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Two months on and I’ve finally had a chance to take stock of the festive madness. We survived but I can’t help feeling that I am the major bottleneck in my own pharmacy – and can’t see this changing any time soon...

HAVING TRAINED in a hospital environment with technician-led dispensaries, the obvious solution is to look at introducing an accuracy checking technician. There are two options: employ an additional person who is already qualified or train one of my two dispensers.

We tried the latter approach about four years ago, when one of my staff approached me about the possibility. It worked well to begin with but then life intervened: maternity leave, part-time return to work, studies falling by the wayside (£1,500 down the drain), before finally leaving her job. Back to square one.

We could try again with one of my current dispensers, but I have no guarantees on completion, and, because a checker is not supposed to participate in the dispensing or labelling of a prescription which they check, I’d effectively cut my dispensing capacity in half, thereby merely shifting the bottleneck along. Hiring another member of staff isn’t an option – there just isn’t the money to support this additional overhead.

Lack of benefit?

When I talk to pharmacy owners, it appears that they are increasingly moving away from training staff to NVQ3 standard (or whatever the training equivalent is these days), mainly because of cost but also because of a perceived lack of benefit – what can a NVQ3 technician do that a NVQ2 dispenser can’t? Plus you’ve got less risk of losing your expensive asset to a hospital (which would be able to pay your technician more and be able to offer a wider career path with better long-term prospects).

There is nothing to stop a NVQ2 dispenser from training as an accuracy checker, although I am not convinced this is a sound move for reasons of safety. While the responsibility for accuracy checking can be delegated to a qualified and competent individual, ultimately the pharmacist is the account- able professional if an error occurs, regardless of the individual being a registered technician or a NVQ2 dispenser.

So you could argue I would be no better off from a professional perspective, as I’d still be accountable if there is an error. Would it get rid of my bottleneck? No it wouldn’t. Every prescription would still need to be screened by me, so I’d still get interrupted. All it does is move the bottleneck from the checking bench to the consultation room - it’s me that’s the problem!

“The optician was available every third Saturday”

Obvious solution

When I look at so many of the problems in pharmacy, I can’t help but see a really obvious solution: we should have a two- pharmacist model. There are currently too many pharmacy students, who will become too many pharmacy graduates and then too many pre-registration trainees, until eventually we get too many pharmacists. In some parts of the country we are already there.

There is so much more I could do for my patients if I could get out of the pharmacy with more flexibility than at present. Now, before someone throws the responsible pharmacist hand-grenade at me, yes, I realise there exists the opportunity to leave the pharmacy for short periods of time. But there is a contractual responsibility for a pharmacist to be on the premises while the pharmacy is open – which is as it should be.

(I remember going for an eye-test with an optician, only to be told she was only available every third Saturday. Pharmacy would cease to be relevant to the public if the same were true of us.)

Putting in a second pharmacist might be a better option for our pharmacy, reducing the locum bill and increasing quality of life for both the first and second pharmacist. Suddenly all things are possible, from community outreach, complicated enhanced services, through to regular contact with practices to improve the overall quality of care.

The network of physical pharmacy premises is a concept that the public understands and creates millions of opportunities for interaction every day. With the right investment in skills and development, this could be leveraged to release savings from other parts of the disintegrating NHS.

The enthusiastic and capable pharmacy graduates who are entering the workforce could provide us with the opportunity to move to an exciting, different model of care that is better for pharmacists and patients alike.