EXCLUSIVE. The Royal Pharmaceutical Society is considering whether to drop its longstanding opposition to the self-selection of Pharmacy-only medicines.

An agenda item seen by Pharmacy Magazine for a meeting of the national pharmacy boards in Bristol on Wednesday (June 19) will consider if the current RPS position “is still a valid [one] to hold and maintain” in line with evolving practice.

This contentious issue last came to a head in 2012 when the newly formed GPhC decided that the prohibition on selling P medicines from open display should no longer apply within the standards for pharmacy premises. 

The GPhC said instead that a decision on whether P medicines should be on self-selection could be made locally by owners or pharmacist superintendents following a risk and training assessment. The RPS and other pharmacy bodies strongly objected to this at the time on the grounds that self-selection of P medicines would take control away from a pharmacist regardless of any planned safeguards put in place.

Nevertheless, because of the GPhC’s decision, there are presently no specific barriers that prevent owners from allowing P medicines on open display.

Briefing notes prepared for board members say that, as a result, some pharmacies have begun to consider the open sale of P medicines, most notably Boots, which is currently running a pilot with redesigned pharmacy counters allowing patients access to P products.

Claire Nevinson, superintendent pharmacist at Boots UK, and Roz Gittins, GPhC chief pharmacy officer and deputy registrar, have been invited to the meeting as guests and a presentation from Boots on its P medicine sales model is scheduled to take place.

Arguments for and against

To help board members, the RPS lists several arguments for and against a change in policy.

Arguments in favour of self-selection include that it allows consumers easier access to products to consider a potential purchase and still gives pharmacists the opportunity to refuse a sale if not appropriate.

Open selection would also allow patients to read the information provided by manufacturers on the packaging and exposes them to a wider range of medications, enhancing their choice and understanding, providing greater empowerment.

Arguments against making a change include that the P classification provides an additional level of protection for the public. The opportunity to prevent the sale of P products would be reduced if they were on open display, making it easier for patients to abuse them or cause accidental harm.

It may also be confusing for the public if one pharmacy allows self-selection and another does not, while “more commercially minded owners may dilute the reputation of pharmacies as being guardians of healthcare and ensuring the safe use of medication”.

Three options

The boards will be asked to consider three options to inform future RPS policy in this area:

Option 1 – Maintain the current position that P medicines must not be accessible to the public via open display and advocate for this position to be reconsidered by the GPhC and pharmacy owners

Option 2 – Evolve existing policy so that P medicines should only be accessible to the public by self-selection if certain conditions are met

Option 3 – RPS policy should be changed to support the availability of P medicines by self-selection with guidance and advice provided to pharmacy owners to enable this.

Reaction

RPS chief executive Paul Bennett told Pharmacy Magazine: “RPS takes very serious consideration of anything that has the potential to affect the safe and effective use of medicines. This includes access by the public to medicines available for retail sale, and current RPS policy is that P medicines should not be available for self-selection.

“We are aware that despite existing professional guidance, the General Pharmaceutical Council has authorised some pharmacies to offer the self-selection of P medicines by the public. Therefore we have invited both Boots and the GPhC to join us at our forthcoming national pharmacy board meetings to inform a discussion on this matter.

“This will be held in the open business session of our meeting, where observers are, as usual, welcome to be present. The agenda and supporting papers for all open business sessions are published in advance and are available on our website and full minutes of the meeting will also be published as is normal practice.”

Meanwhile, the Pharmacists’ Defence Association expressed “deep concern” that RPS members are only permitted to attend the national board meeting as observers in person with no online access available, preventing “genuine debate and participation”. 

The Society’s current position against the open sale and supply of P medicines was a “critical risk management tool, augmenting patient safety by preventing inappropriate use of potentially potent medications”, said the PDA. Any change to the policy had “the potential to jeopardise patient safety”.

Boots was approached for comment.

Story updated June 18 09:26am