Representative calls
(Published 10 May 2004)

Under the ABPI Code of Practice, the principle is that doctors and other health professionals should not be subjected to unacceptable selling techniques. The Code covers the timing and convenience of calls, and prohibits offering any sort of incentive to see a representative.

Who to call on

The Code allows representatives to call on health professionals and ‘appropriate administrative staff’. ‘Health professional’ is defined as anyone who may prescribe, supply or administer a medicine, so this includes doctors, dentists, pharmacists and nurses.

‘Appropriate administrative staff’ could include for example, Practice Managers and, increasingly, staff with managerial or advisory roles within Health Authorities, PCOs or other parts of the NHS. It is not only the person who must be ‘appropriate’ but also the nature of the promotion, in the sense that you must be able to justify the promotion as relevant to that person’s work e.g. you could justify promotion to Practice Managers if it was relevant to the running of the practice, or promotion to Health Authority executives or PCG members if there were budgetary or management implications

The Code specifically prohibits any promotion to the general public. Patients are considered as members of the public. You should never deliberately put yourself into a position which would involve contact with patients. If you find yourself in a situation where patients are present, perhaps in a doctor’s waiting room, you must make sure that nothing you do or say could in any way be considered to ‘promote’ a product. This means that you should never mention any specific product, or discuss any disease area and you should certainly never become involved in any discussion of individual medical matters with a patient.

You will inevitably encounter members of the public working within the NHS. If they can be considered as ‘appropriate administrative staff’, you can promote to them as described above; otherwise, they should be treated as members of the public.

Timing of calls

The main principle to observe is that Health Professionals’ time is valuable and should be treated with respect.

The first requirement therefore is that calls must not be inconvenient. And you need to be aware that it is generally the view of the health professional as to what is or is not convenient which is considered. Factors which contribute to convenience (or not) include the frequency and duration of calls, the interval between calls and the timing of calls.

You should always respect the wishes of any individual (however unreasonable you may consider them to be) and you must follow any local requirements or procedures e.g. in hospitals. It is expected that you take positive steps to establish individual preferences and institutional requirements - it is not enough just to wait for someone to tell you.

Also, in line with good business practice (and good manners), make sure you are punctual and that you give adequate advance notice if you have to cancel or change an appointment.

Frequency of calls

The Code limits the acceptable frequency. It states "the number of calls made on a doctor by a representative each year must not normally exceed three on average". This can appear difficult to reconcile with your call targets which will often be significantly higher. However for Code purposes, not all ‘calls’ or contacts count towards the total. Attendance at a group meeting does not count, nor does any visit made to respond to a specific enquiry or to follow up an adverse event report or at the doctor’s request. This means that if you establish a good professional working relationship with a doctor and plan visits together, you could thus see that doctor more often than three times a year and still be within the Code.

Arranging calls

You may find that you are required by Health Professionals to put requests for appointments in writing, at least for the first call. You need to remember that any letter you write, even a purely administrative one, will be covered by the Code. Any mention of a product will mean that the letter is promotional. You should check with your management about if/when you are allowed to write letters. Using the phone, e-mail or fax is acceptable for administrative purposes only e.g. making or confirming appointments. These methods must not be used in any way which is promotional (without the permission of the recipient). Remember that mentioning a product is promotional.

Always be clear about who you are and which company you represent. Never use any subterfuge to gain an interview e.g. do not describe yourself as a 'personal caller'.

NEVER offer or pay a fee for an interview either to an individual health professional or to a practice or departmental fund. (Doctors should be aware that GMC guidance is that they must not ask for or accept a fee in return for granting an interview.)

Similarly, never use any inducement to gain an interview, such as offering to make a donation to charity in return for interview or providing a book for the library in return for interview.

Be aware when delivering ‘access items’, that despite the name, there are limits to how these can be used. Delivering them does offer you an opportunity to gain access to a doctor but if you insist on seeing the doctor to deliver it (rather than for example, leaving it with the receptionist), you are effectively using it as an inducement to gain an interview - and breaking the Code.

Sources of information

ABPI - Association of the British Pharmaceutical Industry, the industry trade association. www.abpi.org.uk

PMCPA - Prescription Medicines Code of Practice Authority, the independent body within the ABPI which administers the Code. See www.abpi.org.uk/links/assoc/pmcpa.asp - note a copy of the current Code is available to download in pdf format.

Code of Practice Review - published quarterly by the PMCPA and made widely and publicly available. It contains full details of all complaints and rulings, naming companies involved but not individuals. Copies of the latest issue are freely available by contacting the PMCPA directly.

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