The RPS has issued a call for evidence on the “benefits and harms of a facilitated self-selection model for Pharmacy medicines” (P-meds), it announced today (July 12).

The eight-week call will run from today until September 6 and follows a June RPS meeting that discussed the royal society’s position on P-med self-selection. 

RPS chief executive Paul Bennett said that the evidence will “inform a report by RPS Science and Research” that will “enable” the royal society to “consider [its] current position”.

Read more: RPS ‘clearly at odds' with GPhC over P-med self-selection

Bennett added that the RPS is “committed to patient safety and the safe development of innovative practice”.

While the membership body is formally opposed to the self-selection of P-meds, the General Pharmaceutical Council (GPhC) now permits pharmacies to offer P-meds for self-selection in what the regulator refers to as a “facilitated” manner.

The RPS came under fire last month for inviting Boots’ superintendent pharmacist Clare Nevinson to give a presentation on how the multiple allows self-selection in its pharmacies. 

Read more: ‘Betrayal of profession’: RPS slammed for mulling pro P-med self-selection stance

The society’s board includes Sibby Buckle, a member of the executive board of the Boots Pharmacists Association.

Following the meeting, the RPS announced that it was “deeply disappointed” by the GPhC’s decision to permit P-med self-selection, which it said had been done without “wider communication from the regulator to the profession, patients and the public”.

And last week, (July 5), the Pharmacists’ Defence Association (PDA) called on its members to share their views on self-selection using an online survey.

 

“Long history of tension”

 

The minutes of the June RPS meeting contain a paper written by its director for England James Davies to help the royal society decide whether its position of opposition was still “valid”.

Davies presented the “long history of tension” and current state of play regarding the open sale of P-meds in community pharmacies.

He noted in favour of the self-selection of P-meds that it allows patients to inspect different medications, which “drives a more informed public and helps people make better choices”.

Read more: Coroner: Medicines regulator must ‘take action’ after anti-nausea P-med death

And he claimed that current policy “perpetuates the paternalistic nature of healthcare”.

“This may also provide a way for pharmacies to increase their over-the-counter (OTC) sales, to maximise business and help bridge the gap created by the downfall in income in the sector in recent years,” he said.

But in opposition to self-selection, he said that P-meds have been given “an additional level of protection” by the Medicines and Healthcare products Regulatory Authority (MHRA) because they have “potential for harm”.  

Read more: GPhC brands P med rules anachronistic in defence of self-selection

“Putting them onto open display and into the hands of customers may make the decision not to sell more challenging,” Davies noted, adding that offering pharmacies discretion about permitting self-selection could lead to “confrontation with pharmacy staff”.

He said that many online pharmacies sell P-meds in effective self-selection conditions, noting that the RPS has previously raised concerns about “product-led” websites and that discrepancies in barriers between physical and digital structures could disadvantage bricks-and-mortar pharmacies.

“The more commercially minded owners may dilute the reputation of pharmacies as being guardians of healthcare and ensuring the safe use of medication,” he added.

Read more: P-med self-selection plans 'incredibly naïve', say PDA and RPS

And he said that changes to supervision legislation may see pharmacy technicians able to sell P-meds while operating under the “delegated authority” of a pharmacist.

Davies set out that the board can choose to keep its current position, “evolve” its policy to approve self-selection under certain “conditions” or “support the wider open selection” of P-meds.

 

MHRA on self-selection

 

A spokesperson for the MHRA told C+D earlier this month (July 1) that it continues to “monitor and review the acceptable sale of P-meds in the interest of patient and public safety”.

“It is important that a pharmacist is available to provide supervision and advice to patients on the safe use, benefits and risks of the medicine,” they told C+D.

On June 25, a spokesperson for the GPhC told C+D that it “no longer requires pharmacies to contact [it] in advance if they want to introduce self-selection”. 

Read more: Boots remains tight-lipped on P-med self-selection

They added that P-med self-selection “would not be compatible with [its] regulatory standards without key safeguards being in place” and directed pharmacists to an FAQ page.

The FAQ page provides examples of P-meds that might be excluded from self-selection, including “codeine-containing products, recent prescription-only medicine (POM) to P switches, some of the sleep aids or any high value medicines”.

When asked whether these examples suggest de facto sub-categories of P-meds, the MHRA spokesperson said that it did not find reference to sub-categories but that the Human Medicines Regulations 2012 “do not stipulate sub-categories of P-meds”.