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Specialist Anticoagulation Pharmacy Technician Claire Wiebe talks to PIP

Claire Wiebe

How long have you been qualified as a pharmacy technician?


I qualified as a pharmacy technician in 2011.


What did your educational route entail to become a pharmacy technician and what has been your career progression involved so far?


I started my career in pharmacy as a Saturday girl in my local pharmacy whilst at college. 9 years later in 2007,  I returned to community pharmacy as a pharmacy assistant. Whilst here I realised I enjoyed my role and wanted to become a pharmacy technician. However, I knew I wanted to gain my qualifications in secondary care so I had the BTEC Level 3 as well as the NVQ.


In November 2008 I started work as an ATO in Warrington hospital where I was then secured one of four places to study to become a pharmacy technician. Once qualified I left there and worked for 12 months as a rotational pharmacy technician in Brighton. Before moving to Doncaster for just over 2 years to work as a medicines management pharmacy technician in secure environments. In January 2014 I took up my current role.


What is your current role and what does a ‘normal’ day look like?


For the last three years, I have been working as a band 6 specialist anticoagulation pharmacy technician for Liverpool Anticoagulation Service. Although employed by secondary care we are a community-based team made up of thirteen pharmacy technicians but with the senior support of four pharmacists and two specialist haematology nurses. We currently specialise in vitamin K antagonist monitoring but are developing the service currently to cover DOACs as well.


A normal day for me varies. Today I conducted a clinic which had 40 patients booked in. We use POCT to test INR and then dose. As pharmacy technicians with level 2 competency, we can dose any result between 1.0 and 7.9. Over this, we seek advice from a pharmacist. During this clinic today  I have reviewed patients on LMWH bridging and decided whether safe to stop or continue, reviewed medical histories of patients with upcoming surgery to decide whether they require LMWH bridging and arranged this. I generally use my own clinical knowledge to dose appropriately. This afternoon I used the same skill set but during nine domiciliary visits to our housebound patients. I also regularly had to counsel patients and initiate them on anticoagulant medication when referred to our service from either primary or secondary care.


Other days we may be in our office answering queries from patients and other health professionals, assisting colleagues, reviewing patients pre-surgery for LMWH bridging requirements, processing discharge summaries and completing annual reviews of our patients.


Do you work autonomously or are you supervised in your current role?


We work autonomously but with support from colleagues which is only a phone call away.


What do you love and also what do you hate about your current role?


I love that I have such a clinical patient facing role. I really like the fact we have our own clinics that we manage and that we get to know our patients and can provide such continuity of care. I love that as a team our patients’ safety and well being is our primary concern.


The only thing I don’t enjoy is the limited amount of time we get with our patient in the clinic. We are only allocated five minutes per patient which is frequently not long enough to supply the standard of care we strive for so our clinics run late so we can achieve this.


What is your view on education and training for pharmacy technicians? Are they fit for purpose or is improvement required?


I think that post qualification the continued education and training is lacking. APTUK have a foundation framework for newly qualified pharmacy technicians but after this, there are very few opportunities. Bradford college offers the BTEC Level 4 Professional Diploma but many employers will not fund this so I am self-funding. This is not an option for everyone due to cost.


There are also several education providers who do not accommodate unless you are a pharmacist which I feel limits our ongoing development.


Do you think pharmacy technicians should have the opportunity to become independent prescribers?


The honest answer is I’m not sure. We currently do not have the opportunity to use PGDs and I feel this should be looked at first. With the right training and knowledge, I do believe pharmacy technicians are more than capable of diagnosing some conditions and prescribing appropriately. In my experience, I have been asked by doctors and other health professionals frequently for my opinion on prescribing in certain situations. Though I also feel this would need adequate training and regular review as with others who use PGDs already.


Pharmacy technician practice developed tremendously in the 1980’s. Do you think community pharmacy technician practice has progressed to the same degree?


No. I still have colleagues in community pharmacy and they do not use their clinical knowledge as much as I do. Their roles are more limited and they are not always given the opportunity to show what they are capable of.


How do you see the role of the pharmacy technician, in general, developing in the coming years?


I hope that more pharmacy technicians can have opportunities like I have and specialise. With the introduction of funding for care homes, I feel this is becoming more likely. I think as our initial training and post-qualification training becomes increasingly clinical we will be able to take over more roles which may not necessarily need pharmacist input, or at least not initially. But this takes time and gaining the confidence of pharmacists to enable us to work autonomously.


What is your personal ambition as a pharmacy technician?


I am currently self-funding the BTEC Level 4 Professional Diploma as I want to continue to expand my knowledge and not become solely an anticoagulation pharmacy technician. Post completion I would like to look into becoming more involved in the education and training aspect of pharmacy assistants and pharmacy technicians, maybe even look at completing the MSc in Clinical Education. I want to remain patient-focused but pass on my passion for pharmacy and patient safety to future generations.


What is your opinion on ‘accuracy checking dispensing assistants’?


In secondary care, this would probably aid workflow as pharmacy technicians could be freed up to better utilise our skills onwards etc. In community, this could adversely affect the role of pharmacy technicians. Several colleagues in community pharmacy are employed as ACPTs to free up pharmacists to complete other tasks such as MURs. If a dispensing assistant could fulfil this role then pharmacy technicians could potentially become obsolete.


I don’t feel assistants should be able to take on this role unless pharmacy technicians are allowed to fulfil their potential and take on more clinical roles in whatever sector they are employed.


If you could change one thing in pharmacy what would it be?


The view of some healthcare professionals and peers that we’re ‘just pharmacy technicians’ and all we do is dispense medication.

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