Safeguarding Vulnerable Groups

SAFEGUARDING VULNERABLE GROUPS

 

JURISDICTION:  CCA

 

DERIVATION

Policy position developed in response to a Department of Health draft consultation paper on Community Pharmacies and the requirements of the Safeguarding Vulnerable Groups Act.

 

SUMMARY OF POLICY

The CCA position is that:

 

·     The pharmacist is the only member of the team who should need to be subject to the Act as all the other staff work under his or her direction.

·     We do not believe that a blanket approach covering all members of staff will necessarily provide the protection sought in the legislation.

·     The Patient Medication Record (PMR) in a pharmacy is primarily a record of what has been dispensed as opposed to a comprehensive health record.

·     The implementation of the Act needs to be proportionate and workable and, in our view, including all pharmacy staff contradicts the original Home Office assessment, as the impact assessment clearly did not consider all the factors.

BACKGROUND

The Safeguarding Vulnerable Groups Act 2006 was introduced as a result of the Bichard inquiry on the failings of the current vetting and barring procedures.  This inquiry led the need for changes to be made to the current system to increase the level of protection for children and vulnerable adults.  The report was published in 2004 and the government accepted all 31 of the recommendations. 

One of the key recommendations was for the introduction of a new registration scheme so anyone who works with vulnerable groups will have to be registered and continually monitored.  Currently CRB checks carried out by employers are required for new employees, and consist of two levels, standard and enhanced.  The employers handle the raw data and are responsible for deciding whether a candidate is eligible for employment. 

Under the new scheme, the Independent Safeguarding Authority (ISA) manages the register and decides if candidates are registered (and are therefore eligible to work with vulnerable groups in controlled or regulated activity) or barred (and therefore cannot work with vulnerable groups).  The employer will be responsible for checking the register to ascertain the status of a candidate, as it will be illegal to employ someone who is barred.

DETAILED POLICY POSITION

Legislative changes

The CCA understands the reasons behind this legislation, but has concerns over the extent of the legislation and how many people may be captured by it.   There is no real evidence to suggest why everyone in a pharmacy should be on the register and be subject to monitoring (STM).

Registered requirements

The pharmacist is the only member of the team who should need to be subject to the Act; and they are already subject to regulation by the Royal Pharmaceutical Society of Great Britain. All other members of staff work under the direction of the pharmacist, and the existing requirements within professional regulation should provide comprehensive protection to the public.

We do not believe that other pharmacy colleagues who provide general over the counter advice to customers are covered by the definition of "regulated activity" or "controlled activity".  These colleagues are providing assistance, advice and guidance which allows limited, if any, contact with children and vulnerable adults; the advice is provided under the supervision of a registered pharmacist. 

Providing health care is obviously captured by the guidance; however there is a need to consider how it applies in a retail setting.  The level of contact with members of the public when providing advice over the counter is generally similar to that provided by retail staff generally, and the checking obligations do not apply generally to retail staff.   We therefore propose that pharmacy colleagues other than registered pharmacists should be treated in the same way as general retail staff.

One of the principles used to determine if someone should be STM is if they are in a position of trust.  We believe a patient’s trust, where it is required in a pharmacy setting, is placed in the pharmacist, rather than the team members under his or her direction. 

Patient Medication Record and vulnerability

The Patient Medication Record (PMR) in a pharmacy is primarily a record of what has been dispensed as opposed to a comprehensive health record.  A prescription is even further removed; it is a record of what has been prescribed.   We agree that ‘access to all patient medication records is controlled by the pharmacist and is restricted by those under their supervision’ as per the draft consultation; we would add that any information accessed by staff is also covered by the Data Protection Act.  Some staff have no direct contact with customers or their records.  

We feel it is not necessary to label/categorise the general public as vulnerable adults simply because they are in a pharmacy.  The level of engagement of members of the public with pharmacy staff is variable; the simple purchase of a pack of paracetamol tablets is a long way from the detailed provision of advice provided with some prescriptions or what might be seen as more ‘intrusive’ healthcare like a pharmacist medicines use review.  And, since some pharmacies are part of a larger retail offer, some may not be receiving any form of healthcare at all.

Logistical and administrative burden

We do not believe that a blanket approach covering all members of staff will necessarily provide the protection sought in the legislation.  It would not, for example, prevent new abusers without a record slipping through the net, and there may be other gaps in the system. 

Against that, employers will face major issues managing the quantity of work required to vet to the quality standards demanded, especially given the staff turnover sometimes experienced in the retail sector.  People applying to work on a chemist counter would not expect to require an ISA registration and are very unlikely to have such at the time of applying for a role.  Recruiting to replace people already demands significant time and resources.  To add a substantial step such as this will impair our members’ ability to replace people for several weeks while checks are made.  There should be a clear focus on people who are most likely to pose the highest risk.

Finally, we note that when the Act was passed there was no allowance for the administrative burden, which must be greater than originally envisaged as many more people seem likely to be captured by this than first anticipated.

There is a need to minimise unnecessary financial and administrative burdens, especially in these difficult economic times, without good reason.  We therefore argue strongly for a risk based approach, because the logistics of implementation are also considerable, and include staff management, training, and commissioning of services. 

The implementation of the Act therefore needs to be proportionate and workable and, in our view, including all pharmacy staff contradicts the original Home Office assessment. 

 

 

18 September 2009