not relevant would be a breach of GPhC guidelines.

Other behaviours that may be considered signs of sexualised behaviour include: • revealing intimate personal details to a patient during a consultation • giving or accepting social invitations, such as dates and meetings • visiting a patient's home without an appointment • meeting patients outside of normal pharmacy hours, or at times when no other staff are present • asking questions unrelated to the patient's health. 10. It is your responsibility to act appropriately and professionally, and get advice as necessary. Further guidance on maintaining clear sexual boundaries is available from the GPhC's website at pharmacyregulation.org.

Tips for your CPD entry on maintaining clear sexual boundaries Reflect What are the key points when assessing whether a patient may find behaviour inappropriate? Plan Read the 10 points and the GPhC guidance. Act Consider any areas where you could improve practice, for example explaining the reason for private consultations. Evaluate Are you confident you maintain professional boundaries and know what to do if a potential conflict occurred?