Pharmacists Protest Lopsided Task Force On Clinical Governance, Patient Safety

The Pharmaceutical Society of Nigeria (PSN) has protested the federal government’s composition of the Task Force on Clinical Governance and Patient Safety, claiming it lacks equity and balance, and may undermine the objective of the initiative.

In a petition to President Bola Ahmed Tinubu, signed by PSN President, Pharm. Ayuba Tanko Ibrahim, the society commended the federal government for the initiative, describing it as timely and strategic as it is in line with recommendations from its National Conferences over the years.

“We have repeatedly recommended prioritisation of clinical governance and patient safety as a national agenda. We therefore, consider the establishment of this Task Force a welcome and important step aligned with the broader national commitment to ensure that no patient is left behind under the Renewed Hope Agenda.’’

Stressing the key mandate of the Task Force which includes strengthening systems for clinical quality improvement, patient safety, risk reduction, workforce performance, and institutional accountability, he asserted that it was visionary and urgently necessary for the Nigerian health system.

Ibrahim noted that the Task Force which he alleged is lopsided and dominated by the physicians would affect the very essence of the initiative.

“With 18 doctors, only one pharmacist, two nurses, one administrator, and a minimal representation from several other critical clinical professions whose contributions are central to patient safety, clinical risk management, medication safety, diagnostic accuracy, and continuity of care, such composition poses risks to sectoral credibility, trust, ownership, and collaboration.’’

He contended that “clinical governance and patient safety are, by their nature, multidisciplinary enterprises.”

According to him, international best practice and WHO guidance emphasised that sustainable safety systems require substantive contributions from Pharmacy (medication safety, pharmacovigilance, and antimicrobial stewardship), Nursing and Midwifery (bedside surveillance and incident detection), Medical Laboratory Science (diagnostic safety), Health Information Management (audit, monitoring, and indicators.

“These groups, he said, “form indispensable components of the clinical safety ecosystem, and not merely adjunct actors.”

Ibrahim further opined that the team as presently constituted would “destroy team-based care and entrench professional protectionism. This will continue to compromise patient safety which is contrary to our National Health policy.’’

PSN noted the indispensable role of pharmacists in achieving team-based clinical governance and patient safety, insisting that “sector-wide implications and benefits of involving pharmacists and a full complement of relevant health professionals’’ cannot be overemphasised. 

It explained that critical care requires team-based governance because it is drugs and nutrition-oriented, and that complementary specialties enforce checks and balances in organised partnerships.

“Where pharmacists are utilised, errors are detected before patients are consumed. This non-utilisation of pharmacists usually compels systemic reliance on heroics or outright miracles which don’t materialise often.

The PSN leader warned that “physician-centric model in Nigeria which collapses prescribing and dispensing into a single professional loop comes with a huge risk factor.’’

He advised the government to give priority to patient safety rather than encouraging inter-professional rivalries. “We must reverse our hierarchical-oriented health system designed to massage the ego of one group of professionals. Adding that beyond pharmacists who are germane to drug safety and nutrition, our health system must now give due regards to radiographers, physiotherapists, laboratory scientists, nurses and all others because health must not be allowed to be about egocentric propensities,’’ he said.

Continuing he said, “building a health system that respects professionalism, compels team-based collaboration and ultimately enhances therapeutic outcomes, must become the new order and agenda in Nigeria.’’

PSN appealed to the federal government to expand or reconstitute the membership of the Task Force to ensure equitable multidisciplinary representation consistent with international best practices in clinical governance.

In the document, PSN requested that pharmacy representation on the Task Force be expanded to include the President, Pharmaceutical Society of Nigeria (PSN), Director-General, NAFDAC, Chairman, Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), Chairman, Association of Community Pharmacists of Nigeria (ACPN) and Chairman, Association of Consultant Pharmacists in Nigeria (ASSCOP).

Furthermore, the PSN recommended that the Permanent Secretary, Federal Ministry of Health and Social Welfare and the Director General, NAFDAC should be Chairman and Co-Chairmen of the Task Force to ensure high-level technical collaboration. It explained that the NAFDAC content remains important because of its mandate of safety margins in drug and food matters.

Also the Permanent Secretary of the State Ministries of Health should be Chairman, while the State Directors of NAFDAC will be Co-chairmen of the team.

He advised the government against the involvement of ministers and commissioners in responsibilities of this nature as the objective of the Task force may be hindered by the political inclinations of such appointees, saying “it is best that these responsibilities be entrusted to technocrats.”

Ibrahim said that the position of PSN on the matter was a constructive support of government laudable initiative, but submitted that a more inclusive and professionally balanced Task Force will improve the technical quality of outputs, deepen cross-sectoral buy-in, enhance safety culture, facilitate national rollout, and advance measurable patient safety outcomes.’’