General Pharmaceutical Council Restoration Applications – What Pharmacists need to know

Pharmacists removed from the GPhC register, by a fitness to practise committee, can apply for restoration after 5 years but must show evidence of insight and remediation.

What the GPhC means by fitness to practise

Before looking at restoration and how to apply, it is important to understand what the General Pharmaceutical Council (GPhC) means by fitness to practise.  It says:

“A pharmacy professional is ‘fit to practise’ when they have the skills, knowledge, character and health necessary to do their job safely and effectively, and when they act professionally and meet the principles of good practice set out in our various standards, guidance and advice.”

Where the GPhC deems a pharmacy professional’s fitness to practise to be impaired, it will refer the matter to its fitness to practise committee that can decide to either:

• take no action
• agree undertakings
• issue a warning
• impose conditions on the registrant’s practice
• suspend the registrant from practising, or
• remove the registrant from the register

 GPhC Restoration Overview

Pharmacists removed from the GPhC register, by a fitness to practise committee, can apply for restoration. A decision to grant a restoration can only be made by a fitness to practise committee after a full hearing, and only after five years or more has elapsed since the date of the removal by a committee.

By way of a general overview of the GPhC’s restoration process:

• an application for restoration is not an appeal against, or a review of, the original fitness to
  practise committee decision
• there is no automatic right to restoration
• when applying for restoration, the ‘burden of proof’ is on the pharmacist or other pharmacy professional
• applicants must provide sufficient evidence to demonstrate their fitness to practise
• if the application for restoration is refused, the pharmacist or other pharmacy professional must wait at least 12 months from the date of the application before another application can be made.  The committee can however direct that no further applications for restoration can be made
• if the application is successful, the pharmacist or other pharmacy professional’s name will not be restored to the register until they have paid the appropriate registration fee

 The committee may:

• grant the application, and direct that the applicant should be restored to the register without
  conditions
• grant the application, and direct that the applicant should be restored to the register with
  conditions for a period of up to 3 years
• refuse the application
  

Restoration Applications

It is highly recommended that pharmacists seek legal advice at the earliest possible opportunity when considering an application for restoration.  The process can be long, governed by strict legal rules and requires a clear understanding of the process.

When making this decision, the committee will apply the following test: 

“Against the backdrop of the overarching objective[i], is the applicant concerned fit to practise?”

In restoration application proceedings, the burden of proof lies with the pharmacist.  This means it is up to the pharmacist to satisfy the fitness to practise committee that they should be restored to the register.  It is not for the GPhC to prove or to provide evidence in support or opposition.

Relevant Factors

The GPhC’s fitness to practise committee will consider a range of factors when making a decision.  These include:

• The circumstances that led to the removal
• The reasons given by the original committee for the decision to remove
• The applicant’s response to the findings of the committee at the original hearing
• The likelihood of the applicant repeating the conduct that led to their removal from the register
• Evidence demonstrating insight into the seriousness of the allegation which resulted in the applicant being removed from the register
• Evidence of remediation and activities designed to help the applicant learn from the original concern
• Evidence of learning activities designed to keep the applicant’s skills and knowledge up to date
• The lapse of time since the applicant was removed
• Any other relevant evidence to demonstrate that the applicant is fit to practise

Insight and Remediation

Clear evidence of insight and remediation is crucially important when applying for GPhC restoration.  There is a great emphasis on:

• The applicant’s response to the findings of the committee at the original hearing
• The likelihood of the applicant repeating the conduct that led to their removal from the register
• Evidence demonstrating insight into the seriousness of the allegation which resulted in the applicant being removed from the register
• Evidence of remediation and activities designed to help the applicant learn from the original concern

All of these relate to insight and remediation.  Evidence of both must be genuine, clear, measurable and comprehensive.  Pharmacists must however be aware that insight and remediation often takes a long time to achieve.  This further speaks of the importance of seeking legal advice at the earliest opportunity.

Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.

Is Legal Advice Necessary?

The simple fact is, as we have already referred to, the restoration process can be long, governed by strict legal rules and requires a clear understanding of the process.  When considering the need for legal advice, pharmacists’ should consider the following:

1. The burden of proof is on then to make the case for restoration;
2. Without legal advice and assistance, pharmacists will need to deal with preliminary issues, consider the need and call on witnesses and respond to committee questions;
3. Collate and make judgements on evidence to be presented;
4. Failed applications will delay the process for at least a further 12 months or result on the committee ruing that no further applications could be made; and
5. Convince the committee of the relevance and strength of insight and remediation.

Kings View Chambers

With over 30 years combined experience, Kings View Chambers have established itself as one of the best when it comes to fitness to practise defence.  We fully understand that fitness to practise defence is not merely about processes and procedures.  We also understand that we are working with people who are anxious and worried about what investigations might mean for them, their professions and the reputations.

We are proud to be rated ‘excellent’ by our clients.  Our commitment to client care is genuine in both seeking the very best outcomes for our clients, but also ensuring we do what we can to support them through the process.

Contact us today for a no obligation and free telephone consultation about your case in the knowledge that you are speaking to one of the best in the business.

[i] to protect, promote and maintain the health, safety and wellbeing of the public, to promote and maintain public confidence in the profession & to promote and maintain proper professional standards and conduct for the profession.

Social media can blur the boundaries between public and private life and doctors must be careful to maintain professional boundaries when using social media.

Good medical practice & other GMC guidance

It is important to note that the standards expected of doctors do not change because they are communicating through social media as opposed to face to face or through other traditional media.

Good medical practice

The Good medical practice states, amongst other things:

• 36 You must treat colleagues fairly and with respect.
• 65 You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
• 69 When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.
• 70 When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.

Doctors’ use of social media

The GMC has produced guidance for doctors on their use of social media.  When using social media, doctors must be careful to ensure social and professional boundaries do not become unclear or blurred.  Doctors must ensure they follow the GMC’s Maintaining a professional boundary between you and your patient when using social media.  This guidance states, in relation to social media:

“You must consider the potential risks involved in using social media and the impact that inappropriate use could have on your patients’ trust in you and society’s trust in the medical profession. Social media can blur the boundaries between a doctor’s personal and professional lives and may change the nature of the relationship between a doctor and a patient. You must follow our guidance on the use of social media.”

Maintaining doctor-patient partnership, when using social media means that “Patients should be able to trust that their doctor will behave professionally towards them during consultations and not see them as a potential sexual partner.”

Use of social media and fitness to practise

The GMC makes clear that doctors must be prepared to explain and justify their decisions and actions including those that relate to their use of social media.  Social media can blur the boundaries between public and private life in ways that would be more obvious in real life situations and this presents a heightened risk for doctors.

However, fundamentally the issues that may arise through the use of social media does not change; privacy and confidentiality, maintaining professional boundaries, respect for colleagues, anonymity and conflict of interest.

The GMC’s guidance goes on to say that “serious or persistent failure to follow our guidance that poses a risk to patient safety or public trust in doctors will put your registration at risk.”

Social media pitfalls – dos and don’ts

Maintaining boundaries

• If a patient contacts you about their care or other professional matters through your private profile, you should indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.
• If, as a result of the above, there is a professional breakdown, doctors should consider whether it is appropriate to end their professional relationship with a patient.
• You must not use your professional relationship with a patient to pursue a relationship with someone close to them.

Respect for colleagues

• Report sexualised, unprofessional and/or otherwise inappropriate online behaviour towards patients by colleagues.

Anonymity

• GMC guidance makes clear that doctors who identify themselves as a doctor in publicly accessible social media, you should also identify themselves by name.

Conflict of interest

• When you post material online, you should be open about any conflict of interest and declare any financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies.

Maintaining confidentiality

• You must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else.
• Doctors must also take care when discussing “individual pieces of information” because the sum of published information online could be enough to identify a patient or someone close to them.
• The same laws of copyright and defamation as written or verbal communications, whether they are made in a personal or professional capacity.
• You should be aware of the limitations of privacy online and you should regularly review the privacy settings. Remember, social media sites cannot guarantee confidentiality.
• People, colleagues and organisations you are friends with or follow can see your posts and information.  You should regularly review these.
• Take extra care when posting photos online, you may inadvertently be sharing information such as location, identity of other people or other personal information in the background.
• When using professional social media sites that are not accessible to the public, be careful not to share identifiable information about patients and/or colleagues.