Pharmacist suspended for WhatsApp remote supervision while ‘in lavatory’
An “inexperienced” pharmacist has been suspended for “running [a] pharmacy using Whatsapp” and allowing drugs to be dispensed without a pharmacist on site, the General Pharmaceutical Council (GPhC) has revealed.
A pharmacist has been issued a five-month suspension for making “numerous failures” and being a “poor manager” at a GPhC fitness-to-practise (FtP) hearing that spanned several weeks in May and June.
His “failures” included remotely checking medications via WhatsApp, allowing drugs to be supplied without an onsite pharmacist, creating false records and allowing a patient to take home drugs that should have been consumed while supervised, according to the hearing document.
The FtP committee found that Mahmoud Muhiyye, registration number 2211528, was “completely out of his depth” when he became the superintendent pharmacist (SI) and nominated responsible pharmacist (RP) of Cale Green Pharmacy in Stockport – owned by his non-pharmacist brothers - in June 2018.
The committee heard that Muhiyye , who qualified just two years earlier in 2016 and had previously “only worked as a locum pharmacist”, had been “running the pharmacy using WhatsApp messages” after the pharmacy’s trainee dispenser submitted a complaint to the regulator in July 2019.
An unannounced visit from an NHS England (NHSE) official and controlled drugs liaison officer that month also led the council to find that Muhiyye failed to “ensure safe custody of controlled drugs” and “employed inexperienced staff” who he instructed “to act beyond their competency”.
During the hearing, concerns were raised about the “unreliability” of evidence provided by two former employees, as both the trainee dispenser and part-time qualified dispenser left their jobs “on bad terms” with Muhiyye and each other following “an argument between the three of them”.
But despite the “breakdown in the hierarchy boundary”, the GPhC ultimately stressed that “the burden of proof rests on the council”.
The regulator accepted that “there was no evidence of harm to patients” due to Muhiyye’s actions, that he was unlikely to repeat his misconduct and that he had “genuine insight [and] expressed remorse and regret”.
But it stressed that the “breaches were serious and wide-ranging, demonstrating multiple examples of poor pharmacy practices” over “a number of months”.
“Bad habit” when “too busy”
The committee heard that the trainee dispenser “had sent photographs of medication by WhatsApp to the registrant to check” and that she “had not known the pharmacist should be there in person to do the final check”.
Muhiyye told the committee that he started approving the supply of medicines via WhatsApp “when he was too busy”, adding that “it was a mistake to allow this to keep happening” and that it became “a bad habit”.
“The language used and the nature of the WhatsApp messages were an indication of his lack of professionalism and immaturity”, the GPhC said.
It added that on “one occasion…[he] appeared to be in the lavatory when approving the supply of medication to a patient using WhatsApp photographs”.
“The committee was satisfied this was not adequate supervision,” it said.
It also said that “it was more likely than not that the registrant had been absent from the premises for the majority of the dates that the photographs had been sent”.
In total, it found 16 instances in which Muhiyye “caused or allowed” controlled drugs (CDs), prescription-only medicines (POMs) and pharmacy medicines (P-meds) to be “supplied or sold while there was no pharmacist on the premises”.
He “used an electronic messaging system to check the medication” while off-site on 18 instances, it said.
“The private personal and medication data of numerous patients had been stored on the personal device of a staff member for a number of months, including after that staff member had left the pharmacy,” it added.
“Far too much” responsibility
“During the course of his evidence, the registrant admitted that he had allowed one patient to take home buprenorphine medication,” the committee said.
“He confirmed that this had been the patient’s first dose and it had been at the start of Ramadan when the patient was fasting,” it added.
And it found that in 2019, he “claimed payment for an item that had not been supplied” – although the claim was an “error” and he himself had paid for an associated penalty charge notice.
It said that on “at least one occasion”, the registrant “failed to ensure the safe custody of CDs and had not adequately controlled access to the keys to the CD cabinet”.
And he “had not recorded his absences in the RP log while acting in the role of RP”.
The GPhC deemed that Muhiyye “had taken on far too much at an early stage of his career with no real understanding of the responsibility of the roles of RP and SI”.
But it stressed that “being inexperienced and naïve is no excuse for taking on the responsibilities of running a pharmacy and then not meeting the standards”.
Muhiyye took “immediate action” once concerns were raised, resigning as the SI in August 2019 and no longer being involved with the pharmacy, although he had regularly worked as a locum RP in various pharmacies since the events, according to the document.
“A very salutary lesson”
The committee said that Muhiyye “had been a poor manager, with little experience of managing any staff, let alone managing a pharmacy business”.
But it said he was a “good pharmacist” who “had learned a very salutary lesson from these events” and had “excellent testimonials” from colleagues since the events.
Muhiyye “accepted his failings”, admitting that he had shown “bad judgement” and now felt “shame” and “guilt” about the events, as well as taking “significant steps to remediate”, it added.
It found that despite being “a serious misconduct case”, “removal from the register would be a disproportionate sanction”.
It determined that Muhiyye should be suspended from the GPhC register “for a period of five months”.
See the determination in full here.