Regulation Directorate Key Performance Indicators

Council meeting 21 July 2010 07.10/C/07 Public business Regulation Directorate Key Performance Indicators Purpose This paper provides information on the Royal Pharmaceutical Society s (RPSGB s) Regulation Directorate Key Performance Indicators (KPIs). The Regulation Directorate covers registration, education, fitness to practise, the inspectorate, standard-setting and legal and ethical advice. In addition, statistical reports on the caseload of the RPSGB s Fitness to Practise Committees (Registration Appeals, Investigating, Health and Disciplinary) are presented to the RPSGB s Council on a regular basis, usually quarterly. Recommendation The Council is asked to: i. note the content of the attached reports. 1.0 Introduction 1.1 In June 2008, the RPSGB s Regulation Directorate established a set of KPIs for key regulatory functions. The KPIs were developed as a management tool and they also contributed towards the business continuity of regulation. The KPIs have been included in the RPSGB s Business Continuity of Regulation Reports to the Pharmacy Regulation Leadership and Oversight Group (PRLOG). 1.2 Data is collected by the appropriate managers from different sources - mainly electronic spread sheets. Data sets are analysed and transferred to a monthly KPI report latest version dated June 2010 attached at Appendix 1. Where a KPI has not been met, a brief explanation is given together with a note of action taken to rectify or mitigate the position. KPIs are kept under constant review 07.10/C/07 Page 1 of 20

and, whenever necessary revised 1.3 Statistical reports are collated by the Committee Secretariat from a number of electronic spread sheets. Comprehensive pie charts for each committee are produced together with addition text the latest report (presented to the RPSGB s Council on 29 June 2010) is attached at Appendix 2. 2.0 Key considerations 2.1 Council agreed, at its meeting on 14 April 2010, to receive monthly KPI reports at future meetings. 2.2 Council may wish to consider receiving the next and last RPSGB report, which will cover the period June to August 2010 at its September meeting. 3.0 Equality and diversity implications 3.1 There are no specific equality and diversity implications associated with the collection of KPI data or the staticial report in their current forms. 4.0 Communications implications 4.1 KPI monthly reports are circulated internally to staff in the Regulation Directorate. Information can be made available on the Society s and GPhC s intranet sites. 4.2 The RPSGB s Statistical Report has received some media comment in one specialist journal. The Council may wish to be aware of these comments. 5.0 Resource implications 5.1 Existing procedures and processes are included in operational overheads. A comprehensive review might require additional resources. 6.0 Risk implications 6.1 The main risk would be to business continuity and the smooth transfer of the regulatory functions from the RPSGB to the GPhC. This can be mitigated by providing regular updates to GPhC s Council and working with GPhC staff to ensure that KPIs are relevant and fit for purpose. 6.2 The statistical report provides information on the RPSGB s caseload and the main risk would be to business continuity and the transfer of the caseload to Page 2 of 20 07.10/C/07

GPhC. This can be mitigated by providing regular updates to GPhC s Council. In addition, this information could also inform the due diligence exercise that GPhC are undertaking. Recommendations The Council is asked to: i. note the content of the attached reports. Seth Davies, Head of Regulatory Operations Royal Pharmaceutical Society of Great Britain seth.davies@rpsgb.org tel 020 7572 2339 13 July 2010 07.10/C/07 Page 3 of 20

Directorate KPIs Update - June 2010 Appendix 1 Division KPI Ahead of KPI Meeting KPI Not meeting KPI Accreditation Accreditation cycle for 2009-2010 agreed 2009-2010 accreditation cycle begun Reason (if or ) Planning has now started for the 2010-2011 accreditation cycle The MPharm Step 4 visit to Ulster had to be postponed in April as the volcanic ash caused travel problems. The visit has been rescheduled to take place in July. All other visits have taken place as planned. So far in 2010 the following accreditation visits have take place: o 6 MPharm visits (4 step visits, 2 reaccreditations) o 2 MPharm accreditation sign-off visit o 3 MPharm overseas visits (2 accreditation, 1 accreditation checking visit) o 1 UK checking visit for an MPharm overseas course. o 2 OSPAP visit (accreditation) o 3 Independent Prescribing (2 accreditations, 2 reaccreditation) o 2 Medicines Counter Assistant (accreditation) Initial education and training standards for pharmacy technicians now in place. Accreditor team meeting took place in Lambeth- review of the year 07.10/C/07 Page 4 of 20

Two accreditor training events planned for September 2010 and February 2011 Areas for Celebration: Two Schools delivering MPharm have now achieved full accreditation, so two additional cohorts are about to enter the preregistration scheme. Kingston University have now achieved full accreditation to deliver the OSPAP course. They intend to admit students for September start. Code of Conduct for Pharmacy Students agreed and distributed to schools with guidance notes Now complete Student FtP in Schools of Pharmacy document agreed and distributed Distribution complete. Pre-registration Process pre-registration applications for registration within time limits. Responding to queries and quality assurance processes for the preregistration year and experience. Registration Examination An Adjustments Panel meeting has taken place Registration Examination - A Chief Invigilators meeting has taken place and detailed instructions have been updated. The deadline for all exam entries (including late fees) was 28 May. All exam entries (approx 2200) were verified and fees taken by this date, which is 1-2 weeks ahead of previous years (area for celebration). The team had verified, taken fees and entered approx 300 new trainees onto the database for the 2010/11 cohort. 07.10/C/07 Page 5 of 20

The final copy of the trainee and tutor workbooks had been updated and signed off - this is due for delivery in June. The Prereg automated voicemail system was set up and is being updated for answers to FAQs on a monthly basis. The use of this system is being monitored to feed back into the provision of written information. An area of celebration helps reduce frequently asked questions in a coordinated way. Lost Souls Project - approx 1200 people have been identified on the Prereg database, who are not current trainees. A detailed analysis has been undertaken of these, which is nearing completion. Anyone who has outstanding Prereg education and training that needs to be completed are to be sent a letter stating that they have until 20 December 2013 to complete the required elements and make an application to register. After this time people will need to start training for their qualification again. The letters are due to be sent 25 June 2010. International Registration Processing European applications for registration within time limits set in legislation. applications acknowledged within 1 month of receipt and applicant informed of any documents missing. comparative assessment completed and In the first 6 months of the year the division has registered 284 EEA qualified pharmacists through the Directive compliant route processed 18 EEA pharmacists through the Directive non-compliant route and registered 8 pharmacists via this route who had satisfactorily completed a period of pre-registration training. registered 16 pharmacists originally qualified and registered in Northern Ireland and 07.10/C/07 Page 6 of 20

decision on compensation measures (adaptation periods) notified to the applicant within 4 months of receipt of a complete Directive non-compliant application. applicant registered within 3 months of receipt of complete Directive compliant application. received and processed 127 new applications from internationally qualified pharmacists. 130 (including some received in the previous year) were complete and have been assessed as eligible to start the Overseas Pharmacists' Assessment Programme. Pharmacy Technician Registration The number of technicians registered (monthly and aggregated) by country and sector of practice on first registration. The number of pharmacy technicians on the register as at 31 May 2010 was 8,828. In the first 6 months of this year the division has registered 708 pharmacy technicians compared with 563 in the first 6 months of last year - a 26% increase. CPD CPD records of 400 registrants called for review every 2 weeks. Feedback to be given on CPD records submitted for review within 8 weeks. A total of 8050 registrants had had their CPD records called for review by the end of June 2010. Most batches are random samples of registrants within selected regions, but we have now generated batches targeting preregistration tutors, superintendent pharmacists and prescribers. Following the decision that the contract with the supplier of the online CPD system, including the back office system for managing the call and review process, will transfer to GPhC we have been working with the system supplier and internal project teams to ensure a seamless transfer of operations. Registration New Registrations for: Pharmacists Registration has started to plan a revised renewal process for registrants and premises under the 07.10/C/07 Page 7 of 20

Pharmacy technicians Premises to be completed within 10 working days of receipt of a complete application. Pharmacy Order 2010 and GPhC registration rules and identified a number of processes requiring automation to support a rolling register. The premises retention process is scheduled to end on 30 June 2010. A list of premises where no retention fee has yet been received has been forwarded to the relevant Inspectors to chase. A revised KPI of 10 working days from receipt of a complete application by the section to process new registrations has been adopted. Advisory Service Responding to enquiries within the required time periods 90% of the time. The Advisory Service is in the final stages of amending the 2010 edition of the Medicines, Ethics and Practice (MEP) guide. The Advisory Service has now completed a 3 month training programme to kick start the training of an individual advisor for the PLB full time and training for the whole PLB advice team in weekly sessions. Inspectorate CD Monitoring: All community pharmacies in England will receive a CD monitoring visit by 31 st Dec 2010 N.B. CD funding is due to cease post the transfer of regulatory functions and it is likely that CD monitoring and inspection will become part of the overall risk based inspection programme. All community pharmacies in Scotland will receive a CD monitoring visit by Sept 2010 All registered pharmacy premises The Northern (including Scotland) and the South Eastern regions are on target. Resources are 07.10/C/07 Page 8 of 20

will receive a monitoring visit every three years. currently being targeted to complete the remaining small number of outstanding visits in the Central region. N.B. This KPI will need reconsideration for the future in light of risk based inspections. Inspectorate (investigations) Non-referral process; Investigations of non-referral cases will be completed within 12 weeks. FtP investigations; The inspectorate will investigate all cases with the agreed and documented time frame specific to the case. (CaMS does not currently support collection of data on this KPI) Investigations 5 working days KPI for closure at triage 10 working days KPI for closure without referral to IC 3 month KPI for referral to IC following completion of investigation 4 week KPI for referral to IC following receipt of medical information/medical assessment report Not yet measurable The Investigations team is continuing to exceed their KPIs. In June the team met their KPIs in 96 percent of cases. This is an excellent achievement in light of the work the team has been doing preparing for the transfer of regulatory functions to the GPhC. This KPI was agreed in May. As yet, no health cases have been capable of measurement against this KPI. Hearings and Advocacy The proportion of cases conducted by the Hearings and Advocacy teams where the Society s case is served in accordance with the relevant time limits under the FtP and Disqualification Rules is at least 80% 07.10/C/07 Page 9 of 20

Secretariat Number of pre-agreed meeting days listed fully before the Investigating Committee. Number of pre-agreed hearing days listed fully before the Disciplinary Committee. Due to the recent resignation of 2 chairmen on the Disciplinary Committee, 6 hearing days were lost as the remaining 2 chairmen were unable to cover the days. The hearing days were cancelled significantly well in advance in order that cost were not incurred. The lost hearing days will be made up in October and November. The Secretariat is using the time productively on IT projects (CAMS, developing a committee portal), training staff and working on the changes that will be required for the GPhC. The recruitment project for the replacement of the vacant chairmen positions was successful and all 3 candidates have accepted the offers of appointment. All current members on the 4 statutory committees apart from one (who is on holiday) have confirmed their willingness to transfer over to the GPhC. 07.10/C/07 Page 10 of 20

RPSGB Statutory Committees Statistical Report Appendix 2 Council Meeting 29 June 2010 PUBLIC BUSINESS FOR NOTING Purpose To inform Council of the number of cases heard by the Statutory Committees (Disciplinary, Health and Registration Appeals) and cases considered by the Investigating Committee under the Pharmacists and Pharmacy Technicians Order 2007. This figure includes the number of cases heard by the Disciplinary Committee sitting under the previous legislation in accordance with the transitional provisions. the current position regarding caseload for all four Statutory Committees (Disciplinary, Health, Investigating and Registration Appeals) and total number of open cases with the Fitness to Practise Directorate. forecast of cases progressing through the statutory committees hearings procedures. Strategic objective domain An organisation that consistently performs as a regulator, professional representative leader and publisher. Action required Council is asked to note the report. 1. Background The Pharmacists and Pharmacy Technicians Order 2007 came into force in February 2007 and the Royal Pharmaceutical Society of Great Britain (Fitness to Practise and Disqualification etc) Rules 2007 on 30 March 2007. This legislation provides the framework for the Statutory Committees. Council receives this statistical report on the activity of the statutory committees at each of its four formal meetings every year. Notes: The previous statistical report provided to Council in February 2010 covered the period 1 September 2009 to 31 December 2009. This statistical report covers the period 1 January 2010 to 30 April 2010. Forecast of cases is up to date as on 1 June 2010. Charts set out the typology of cases according to type of case and outcome. Progress made quarterly is included for the Investigating Committee. The outcomes for NFA s (no further action) and Dismissals issued by the Investigating Committee is further broken down according to allegation type. The first Fitness to Practise annual report was published in September 2008. The second Fitness to Practise annual report which contains data up to 31 March 2009 was 07.10/C/07 Page 11 of 20

published in September 2009. The third Fitness to Practise annual report which contains data up to 31 March 2010 will be published in September 2010. An annual report on the activities of the Investigating Committee, prepared by the Chairman of the Investigating Committee according to Rule 6 of the Fitness to Practise and Disqualification Rules, was reported to Council in March 2010. 2. Cases heard 2.1 Cases heard by the Disciplinary Committee sitting under the Statutory Committee rules (1 January 2010 to 30 April 2010) There has only been one case heard by the Disciplinary Committee sitting under the Statutory Committee rules between January and April 2010. This case resulted in a reprimand. Page 12 of 20 07.10/C/07

2.2 Cases heard by the Disciplinary Committee (new legislation) Outcomes of matters heard from 1 January 2010 to 30 April 2010 by the Disciplinary Committee under the new rules. Matters heard by Disciplinary Committee under the new rules Outcome/Month January February March April Total Interim Suspension Order 4 3 7 (17%) Interim Order Review (rule 2 3 4 9 39(2)) continued (21%) Principal Hearing Warning 1 3 1 2 7 (17%) Principal Hearing Adjourned 3 1 4 to resume (10%) Principal Hearing Fitness to 2 2 practise not impaired (5%) Principal Hearing Removal 2 1 3 (7%) Principal Hearing Conditions 1 1 3 5 (12%) Restoration Subject to 1 1 Conditions (2%) Restoration Review 1 1 2 Conditions (5%) Restoration - Application 1 1 refused (2%) Restoration Postponed (2%) 1 1 Total = 42 07.10/C/07 Page 13 of 20

2.3 Cases heard by the Health Committee Outcomes of matters heard from 1 January 2010 to 30 April 2010 by the Health Committee. Matters heard by the Health Committee Month/Outcome January February March April Total Interim Suspension Order (19%) 1 1 2 Interim Suspension Order Review - Continued (18%) 1 1 2 Interim Suspension Order Review Conditions (9%) 1 1 Principle Hearing Postponed before heard at Committee (9%) 1 1 Principal Hearing - Conditional Registration (18%) 2 2 Review of Principal Hearing Suspended (9%) 1 1 Review of Principal Hearing Adjourned to resume (9%) 1 1 Review of Principal Hearing Conditions (9%) 1 1 Total = 11 07.10/C/07 Page 14 of 20

Breakdown according to case type Outcomes Totals on number of Cases Regulation Directorate KPIs Council 21 July 2010 2.4 Cases heard by the Investigating Committee Outcomes of matters heard from 1 January 2010 to 30 April 2010 by the Investigating Committee. The Investigating Committee heard 78 cases involving 83 registrants. The total number of outcomes of allegations dealt with was 89. A quarterly breakdown of the outcomes follows as well as a breakdown of NFA s (no further action taken) and dismissals. Total Total number of cases considered by Investigating Committee 78 Number of Respondents 83 Premises 1 Number of Superintendents involved in allegation(s) 9 Full 29 Health 3 Recommendation 43 Applications for Rescission 3 Referred to Disciplinary Committee 11 Referred to Health Committee 1 Issued a Letter of Warning 2 Issued a Letter of Advice 33 Issued Undertakings 2 Referred back to Society 10 No Further Action/Dismissal 15 Letter of Special Warning 12 Postponement 3 Total 89 Reconsideration Cases 0 Review of Undertakings 0 2.4.1 Update on cases captured by single dispensing and non-referral provisions Since the single dispensing error and non-referral to Investigating Committee provisions commenced in November 2007, 407 fewer cases have been referred to the Investigating Committee. 2.4.2 Pharmacy policy and practice points Pharmacy policy and practice points are being captured and are reported to the Law & Ethics Committee or National Pharmacy Boards as part of the agreed feedback process. Issues are identified to the Legal and Ethical Advisory Service as appropriate subjects for Law and Ethics Bulletins and Fact Sheets. 07.10/C/07 Page 15 of 20

Outcomes of matters heard from1 January 2010 to 30 April 2010 by the Investigating Committee. Some cases may have more than one allegation. Therefore those cases may have more than one outcome. Accordingly the figures in this table will not tally with the total number of cases heard. Outcomes at IC (January 2010 April 2010) Matters heard by IC (Jan Apr 2010) No. % Referred to Disciplinary Committee 11 12 Referred to Health Committee 1 1 Letter of Advice 33 37 Letter of Warning 2 2 Letter of undertaking 2 2 Referred back to Society 10 11 Letter of Special Warning 12 14 No further Action (NFA) 1 1 Dismissed 14 16 Postponed 3 4 Total: 89 07.10/C/07 Page 16 of 20

Outcomes of NFA s (no further action) and dismissals heard from 1 January 2010 to 30 April 2010 by the Investigating Committee. Some cases may have more than one allegation. Allegation Type for NFA & Dismissal Outcomes (January 2010 April 2010) Allegation Type No % 1a.) Dispensing Errors): Incorrect Medication (includes picking and counting) 5 24 1b.) Dispensing Errors): Incorrect Strength & Dosage 1 5 2.) Failure to adhere to professional/legal standards of practice (Standard Operating Procedures (SOPs)) including general Code of Ethics issues and restricted titles 8 38 3.) Behaviour and concerns regarding professionalism to customers and colleagues, including customer service and complaint handling issues 4 19 4.) Controlled Drug Errors) (including dispensing & record keeping) 2 9 5.) Dishonesty (including theft, defrauding, reissuing patient returns) 1 5 Total: 21 07.10/C/07 Page 17 of 20

2.5 Registration Appeals Committee The Registration Appeals Committee heard 2 registration appeal applications from 1 January 2010 to 30 April 2010. One appeal was dismissed and the other upheld. 3. Figures on current caseload 3.1 The total number of open cases within the FTP Department as at 1 June 2010 is 739: The number of complaints under investigation is 347: Number of misconduct complaints under investigation by office staff is 87. Number of misconduct complaints under investigation by other agencies is 2. Number of misconduct complaints under investigation by Inspectorate is 232. Number of health/hybrid complaints under investigation by Office is 26. The number of complaints being reviewed/prepared by the office is 77: Number of complaints to be closed is 5. Number of complaints to be non referred is 48. Number of complaints under IO consideration is 8. Number of complaints to be referred to IC is 16. The number of cases (excluding health cases) involving allegations of impairment at the pre-investigating Committee stage (i.e. prepared by the case managers and waiting in a queue to be considered by the Investigating Committee) is 72. The number of health cases is 55: Number of health cases listed for an Investigating Committee meeting: 3. Number of health cases that have been considered by Investigating Committee and have acceptance of undertakings pending: 0. Number of health cases under investigation: 18. Number of health cases further info requested/review/pending decision: 17 Number of health cases on the watch list (been considered by the Investigating Committee and issued with undertakings or historic cases): 17. The total number of cases awaiting a hearing by the Disciplinary Committee under the old and new rules, Health Committee and Registration Appeals Committee is 188. 3.2 Cases at hearings stage Hearings stage: Disciplinary, Health and Registration Appeals Committees - summary: The total number of cases awaiting a hearing by the Disciplinary Committee under the old and new rules, Health Committee and Registration Appeals Committee is 188: Number of cases awaiting a principal hearing before the Disciplinary Committee (new rules) is 134. Number of cases awaiting a hearing before the Health Committee is 35. Number of appeals awaiting a hearing before the Registration Appeals Committee is 1. Number of cases awaiting a review hearing (cases with conditions, suspensions and undertakings) is 12 Number of cases where restoration was granted with conditions by DC is 4 Page 18 of 20 07.10/C/07

Number of cases awaiting a hearing under the interim provisions for Pharmacy Technicians is 2. 3.3 Hearings stage detailed analysis Cases awaiting a hearing by the Disciplinary Committee (new legislation) There are 134 cases awaiting a principal hearing before the Disciplinary Committee. Of the 134 cases, 19 are subject to interim orders. Interim orders are subject to review every six months. Cases awaiting a hearing by the Health Committee There are 35 cases awaiting a principal hearing by the Health Committee. Of the 35 cases, 4 are subject to interim orders. The interim orders are subject to review every six months. The directions are subject to review hearings. 4. Forecast of cases progressing through the Statutory Committees hearings procedures 4.1 Cases listed and awaiting consideration by the Investigating Committee The Investigating Committee met once a month from January 2010 but will meet twice a month from Augsut 2010. As of 1 st June 2010 there are 41 full and 34 recommendation cases waiting to be considered by the Investigating Committee. Of those, 22 full and 17 recommendation cases are yet to be listed.. Every month an average of 80 complaints are received by the Society. 4.2 Cases listed and awaiting a hearing by the Disciplinary Committee From 2007 to 2009 the Disciplinary Committee prioritised hearing cases under the old rules whilst also hearing cases under the new rules, interim order hearings, interim order review hearings and restoration hearings. From September 2009 the Committee heard cases on fifteen days per month instead of the previous ten days per month. Between June and December 2010 cases are listed as follows: Principal hearing (incl. reviews) 24 (1 case has a time estimate of 15 days) Interim Order application 1 Interim Order review 18 Restoration application / review 4 Factors which affect the listing of cases: disclosure provisions for parties to serve their case the number of days a hearing may take (the Statutory Committees Secretariat lists according to time estimates received from parties). Time estimates for hearings range from half a day to three weeks Applications for postponements by the parties Cases adjourned by the Committee. 5. Age of complaint of cases awaiting a principal hearing 07.10/C/07 Page 19 of 20

Year of complaint Number of cases awaiting a principal hearing 2004 2 2005 7 2006 20 2007 35 2008 33 2009 27 2010 10 TOTAL 134 5. Registrants contacting Council members Council members should be aware that they may be approached by Registrants who are involved in fitness to practise or registration appeals cases. Any queries should be passed to Jeanne Thircuir, the Statutory Committees Manager. The following paragraph from section 2.1.3 of the Council Governance Handbook sets out the relevant policy. All Council Members are required to support the integrity and probity of the Society s Fitness to Practise processes and to maintain public and professional confidence in these proceedings. Council members should not become involved personally in specific cases and should not act as character witnesses in Fitness to Practise proceedings at any time. In addition, they should not give support to any application for restoration to the Society s register after removal as a result of Fitness to Practise procedures. This restriction will remain for a three year period after vacating office. Jeanne Thircuir Statutory Committees Manager Page 20 of 20 07.10/C/07