In 2019, the Pharmacists’ Defence Association (PDA), the trade union for pharmacists, released a comprehensive report on the future role of pharmacy technicians, titled ‘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’. The organisation caused controversy by saying there needs to be a clear distinction between the practitioner role of technicians and the professional role of pharmacists.

PDA’s Head of Policy for Scotland, Maurice Hickey, writes for healthandcare.scot to put the record straight on the organisation’s ambitions for these members of the pharmacy team.

There was nothing controversial in the title of our assessment report, but to this day a belief persists among many health professionals that the PDA is anti-pharmacy technician.

This assertion is promulgated by people who have likely never read the report because nothing could be further from the truth; put simply, the PDA wants nothing less for our technical colleagues than it wants for its pharmacist members, such as rewarding career frameworks and appropriate use of their skills.

The original report was the fruit of three years of research. It is extensive at 321 pages and, in light of recent proposals to enable pharmacy technicians to undertake clinical roles and work with PGDs, the PDA believes it is timely for the report to be reviewed again by all stakeholders.

Earlier this month, the PDA released a short infographic which summarises its recommendations and overall position, with links to the original report.

The PDA states categorically that it “strongly believes that if the workforce in community pharmacy could be appropriately reconfigured and developed, then this would enable the sector to take on many new, professionally fulfilling, and exciting opportunities”.

The PDA strongly advocates for a skill mix model which leans into the clinical training and expertise of a pharmacist and the technical training and expertise of a pharmacy technician and seeks a collaborative approach which enhances fulfilment for both groups, contributing, in different ways, to patient care. Workforce capacity, good governance, and the safe delivery of clinical services are all dependent on effective and appropriate levels of skill mix.

Current proposals around the expansion of the scope of practice for pharmacy technicians into clinical areas are not supported by the PDA.

Pharmacy technicians receive training to the minimum of SCQF Level 6 in Scotland (RQF Level 3 in the rest of the UK), and the underpinning knowledge required to be able to safely undertake clinical decisions is not appropriate.

With many pharmacy technicians entering the GPhC register through a ‘grandparenting’ arrangement in 2011, there is also a deficit in evidence of the qualifications and competence of an estimated 50% of the workforce, mainly those working in community pharmacy.

Careful planning and proper investment is needed to:

• Protect the public from an ill-thought-out and hastily rolled-out government agenda which is compromising patient safety.
• Minimise both types of registrants’ risk of exposure to liability and professional sanction.
• Prevent confusion amongst patients over professional roles.

The PDA is keen to promote continued wider engagement and constructive debate with fellow healthcare professionals. To that end, the enablers that the PDA has identified include:

1) Clarity and differentiation around professional and technical roles are essential. There must be no confusion among patients of the role being undertaken by the individual they are talking to and patients must be clear about who can provide any given treatment or service.

2) Development of the initial education and training of pharmacy technicians. Educational provider standards are variable and should be standardised, and admission to the GPhC register should only be after a registration assessment, i.e. a closed examination independent of the training provider or educational institution awarding the qualification. This is the procedure pharmacists undergo and should apply to all GPhC registrants, and therefore, also pharmacy technicians.

3) Public protection is delivered through pharmacy regulation. Areas of specialisation must be recorded transparently and CPD requirements for all registrants should be the same. If pharmacy technicians wish to take on clinical roles, then they should undertake appropriate training, in much the same way as pharmacists have to when they train to become an independent prescriber. All pharmacy technicians who have joined the GPhC register via the ‘grandparent rule’ should be similarly skilled up.

4) There should be a clearer definition of areas of responsibility and accountability for pharmacy technicians. Clarity on roles in community pharmacy is essential to protect patients.

5) There needs to be an alignment of the interests of pharmacists and pharmacy technicians. Both groups are part of the same team and what is good for one is good for the other; consensus amongst professionals protects everyone.

6) All roles in community pharmacy must better utilise skill mix. Much work has been done to advance both professional groups in other sectors, but in community pharmacy rewarding career frameworks, supported by skills and salary escalators and appropriate remuneration, are desperately needed and not supported by the current NHS financial envelope to community pharmacy.

When true professional and accountable responsibility for technical processes is fully devolved to pharmacy technicians, pharmacists will be enabled to fully embrace the clinical roles that their years of training have prepared them for.

The PDA’s vision is simply to make pharmacy better for patients, pharmacists, and pharmacy technicians, and to unify those in both roles behind a common vision and purpose - one that is based on shared interest, specific knowledge and skills, and mutual benefit.

 

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