The PDA is concerned that the government is pressing ahead with its plan to give new powers to pharmacy technicians to undertake PGDs despite patient safety concerns being raised by the largest pharmacy representative organisation in the UK.
The PDA is the largest membership organisation for employed and locum pharmacists and acts in their interests. It does so by trying to ensure that pharmacists can work in ways that keep their patients safe. With more than 38,000 members and through its role of supporting pharmacists in more than 5,000 incidents each year, the PDA has a unique insight into how poor working practices and practice environments can cause harm to patients and the risks that should be avoided to improve patient safety.
The PDA agrees that pharmacy technicians have a key role in supporting pharmacists through Skill Mix, and in this way, delivering benefits to patients, but what the PDA does not support is simple role substitution.
Consequently, the PDA did not support proposals made in the government’s consultation to add pharmacy technicians to the list of those professionals who could independently operate PGDs. In March 2024, the PDA additionally wrote to the Pharmacy Minister, Dame Andrea Leadsom MP, and a number of parliamentarians to reiterate the concerns about the government’s overall and undeniable policy move of undermining the role of clinicians in favour of colleagues with inappropriate levels of training, skills and expertise and so creating additional risks to patients.
In the letter, the PDA made clear that in the interests of patient safety there must be a distinction between clinical activities (undertaken by a pharmacist) and technical activities (undertaken by a pharmacy technician).
On Tuesday 26 March 2024, the Pharmacy Minister and the Chief Pharmaceutical Officer (CPhO) for England were called to give evidence to the Health and Social Care Select Committee’s inquiry into pharmacy. Members of the Health Select Committee raised concerns about the blurring off the lines between pharmacy technicians and pharmacists and compared it to the current concerns being raised about physician associates (and other medical associate professionals) being placed into doctors’ roles. One parliamentarian, Paulette Hamilton MP, explicitly suggested that with the use of phrases like ‘parity of esteem’ and pharmacy professionals, members of the public and parliamentarians were confused and may not know the difference between these two occupational groups. It was important to reflect upon the fact that some of the roles being proposed for pharmacy technicians were roles for which they lacked the basic degree level underpinning education.
The Pharmacy Minister and the CPhO were asked to ‘listen to the pharmacists’ otherwise pharmacy could end up with the same problems as encountered by patients who have been attended to by physicians associates.
However, in just over 24 hours since this challenge, the government moved to announce that they intended to proceed with their plan.
During the CPhO’s evidence, he supported the need for patients to be clear about who is providing their care, suggesting the use of badges which clearly identify each person’s role. He also suggested that arrangements could be put in place to ensure that only pharmacy technicians with proven skill levels could be enabled to do more.
However, the PDA remains concerned as the current registration requirements from the pharmacy regulator, the General Pharmaceutical Council (GPhC), do not have credentialing, with 50% of the current register joining through a grandparenting clause where they were automatically added to the register when it was created in 2011.
The PDA maintains that even the new Initial Education and Training for Pharmacy Technicians (IETPT), which is supported by a short online course, does not provide the degree-level underpinning education that is needed to support their independent role in PGDs.
PGDs can be a clinically challenging process involving aspects of diagnosis which lead to the making of important clinical decisions such as whether a particular medicine is safe and suitable for that individual patient following a full and comprehensive history taking, including an analysis and an understanding of their underlying medical conditions, their likely impact upon metabolism, the need for dosage adjustment as well as any contra-indications.
Pharmacy technicians are trained to NVQ level 3 and the Department of Health and Social Care (DHSC) is making these proposals at a time when the nearest comparator for PGD delivery in other healthcare sectors is at NVQ level 5 or 6 and even at level 7.
The government’s announcement is endorsed by the Royal Pharmaceutical Society (RPS) and the Association of Pharmacy Technicians (APTUK).
Mark Koziol, PDA Chairman said, “We are extremely disappointed that the government has chosen to roll out their original plans, regardless of the patient safety concerns which we and patient representative organisations have highlighted, and the most recent challenges laid in parliament. Patients coming into a pharmacy should have no less protection than other healthcare sectors where the pre-conditions for involvement of healthcare staff in PGDs are far higher than what is currently being proposed for pharmacy. We will continue to press the government and the GPhC for a safer approach and much more appropriate training and qualifications for the delivery of PGDs.”
Learn more
- PDA cannot support the Department of Health and Social Care proposal for the use of patient group directions by pharmacy technicians
- PDA writes to Pharmacy Minister about the differences between pharmacists and pharmacy technicians
- Paulette Hamilton MP’s suggestions
- Consultation on proposals to enable pharmacy technicians to supply and administer medicines under PGDs
- REMINDER: Have your say on proposals to enable pharmacy technicians to supply and administer medicines under PGDs
- PDA release their Pharmacy Technicians Report in its entirety
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