The Pharmacists’ Defence Association (PDA) yesterday (February 13) revealed the “overwhelming opposition to making P-meds available on open display for self-selection, primarily due to concerns over patient safety, inappropriate use and the increased risk of harm”.
Launching a new report titled “Beyond Convenience. Protecting Patients: The Case Against Liberalisation of P Medicine Sales”, the PDA urged policymakers to “prioritise patient safety and maintain pharmacist involvement in the supply of P-meds”.
It revealed that a “snapshot” member survey - conducted in July and completed by 1,323 pharmacists - found that 93% of respondents “opposed the concept of self-selection”.
Read more: PDA slams ‘disingenuous’ RPS as P-med self-selection row rages on
When asked about their main concerns, the top three reasons for opposition were “inappropriate selection” (96%), difficulty in supervision (94%) and the potential for “disputes or violence” (87%), the PDA said.
Among those in favour of a change to enable P-med self-selection (5%), the top three reasons for the position were that patients can ask questions if needed (85%), it would “save staff time” (64%) and it may “encourage embarrassed patients” to access products (64%), it added.
It follows a row that erupted over the summer, which saw the PDA brand the Royal Pharmaceutical Society’s (RPS) decision to “renew” the debate on self-selection “both premature and disingenuous”.
“Impossible to monitor”
One survey respondent said that with “no supervision of these sales, the P-med category would need to be abolished and items just be general sales list (GSL) or prescription-only medicines (POM)”.
“The current legislation…provides an important distinction between retail outlets and pharmacists - allowing self-selection of P-meds would not only risk jeopardising patient safety but also risk lowering the status of community pharmacies,” another added.
Read more: RPS launches call for evidence on P-med self-selection amid controversy
Others referenced concerns about drug interactions, patient aggression when pharmacists refuse a sale, counter assistants mistakenly permitting sales and the use of adult medication for children.
“It will be impossible to monitor while we are doing all our ‘extra’ services [such as] vaccination and Pharmacy First and are not in earshot,” another respondent said.
“Full consultation”
The PDA stressed that “any changes” to current regulation - which mandates restricted access and pharmacist intervention - must “only be made following full consultation with pharmacists”.
The current model is “not just beneficial but essential for ensuring the appropriate use of P-meds, preventing harm or misuse and providing professional advice”, it said.
Read more: RPS supports DH move for more POM to P reclassifications
It set out a raft of recommendations, including that the General Pharmaceutical Council (GPhC):
- Provides “clear guidance to pharmacy owners explicitly prohibiting open display”
- Reinforces pharmacist supervision in P-med transactions
- Implements “mandatory training” for pharmacy teams on P-med “risks and safe practices”
- Strengthens “compliance monitoring through regular inspections, mystery shopper exercises and audits”
- Establishes a framework to “prevent financial incentives from compromising professional judgment”
It also called for “public awareness campaigns highlighting pharmacists’ role in medicine selection and patient safety”.
Read more: RPS ‘clearly at odds’ with GPhC over P-med self-selection
PDA chair Mark Koziol said the new report “demonstrates why consumer convenience must never be given priority over patient safety in a community pharmacy, regardless of how attractive this might be to those in the business of retailing”.
He added that healthcare professionals must “focus on their own unique and distinct roles”, which for pharmacists is “being the patients’ medicines-related champion”.
“Key safeguards”
GPhC chief pharmacy officer Roz Gittins yesterday said that the regulator “fully [agrees] with the PDA that pharmacists play a crucial role in protecting patients by providing expert advice, ensuring the appropriate use of medicines and preventing potential drug interactions”.
“Our position continues to be that open display of P-meds is not compatible with regulatory requirements without key safeguards being in place,” she added.
“This includes ensuring continued compliance with the current legal requirement for pharmacist supervision and assurance that where facilitated self-selection is available, the systems and processes ensure patient and public safety,” she said.
Read more: ‘Betrayal of profession’: RPS slammed for mulling pro P-med self-selection stance
In July, the PDA called on members to share their views on P-med self-selection citing “several concerns” with the RPS’s discussion on the controversial topic.
The RPS issued a call for evidence on the “benefits and harms of a facilitated self-selection model” earlier that month, saying at the time that the evidence would “enable” the royal society to “consider [its] current position”.
Self-selection is now permitted by the GPhC, although the regulator has insisted that pharmacies offering P-meds for self-selection must do so in a “facilitated” manner.
It comes as the RPS last week welcomed a government recommendation for the reclassification of numerous POMs to P-meds or over-the-counter (OTC) medicines, arguing it will play a “critical role” in minimising “unnecessary” GP appointments.
