Tess Fenn APTUK President
Do you feel pharmacy technicians should be supplementary or independent prescribers?
As the pharmacy profession evolves and there are advances in initial education and training, roles will change for instance currently there is a call for independent prescribing to be integrated into the MPharm. For practitioners to be prescribers, at whatever level requires legislation change.
The legal framework that enables specified healthcare practitioners to prescribe and supply/administer medicines encompasses Patient Specific Direction, Patient Group Direction, Exemptions, Supplementary prescribing and Independent prescribing.
This is generally a hierarchical process and currently, pharmacy technicians sit within the ‘supply or administer prescription-only medicines to patients through a legally valid prescription or patient specific direction’ process. Over a period of time, APTUK and other pharmacy bodies and organisations, have called for pharmacy technicians being able to supply under a Patient Group Direction (PGD).
Last year, APTUK submitted to NHS England a preliminary ‘Scoping Report and Outline Case of Need for the use of Medicines Supply and Administration Mechanisms by Pharmacy Technicians’ to the ‘Chief Professions Officers’ Medicines Mechanisms programme board’. The report was put forward to demonstrate that the use of PGDs by pharmacy technicians would be a valuable addition to the care they give to their patients, in order to enable implementation of the recommendations of the Community Pharmacy Clinical Services review 2016 (Murray report). APTUK were advised that although not being taken forward at this moment in time the ‘Case of Need’ remains with the programme board for future consideration.
What is your view on the role of ‘accuracy checking dispensing assistant’ that has emerged?
In 2012 APTUK published a ‘position statement’ that acknowledges the final accuracy check on dispensed items is a process which can theoretically be undertaken by any suitably trained and experienced person. However, the final accuracy check is the last step in the process prior to the medicine being given to the patient.
APTUK raises the question of responsibility and accountability and advocates that the final accuracy check of dispensed medicines should only be undertaken by suitably qualified and experienced registrants of the Pharmacy regulator.
Technicians are not regulated in Northern Ireland, does this need to change?
Pharmacy Technicians in Northern Ireland undertake a variety of roles akin to those practised in Great Britain. Thus patients and pharmacy users could expect to have the same confidence that those who provide their pharmacy service are qualified and practice to a standard that is required by a pharmacy regulator. The Northern Ireland Department of Health are currently undertaking a review of the pharmacy workforce, to inform the government of the workforce development needs for the next ten years. The review incorporates pharmacists, pharmacy technicians and pharmacy support staff and APTUK is a member of the Pharmacy Workforce Review Project Board. This is an exciting project and I am delighted to represent Pharmacy Technicians and our members from Northern Ireland and look forward to its outcomes.
What is your view on the current education and training arrangements for pharmacy technicians in the UK?
I believe that the October 2016 Initial Education and Training (IET) Standards published by the GPhC are a step in the right direction and have made an attempt at bringing the initial training for pharmacy technicians in line with the job roles required to deliver healthcare policy across all the devolved countries. As we all know, the qualification to meet the IET outcomes is currently in development and APTUKs response to the draft units are on our website. I feel it is crucial that we get this qualification right and at the right level to equip pharmacy technicians for the next five years and beyond. As I have said many times, pharmacy technicians are professionals in their own right and are key members of the pharmacy team. To utilise the pharmacy technician profession well, to meet patient needs and compliment and support the evolving role of pharmacists, requires confidence in the training and individual competence. It requires all providers to be delivering training and assessment consistently to the same standard and level. I believe that the GPhC has a greater quality assurance role to play here and to ensure there is as little variation as possible.
For as long as I have been a pharmacy technician post qualified education and training has mostly been at the discretion of the employer, often lobbied for by the pharmacy technicians, and although there are some embedded career developments and a loose structure such as medicines management and final accuracy checking, there has been no overall tangible framework. As already indicated APTUK developed the FPF to support foundation practice. We are also shortly to embark on a project in collaboration with WCPPE on developing an Advanced Framework to support specialist and evolving roles and career progression.
How do you feel pharmacy technicians differ from pharmacists and do you think there is ever a blurring of the lines in practice?
We are all part of the pharmacy team along with our non-regulated colleagues and we all work in a healthcare environment, so by default, there will be a blurring of the lines of practice and tasks undertaken. If we take assembly of a prescription as an example, this task can be undertaken either by a pharmacist, pharmacy technician or a pharmacy assistant (dispenser). The physical task and skills carried out to complete the task are the same whoever does this. The difference would be in the level of knowledge and responsibility that underpins the task and this is where the right skill mix is required.
I was asked a question last year when I was a participant in a panel debate at the Pharmacy Show discussing the government Rebalancing Medicines Legislation and Pharmacy Regulation Programme. The question I was asked was ‘What is in it for Pharmacy Technicians’ and I turned the question around to ask ‘What is in it for patients’ as the Rebalancing programme is not about what is in it for pharmacy professionals. I would argue the same here, it’s not about pharmacists and pharmacy technicians; us and them, so I will give the same answer. It’s about how the pharmacy team can deliver the services to patients that they want and need. It’s about how this can be done more effectively and efficiently in the current and future demanding and changing healthcare landscape. It’s about utilising the pharmacy team to its capacity, and for pharmacy technicians, that is in the context of their professional registration, skills, knowledge and experience. A term that has gained traction recently, ‘working to the top of your licence’ explains this well. It means working in the team and practicing to the full extent of your education and training, instead of spending time doing something that could effectively and safely be carried out by someone else who is suitably trained and competent.
Some have claimed that pharmacy technicians in the UK are not a ‘profession’. How would you respond to these views?
APTUK is steadfast and clear in their belief, as I am that Pharmacy Technicians are a profession and are professionals in their own right. Since mandatory registration with the General Pharmaceutical Council in July 2011, it has been said on many occasions that Pharmacy Technicians are still relatively young as a profession. Indeed we are, although the campaign to achieve it began a long time ago.
APTUKs first records and its formation began in January 1952 with a select group of technicians campaigning for professional recognition; fighting for recognition of the role and seeking professional regulation.
There are varying definitions of a profession but they all agree that a profession is a disciplined group of individuals who adhere to professional and ethical standards; it attains a predetermined set of knowledge education, training and skills; it maintains knowledge and skills through continuing professional development and applies these in the interest of others.
Pharmacy Technicians are admitted onto the GPhC register only when they can demonstrate they have attained a set standard of knowledge and skills, they commit to behaving ethically and working within the standards for pharmacy professionals to protect the interest of patients and the public, and they are subject to revalidation and fitness to practice investigations if they fall short of professional practice and expectations. Let’s be absolutely clear in our understanding that they are subject to the same GPhC requirements in every aspect as Pharmacists.