Baroness Merron (Lab)

My Lords, I thank all noble Lords for their valuable contributions to today’s debate. I noted the discussion between noble Lords about whether they could agree with several noble Lords at one time; the answer is yes because I can do so, too. I feel that the questions asked will shine a useful light. I am grateful for the support that this order has received and for the understanding that it is about releasing capacity and meeting what people need these days, as compared to the situation in 1933—or, indeed, at any time since then. This is about our move from hospital to community; our reliance on and welcoming of the whole pharmacy sector; and what that sector can bring to us. This sector is a tremendously important part of our National Health Service and allows us to provide services when, where and how we need them; I add my thanks to pharmacists, pharmacy technicians and their professional bodies for their work in this area. I hope that, overall—I picked this point up—noble Lords will see that this order is about supporting pharmacy services, supporting patients and cutting the red tape that frustrates both the sector and those who use it. I turn to the specific questions asked by noble Lords; I will of course be glad to write if I do not manage to address any of them. The noble Baroness, Lady Hollins, my noble friend Lady Ritchie and the noble Lord, Lord Scriven, raised concerns about the order, particularly in respect of pharmacy technicians’ qualifications. Let me say at the outset—this is quite a good framing, really—that pharmacists are of course absolutely critical in delivering pharmaceutical services, but the fact is that they cannot deliver without a dedicated team. That is what we are building on. Pharmacy technicians are ready for these changes. Their training and expertise enable them to take responsibility for many activities that would previously have been the sole responsibility of the pharmacist. I can certainly say that post-registration training and professional guidance will be supporting these changes into practice. I say this to noble Lords: the answer to a number of the questions that have been legitimately asked is the professional guidance, because, as I know noble Lords will understand, this cannot all be laid out in legislation. The noble Baroness, Lady Hollins, and the noble Lord, Lord Kamall, asked about definitions in respect of clinical checks. Let me start by talking about the professional guidance, which will set out what the pharmacist’s role is to be—including when and how there will be a need for a clinical check. It is important to say that the sector wanted pharmacy technicians to be able to work autonomously; that falls outside what “supervision” traditionally means. Therefore, we are introducing a second form of delegation, which will allow pharmacists to authorise a pharmacy technician to undertake or supervise dispensing activities without the need for direct supervision by the pharmacist. We are aware that we need to give the sector the legal clarity that noble Lords have asked for with regard to what “supervision” means in this context; I can refer noble Lords to a detailed annexe that was published alongside the consultation, but the point is well made. The noble Baroness, Lady Hollins, my noble friend Lady Ritchie and the noble Lord, Lord Scriven, raised various questions in respect of what I will refer to as indirect supervision en masse and the need for a responsible pharmacist. So let me give the reassurance that these proposals do not remove supervision or change the legal requirement that a responsible pharmacist must be signed in at a registered premises when dispensing activities are taking place and when open to the public. We have stressed at every stage of formulating this policy our commitment to maintaining the legal requirement that noble Lords are rightly concerned about, whereby every community pharmacy must have a pharmacist on the premises. The noble Lord, Lord Scriven, asked why there is a reference to “any member of staff”. The reason is that pharmacists will be able to authorise any member of staff to hand out checked and bagged prescriptions but they must be authorising only staff who are trained, competent and confident to undertake a task. There will be updated professional standards and guidance to ensure that good governance supports the safe implementation of these changes in practice. Therefore, it could not be, for example—the noble Lord might have had this in mind—an assistant in a supermarket who happens to be working in the pharmacy. That would not meet what is required. Again, that is an important point. The noble Baroness, Lady Hollins, asked how authorisations will be tracked and what happens if there is conflict. I go back to my opening comments that practice matters cannot be set out in law. They will be addressed in professional standards and guidance, as I have said. That will be set by the regulators and professional leadership bodies to support the implementation of these changes into practice, and we look forward to working with those bodies. That should include professional expectations for record-keeping requirements when an authorisation is given. Training is to make clear to all staff—I return to the point raised by the noble Lord, Lord Scriven—that they need to follow standard operating procedures for when the authorisation is given, when they should consult the pharmacist and when a supply should not go ahead. That will all be part of that. My noble friend Lady Ritchie and the noble Lord, Lord Kamall, asked about matters relating to Northern Ireland. As I mentioned, when pharmacy technicians become a registered profession in Northern Ireland, which is expected by April 2027, we will work with the Northern Ireland Department of Health to enact the other changes as soon as possible.