Right roles for the right person: collaborative working – pharmacists and pharmacy technicians

THE job roles that pharmacists and pharmacy technicians undertake have changed subtly over the last decade, with lines of responsibility overlapping ,requiring a more balanced and equal working relationship. With pharmacy technician roles expanding beyond the boundaries of the dispensary, the key to productive output is ensuring a clear understanding between pharmacist and pharmacy technician about what each other can do.

Seizing the opportunity with the creation of the Bart’s Heart Centre, we focused on ensuring a task-based approach to patient care to encourage the right role for the right person and allow flexibility in the system.

A task-based handover sheet was developed to ensure that all patients on the ward have had a minimum level of pharmaceutical input, be it from a pharmacist or pharmacy technician. The task-based handover allows the pharmacist to focus on more clinical aspects and appropriateness of prescriptions, and allows pharmacy technicians to focus on operational aspects of supply and facilitate the process of medicines reconciliation and counselling.

I don’t consider myself as an individual with my own set of tasks to tick off as I go about my day, but instead I am a member of a team, and within that team there are duties to carry out and as a ‘pharmacist/technician team’ we work together to carry out those duties for the patients, for the ward and for our department…together.

Teamwork
Our current set up ensures all patients are seen by a member of the pharmacy team and enables an understanding between the pharmacist and a pharmacy technician over who will do what, and in what order. The use of the task-based handover sheet also prevents duplication of effort, as for certain tasks either a pharmacist or pharmacy technician can undertake the same task.

I will check drug charts for each patient and indicate the information I have seen on a communication tool. Alongside carrying out my day-to-day tasks such as ordering and assessing patients’ medication and medicines reconciliation, I will document a number of tasks that I have carried out, or information I have discovered that needs to be handed over to the clinical pharmacist.

This may include finalising medicines reconciliation and any additional information collected from patients, such as a reluctance to take certain medication or prescribing errors for items not yet screened by the pharmacist. If I am on the ward before the pharmacist, I am also alerted to urgent medications required such as IV antibiotics that need to be administered as soon as possible. I can check the drug chart and order what is necessary and ensure that the pharmacist can verify it urgently while I go and prepare the doses for checking.

Additional roles
Other roles that I undertake include assessing newly prescribed items to ensure they are clinically appropriate before supplying, the need for venous thromboembolism assessment, and flag drugs requiring therapeutic drug monitoring to enable a pharmacist to monitor the latest blood results. Tasks such as the clinical sign off of 3^rd stage medicines reconciliation, counselling needs, anti-coagulant dosing or referrals are also documented. Completing the task-based handover for all patients enables the pharmacist to prioritise the work they need to carry out and also highlights the drug charts they may not need to review.

After I’ve been round the ward, I’ll find the pharmacist and will handover tasks that we each need to complete. Additionally this information is brought to a site-based meeting with the ward pharmacists and pharmacy technicians to establish if there are areas in need of support and to identify what jobs still need to be completed.

Having this meeting engages the team, as tasks such as medicines reconciliation, counselling and preparing discharge medication was previously only done by a pharmacist can now be facilitated by the pharmacy technician team. Working together and being able to identify appropriate tasks for our role promotes a safe and efficient service.

One of the most important things I enjoy about my work is the relationship I have with the pharmacists. The set up and team work approach means pharmacists will take time to explain things that are new or that I don’t understand. I am also encouraged to question what I see on the drug charts leading to improved patient safety. Individual teaching provided by the ward pharmacists is cemented by twice-weekly teaching sessions to the whole pharmacy technician team.

Medicines Management Pharmacy Technician, Dipal Samuel, and Lead Cardiac Pharmacist Paul Wright work together at Barts Health NHS Trust 

The rest of the team