general pharmaceutical council general pharmaceutical council the general pharmaceutical council (gphc) is the body responsible for the independent regulation of the pharmacy profession within england, scotland and wales, responsible for the regulation of pharmacists, pharmacy technicians and pharmacy premises. it was created, along with the royal pharmaceutical society, in september 2010 when the previous body responsible for regulation, the royal pharmaceutical society of great britain, was split so that representative and regulatory functions of the pharmacy profession could be separated. statutory the health and social care act 2008 and the subsequent pharmacy order 2010 allowed for regulatory functions of the rpsgb to be transferred to the new pharmacy regulator, the gphc. the gphc is therefore responsible for the update and maintenance of the registers of pharmacists, pharmacy technicians, pharmacy premises and pharmacy training premises. these registers can be accessed electronically by any member of the public online at the gphc's website. in addition the gphc states that the health and social care act 2008 has sufficient provisions to allow for the transfer of regulatory powers from the pharmaceutical society of northern ireland to the gphc in the future, subject to approval of northern ireland ministers. the principal functions of the gphc, as stated within pharmacy order 2010 are: to establish and maintain a register of pharmacists, pharmacy technicians and premises at which a retail pharmacy business is; to set and promote standards for the safe and effective practice of pharmacy at registered pharmacies; to set standards to which registrants must demonstrate that their fitness to practise is not impaired; to promote the safe and effective practice of pharmacy by registrants; to set standards and requirements in respect of the education, training, acquisition of experience and continuing professional development that it is necessary for pharmacists and pharmacy technicians to achieve to be entered in the register or to receive an annotation in the register and to maintain competence; and to ensure the continued fitness to practise of registrants. furthermore, under statute, the gphc must have the following committees; investigating committee (considers allegations that a registrant's fitness to practise is impaired, and can refer to the fitness to practise committee for a full inquiry); fitness to practise committee (makes decisions in cases where a registrant's fitness to practise may be impaired, for reasons concerning their conduct, professional performance or health); and appeals committee (considers appeals of decisions relating to applications for registration and registration status). the pharmacy order 2010 requires not only that the gphc sets acceptable standards of continuing professional development (cpd), but that it ensures that all registrants meet those required standards, and that there are processes in place for various remedial measures, including removal of a registrant from the register if they either fail to meet these standards, or make a false statement in relation to their cpd. governance the gphc is governed by a fourteen-member gphc council, with equal numbers of lay and registrant members, which is independent from the government, the professionals it regulates and any other interest groups. the gphc state that to reinforce this independence, all members of the gphc council, including the chair, are appointed by the privy council, rather than elected. the first chair of the gphc council was bob nicholls cbe, a lay member with extensive experience in the national health service, who has previously been a lay member of the general medical council, among other regulatory appointments. the current chair is nigel clarke, a lay member with experience of the general osteopathic council and chairing the future professional body for pharmacy and then the transitional committee, which created the prospectus for the reformed royal pharmaceutical society interests of members of the governing council nigel clarke, gphc chairman from 2014–2022, was previously a partner of gjw, the firm boots used for its public affairs and lobbying, between 1993 and 1998 and onwards. he was part of prime minister david cameron's business trade delegation to india in 2013, the year before his appointment to the healthcare regulator in 2014. clarke was also the business partner of digby emson, a former boots superintendent, who was the chairman of the gphc's audit and risk committee (circa 2017-2020) and also a council member (2014-2020). the chairman of the gphc's audit and risk committee, digby emson was (from 2008 onwards, and ongoing as at july 2022) the chairman of buttercups, an organisation that sells training courses for pre-registration pharmacists, and training courses and apprenticeships for pharmacy technicians and pharmacy support staff. the gphc's regulatory duties include setting standards for and accrediting the education and training of pharmacists and pharmacy technicians. the gphc also sets requirements for the education and training of pharmacy support staff. as such, there was an apparent conflict of interests in holding this role. regulation of pharmacy premises as well as regulating pharmacists and pharmacy technicians as individuals, the gphc is also the regulator of pharmacies across great britain. it carries out inspections of pharmacy premises. it does not publish a register of pharmacy premises, registered pharmacy owners, sanctions that it has issued against either, or a hearings schedule in respect of sanctions it may issue in respect of either. failures in premises regulation a freedom of information request submitted by the pharmacists’ defence association in late 2017 found that although the gphc had issued over 3,500 sanctions against individual registrants (rising to 4,111 by mid 2018), i.e. pharmacists and pharmacy technicians, it had never issued a single sanction for a breach of pharmacy premises standards since its inception in 2010. this was despite the fact that there were 995 occasions in the two financial years preceding the foi request where the gphc had identified serious issues that it wanted rectifying, where its standards hadn't been met. the freedom of information request also identified that the gphc had never: fulfilled its legal obligation to set standards for registered pharmacies in rulesissued an improvement notice to a pharmacy owner under its powersbrought a fitness to practise case against a registrant for a failure to comply with its standards for registered pharmaciesestablished a category in its fitness to practise database for recording allegations which relate to compliance with its standards for registered pharmaciesdisqualified, removed, or sought to disqualify or remove, a pharmacy from the register (article 14 of the pharmacy order 2010 – failure to comply with an improvement notice, which could lead to a fine)sought or obtained a conviction against a pharmacy owner under articles 12 or 14 of the pharmacy order 2010 (failing to assist or obstructing an inspector, providing false or misleading information to an inspector, failing to produce a document or record to an inspector when requested to do so or failure to comply with an improvement notice) a further freedom of information request submitted by the pharmacists’ defence association in mid-2018 revealed that whilst carrying out routine inspections of pharmacies, the gphc had issued 667 ‘poor’ ratings between 1 november 2013 and 24 june 2018. a poor rating signified that: the gphc has "major concerns about patient safety… that require immediate improvement"the pharmacy is "likely to present an unacceptable risk of harm to patients and the public. this means the risk is likely to occur and/or will have moderate to high impact." the pda juxtaposed this finding against the finding from its earlier foi request that the gphc had never issued any sanctions for premises breaches. the gphc keeps a "bank of acceptable tolerances" to help it decide what pharmacy inspection rating to give. it refused to disclose it, saying that it would prejudice the exercise of its functions. the gphc's inappropriate approach to pharmacy premises regulation worsened in 2023 when it announced that it would conduct fewer routine inspections of pharmacies "to ensure we support pharmacies during these challenging times to provide safe and effective care to patients". the gphc has no role in "supporting pharmacies" and would be less likely to detect problems if it wasn't conducting inspections; whether or not "challenging times" exist is not, according to the gphc's statutory role set out in the pharmacy order 2010, meant to be the concern of the gphc. according to the gphc's statement, the cessation of inspections would improve the provision of safe and effective care; this implies that its conduct of inspections would in fact reduce the safe and effective care provided to patients. relationships with pharmacy chains as part of its role as a premises regulator, the gphc appoints strategic relationship managers to chain pharmacies with more than 50 pharmacies. the gphc has not provided any information about this role in the public domain, such as how it contributes to pharmacy inspection results or why it treats multiple pharmacies differently. it appears that some of the inspection outcome is predetermined as a desktop exercise at a head office level before visiting the pharmacy, irrespective of how it is applied in practice. an internal document from a large pharmacy multiple stated "the gphc is mindful that community pharmacy multiples are different from independent pharmacies in that their policies and procedures are developed centrally and much of the decision-making cannot be made at local level. therefore, the gphc has appointed a designated strategic relationship manager to all multiples with more than 50 pharmacies. the purpose of this is to achieve improved consistency, with the strategic relationship manager holding three formalised structured meetings with the superintendent pharmacist and his/her team each year to review corporate documents and processes. this will facilitate other inspectors’ reviews of individual premises to confirm ongoing compliance with company policies and procedures." powers to regulate corporate bodies the gphc listed its powers to regulate corporate bodies, effected through its committees, thus: the committee has the power under section 80 of the medicines act 1968 to deal with ‘disqualification allegations’ made against a corporate body that carries on a retail pharmacy business. the committee may direct that: a corporate body should be disqualified for the purposes of part iv of the medicines act 1968 a ‘representative’ of the corporate body should be disqualified as being a representative for the purposes of part iv of the medicines act 1968 the registrar should remove from the register of premises some or all of the premises at which the corporate body carries on retail pharmacy the registrar should remove from the register of premises, for a limited time, some or all of the premises at which the corporate body carries on retail pharmacy failure to regulate large corporate chain pharmacies in september 2022, the professional standards authority launched a report in parliament on improving patient safety. noting the gphc’s powers to regulate pharmacy owners and pharmacy premises, the psa stated: “the gphc has more modern legislation, established under the pharmacy order 2010… the gphc can issue improvement notices or conditions, or ultimately, disqualify a pharmacy owner and remove all their premises from the register.” it also observed that “the gphc’s inspection and enforcement powers are unique among the healthcare professional regulators. they give it significant scope to influence a number of areas including governance, risk management and safe staffing.” the psa then noted that regulation by the gphc may not be fit for purpose: “we are seeing large corporate chains accused of ‘hard sell’ tactics, and other questionable practices, that seem to prioritise profit over the best interests of both patients and registrants. however, the regulation of ‘high street’ providers of healthcare is complex and piecemeal, and may not be fit for purpose.” failure to regulate temporary closures of large corporate chain pharmacies in 2018, a freedom of information request revealed that 5,878 temporary pharmacy closures occurred in england in a 12-month period in 2016-17. in november 2022, a freedom of information request revealed that 20,924 temporary closures occurred in england in a 12-month period between oct 2021 and sep 2022. 86% (17,894) of the 20,924 closures were reported by six of the largest pharmacy chains (lloyds, boots, well, tesco, rowlands and asda) despite these chains accounting for only 36% (4,134) of the 11,600 registered pharmacies in england. the gphc has not taken any discernible regulatory action regarding the closures. in september 2022, the gphc issued a statement, saying that closures “may raise concerns for patient safety, particularly if people cannot access the medicines and other pharmacy services many rely on”. however, it claimed that “as a regulator” it