Should technicians have more responsibility and even be allowed to supervise the sale and supply of medicines? Two community pharmacists present the arguments, for and against

YES

One of the things that frustrated me most when I worked full-time in community pharmacy was being stuck within four walls all day. If I popped out for two minutes to buy a sandwich, there would be people waiting to pick up prescriptions or buy some P medicines when I got back.

Many of the tasks I currently do as a locum could easily be carried out by technicians without my direct supervision – but the problem is there aren’t enough of them to help us fulfil our potential.

I am not advocating that we run pharmacies without pharmacists, but I am saying – let’s be sensible. We can make changes without compromising safety and we should make those changes. With proper procedures in place, as a minimum, patients should be allowed to collect dispensed medicines and buy P medicines during a brief pharmacist absence.

If we want to do the exciting stuff like our GP practice pharmacist colleagues, then something has to give (but never patient safety). There has to be proper provision that allows us to perform these roles, along with clear professional accountability.

Some may argue that the responsible pharmacist regulations allow this flexibility, but if the pharmacist is on the premises and busy in a consultation room, how is that any better than being away from the premises? We need to work closely with our pharmacy technician colleagues, and if appropriate changes to supervision can help with that, I’m all for it.

So, for me, there are two issues: improving on the current supervision requirements to enable us to do more; and making better use of pharmacy technicians. We are an amazing resource in the heart of communities, but to do our best for the profession and, more importantly, for patients, we can’t deny the progress that is needed. If we want to expand our roles, then we have to welcome the ambitions of pharmacy technicians too.

If supervision stays as it is, it’ll be a Pyrrhic victory for the profession. At the extreme, there is a threat (real or not, I don’t know) that pharmacy technicians will supervise pharmacies without pharmacists, but we can’t let this possible scenario prevent us from suggesting improvements to what we have now.

However, so far, I haven’t seen anyone suggest positive changes. What we should fear is the status quo that resigns us to trudge on exactly as we are. Where has that got us?

• A longer version of this article can be found at pharmacyinpractice.scot

 

NO

In my pharmacies, pharmacists are constantly in demand, answering queries, dealing with problems or delivering services. Often the most seemingly inconsequential enquiry leads to the most significant of interventions.

Community pharmacy is never boring because you never know what is about to hit you. So the suggestion that a pharmacy could safely operate without a pharmacist, even for a few minutes, leaves me terrified. I will not submit to having my life’s work destroyed by ivory tower civil servants hell bent on giving pharmacy technicians the same legal rights as pharmacists to supervise the sale and supply of medicines.

To be pro-pharmacist is not to be anti-technician or Luddite. I am a committed professional who has, through a long and varied career, seen and done it all. There have been close calls along the way but I have always known my own limits thanks to the breadth and depth of my training. To equate two years’ worth of NVQ training with master degree level education is patently wrong.

The technician register is largely composed of registrants qualifying under grandparenting arrangements. Would it surprise you to know that the proportion of registrants who have been grandparented is actually growing? Newly qualified technicians are increasingly leaving the profession.

There is no consistent level of qualification, let alone syllabus or curriculum for registered technicians. As utterly invaluable as they are, there is no way you could be confident of handing the role of ‘responsible pharmacist’ to a technician.

Whenever things go wrong I know that it is my neck on the line. The gravity of a pharmacist being struck off is beyond comprehension. For registered pharmacy technicians there isn’t the same level of risk, as there are many equivalent paying jobs open to them. How do I know this? Because there have been a number of cases before the GPhC where technician registrants didn’t even bother to turn up.

Some argue that tying pharmacists to the pharmacy is a backwards step, but the public need and expect to speak to a pharmacist. They are not clamouring to speak to a pharmacy technician.

It is only by maintaining a constant level of service by having a pharmacist in every pharmacy all of the time that the NHS can hope to make best use of pharmacy to deal with the one-third of patient contacts that would otherwise end up in general practice and the 8 per cent that end up in A&E.

A pharmacy without a pharmacist is just a shop.

To be pro-pharmacist is not to be anti-technician