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20 September 2016

Knowledge of English

In 2014, the GMC gave in to pressure to put in place additional checks on the English language skills of doctors following the death of a 70-year old Cambridgeshire man to whom a German doctor had administered a fatal overdose of diamorphine. The doctor had recently failed an English language test.

The General Pharmaceutical Council's legal powers to regulate the pharmacy profession are contained in the Pharmacy Order 2010. This Order has recently been amended to allow the GPhC to assess the knowledge of English of all pharmacists and pharmacy technicians before they are permitted to join the register or renew their registration. If the regulator is not satisfied that potential registrants have the necessary knowledge of English, it may refuse them access. Previously, the GPhC's powers concerning knowledge of English were restricted to nationals of non-EEA countries, but the new rules have no boundaries.

All doctors and dental professionals are already required by their regulators to show that they are sufficiently fluent in English to be able to communicate with others. However the GPhC's website, despite the change in law, still states that the pharmacy regulator is currently unable to ask for evidence of English competency from EEA citizens. This is probably because it is in the process of formulating amendments to its rules regarding registration and fitness to practise. It is also formulating guidance on the evidence that may be required to prove a satisfactory knowledge of English. The GPhC undertook a consultation which ended last December, but it has yet to publish its findings on these issues and the draft rules are not yet in force; so what is the current state of the law?

As of 1 June 2016, the GPhC must be satisfied that all potential or current registrants have "the necessary knowledge of English". Until the relevant rules have been updated and the guidance published, the GPhC will not have clear published criteria to help applicants. The GPhC's website reminds prospective registrants that upon registration they will be required to follow standard 7 of its Standards of Conduct, Ethics and Performance, namely to:

"[m]ake sure that you and everyone you are responsible for have the language skills to communicate and work effectively with colleagues".

The Standards do not currently require those language skills to be English. Therefore, perhaps like some footballers in a multinational team in the English Premier League, a pharmacist or pharmacy technician will be compliant if he or she can communicate effectively with colleagues in another language even his or her knowledge of English is poor. It would probably be more appropriate to ensure compliance with the GPhC's requirement that pharmacy professionals must:

"[c]ommunicate effectively with patients and the public and take reasonable steps to meet their communication needs".

Again, if a pharmacy is based in a predominantly non-English speaking area, even a non-English speaker would arguably meet this requirement and it should be borne in mind that "communicating effectively" may not require fluency.

In any event, the GPhC currently requires potential registrants from outside the EEA to achieve a minimum score of 7 on the International English Language Testing System and it seems likely that this requirement will encompass all applicants hailing from a non-English speaking country soon. (In its consultation, the GPhC suggests that it may also accept other proof such as a primary pharmacy qualification assessed and examined in English, from an English-speaking country.)

Lack of English proficiency may be not only a bar to those seeking to renew their registration or join for the first time; it may also lead to a misconduct finding for those currently registered. The GPhC's draft amendments to its fitness to practise rules add a 'knowledge of English allegation' as an additional allegation upon which misconduct can be found. If the draft rules are accepted, the GPhC will have the power to direct a potential or existing registrant to undertake an English examination, with failure to do so constituting an additional allegation and grounds for the case handler to refer the matter directly to a fitness to practise committee.

The changes to the Pharmacy Order, as well as the draft rules and guidance, are unlikely to affect the vast majority of pharmacy professionals. However, any pharmacy owners who are concerned that their registered staff may not meet the necessary standards should ensure that steps are taken to improve their English in time for renewal of their registration, or else seek to hire more conversant staff. As lack of English may shortly constitute misconduct, taking such steps will also help pre-empt unwanted investigations by the GPhC into their staff. Pharmacy owners who intend to recruit qualified staff from within the EEC will also need to pay more attention to their level of English than they have had to in the past.

This article was written by Andrew Sweetman and originally published in Pharmacy Business magazine in September 2016. For more information please contact Andrew on +44 (0)20 7203 5065 or