Boots could be investigated by pharmacy watchdog

The General Pharmaceutical Council (GPhC) is to investigate allegations by The Guardian that managers at Boots have been abusing an NHS scheme in order to boost company profits. As we reported last week, the newspaper claimed that store managers pressured pharmacists to carry out unnecessary Medicine Use Reviews (MURs), which are designed to provide advice on diet and medication. The NHS pays £28 for each MUR – if each Boots store carried out the maximum 400 MURs, this would earn the company £30m.The GPhC has also asked to see an as-yet-unpublished survey of members by the pharmacy trade union, the Pharmacists’ Defence Association (PDA), which indicates that 75% of respondents felt that the financial considerations of their employer had impacted on patient safety.

Boots faces the prospect of an investigation by the pharmacy watchdog, following a Guardian investigation into the multibillion pound chain.

The General Pharmaceutical Council (GPhC) is calling in evidence on the allegations made in the report, which revealed that managers at Britain’s biggest chain of chemists have been forcing staff to milk NHS schemes, in order to increase company profits.

The report also detailed a recent and yet to be published survey by the pharmacy trade union of its members, to which more than one in 10 of all Boots chemists responded. Asked “how often do you believe financial cutbacks imposed by your main employer have directly impacted upon patient safety?”, more than 75% of those who responded to the Pharmacists’ Defence Association (PDA) said that was the case at least half the time.

The union has been asked to show the pharmacy regulator its survey and other relevant documents, in what are understood to be the first steps towards a possible full investigation of Boots.

The regulator said on Sunday night: “Our standards are clear that pharmacy owners have a responsibility to enable their staff to make the care of patients their first priority and to raise concerns with the relevant authority about any issue that may affect patient care or public safety.”

But it was attacked by the PDA for being far too slow to act on the business culture at Boots. “The GPhC must be aware of the extent to which the undermining of the professionalism of pharmacists is a significant problem, not least because we have repeatedly told them about it,” said Mark Pitt, the union’s assistant general secretary. He added that since the watchdog was established in 2010, its officials have been regularly updated by the PDA on the problems at Boots – but that no action taken.

The regulator has also approached the Guardian for information.

The Royal Pharmaceutical Society, the professional members’ body for chemists, has also responded with alarm to the Guardian report, saying the paper’s allegations “will make difficult reading for many in the sector”.

The RPS is especially concerned by allegations that NHS schemes, such as the Medicine Use Reviews (MUR) and New Medicine Service, are being exploited by Boots managers for the public money the schemes pay out.

The NHS pays £28 for each MUR, which is intended to give sick patients professional advice on medicine and diet. But the Guardian discovered that Boots managers were pressuring pharmacists to carry them out on people who did not need or want them – and even to give them to other staff members. If the chain carries out the limit of 400 MURs at each of its pharmacies, it stands to make about £30m from the scheme.

Staff who have questioned or resisted the alleged misuse of the MUR system report that their pay and career prospects have suffered. All allegations were denied by Boots. It said: “We make it clear to our colleagues that these services should not be undertaken inappropriately.”

Sandra Gidley, who chairs the English pharmacy board of the RPS, said: “There is an urgent need to address the issue of target setting and unacceptable commercial pressures within large company settings. Individual pharmacists must have professional autonomy when providing patient care wherever they are working.”

She confirmed that the newspaper’s allegations that understaffing at Boots is threatening patient safety had also been raised with the RPS by its members.

Within hours of the Guardian publishing the investigation, Boots staff received two messages from senior managers. The newspaper has seen both. The first, from the director of retail pharmacy operations, Kevin Birch, attacked the Guardian for “a very specific and strong negative agenda”. He also directs staff that if asked by customers about the allegations, “please reassure them we take patient safety seriously” before putting them “in touch with the customer care team”.

In a second note, the chief pharmacist at Boots, Marc Donovan, advised the chain’s pharmacists: “Services must be for the benefit of patients, not the attainment of numerical targets.”

Boots’ pharmacists who contacted the Guardian about the note argued there was a wide gulf between company policy and their experience on the shop floor. One simply described Boots’ note as “complete nonsense”.