In 2019, the PDA released their highly anticipated Pharmacy Technicians report. The 250-page document entitled; “Pharmacy technicians: an assessment of the current UK landscape, and proposals to develop community pharmacist and pharmacy technician roles and skill mix to meet the needs of the public”, which took 3 years to compile, highlighted significant empirical evidence and made recommendations to develop the roles of both community pharmacists and pharmacy technicians, and the skill mix required to meet patients’ needs.
The “Technicians Report” examined in detail the role of pharmacy technicians in community pharmacy.
The PDA still believes that pressure on the NHS can be managed much more effectively through the better use of pharmacists and pharmacy technicians. In the community pharmacy setting, it is evident that if the further development of the pharmacist’s role is to be facilitated and pharmacists are to become more patient facing in the future, an extended role and greater responsibility for pharmacy technicians is not only desirable, but ultimately it is essential.
The Pharmacy Minister in England, Maria Caulfield MP was recently quoted as saying the Westminster government were “…looking at developing the role of community pharmacy teams, because it is not just the pharmacist who has clinical knowledge and skills. We are working in a number of areas to upskill the whole community pharmacy team so that they can deliver more and use their skills in a better way”
In anticipation of such announcements the PDA reiterate that it is essential, when skill mix is being considered, that patient safety standards be maintained. Pharmacy technicians are a vitally important group of practitioners in the modern NHS; however their roles and responsibilities must not be confused with those of pharmacists. The public must never be confused or misled into thinking that they are dealing with a pharmacist, when they are actually dealing with a pharmacy technician.
The Technicians report covers many considerations including comparisons to the role of technicians in other areas of healthcare and internationally. The report explains the difference between a technician and a professional role as follows:
Section 1.7 The difference between a professional and a technician
A technical role, as performed by a technician, will have a set of instructions; there will be a script to follow. If a technician identifies a problematic situation, he or she will know whether the matter will have to be handed over to someone else who knows what to do, or to seek guidance on how to proceed. As the person supporting the role of the professional, in such problematic situations, the technician will naturally turn to the professional for guidance, including in respect of the appropriate steps to be taken. Many technical procedures, such as taking blood or performing an x-ray, or assembling and labelling medicines as ordered on a prescription, require specific technical steps that rarely vary. Satisfactory delivery of the technical role relies largely upon accuracy and precision.
As an example of this in practice, the National Occupational Standards (NOS) applicable to pharmacy technicians require adherence to standard operating procedures at all times, whilst the responsibility for establishing, maintaining and reviewing them rests with the pharmacist.
Technicians will be different from professionals. In a pharmacy context, whilst both groups will see differences between patients, pharmacists have a much broader base of skills and knowledge with which to interpret and act upon those differences. Pharmacy technicians do not have to make complex decisions based on extensive degree-level training and significant professional experience. Pharmacists, due to the nature of their training, will not only understand the need for specific questioning and tests; they will know how to interpret results, make decisions based on what they find and explain what is happening to their patients – and why. They also need to be able to practice ethical decision making and operate in ‘shades of grey’ where clinical situations require them to be able to critically appraise and balance the available evidence and options regarding an intervention – and use that evidence to inform decisions based on the needs of individual patients.
It is in the public interest that healthcare professionals are involved in all clinical and ethical decision-making. Pharmacists do not need to perform every task themselves, but as individuals held to account by the public for patient safety, they must be satisfied that only suitable tasks are delegated to pharmacy technicians, who in turn must be appropriately qualified and experienced. Pharmacists should usually be supervising the work of pharmacy technicians to some extent, and always be readily available for pharmacy technicians to consult when the need arises.
It is also in the public interest to ensure that both pharmacists’ and pharmacy technicians’ skills and competencies are used to the best effect, which requires an understanding of where the boundaries lie between their respective skills and competencies. These boundaries must be clearly linked to the underpinning qualifications, competency assessment and professional awareness, to ensure that their roles interlock effectively and safely.
One significant concern raised in the report was that 73% of those on the register of pharmacy technicians (as at April, 2017) had been admitted onto the register through ‘grandparenting’ arrangements, and the GPhC held no records of any assessments having been conducted as to the suitability of the qualifications which were relied upon during the grandparenting process. Though this figure has since reduced to 53% (at 31 March 2022) of registrant technicians, the above still applies for the majority of the Technician workforce.
Overall, the Technicians Report recommended and described a way forward which could be embraced, to:
- Unify pharmacists and pharmacy technicians behind a common vision and purpose, based on shared interests and mutual benefit.
- Develop more rewarding, fulfilling roles for both groups, including enhanced clinical roles, which make more appropriate use of their respective skills.
- Establish a symbiotic, complementary and effective skill mix model in community pharmacy.
- Create rewarding career frameworks, supported by skills and salary escalators and appropriate remuneration.
- Enhance patient care and safety, improve governance and regulation, develop the UK healthcare infrastructure and reduce the burden both on community pharmacy and other areas of the NHS such as GP surgeries and secondary care.
The PDA hopes that any decisions about future skill mix and the roles of pharmacists and technicians will have considered the factors covered in the report and will have considered how the above points can be delivered.
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