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Now is not the time to deprioritise MCA training

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Now is not the time to deprioritise MCA training

Could pharmacies decide to deprioritise medicine counter assistant training as funding cuts begin to bite? This would be a false economy and a mistake – continued and even enhanced efforts on this front are essential for the sector to improve quality of care.

Community pharmacy is under scrutiny like never before, as the Government consults on proposed funding cuts, investigations by national media expose various shortcomings in professional practices at both multiples and independents, and another Which? report looks likely in the near future.

The last such report, in 2013, claimed serious failings in standards, many related to the service and advice provided by medicines counter staff. The profession can ill afford a similarly damning report in the current climate.

Pharmacy is a soft target for investigations of this sort, given its easy access and ‘no appointment necessary’ service. Counter assistants and other support staff are on the front line as they are often the first point of contact for patients and mystery shoppers. Given that two-thirds of the visits handled solely by counter assistants were rated unsatisfactory in the last Which? report, the service provided by support staff needs to have improved since 2013 if the profession is to avoid further reputational damage.

Reinforcing pharmacy’s value and professional standing will require a team effort across all community pharmacies, with training a vital ingredient, says Ash Soni, president of the Royal Pharmaceutical Society.

“A pharmacy’s reputation depends on not just the clinical skills of the pharmacist, but on the frontline support staff who usually see the patient first. “Training and support are vital to ensure a good skill mix across the team, so individual team members complement each other and as a whole deliver an excellent service. 

A pharmacy’s reputation depends on this. Training support staff is essential to both high quality patient care and business success.”

False economy

Cutting back on staff and training in response to the pending funding cuts would be a false economy, says Soni, as the benefits of a well-trained team are “huge” to both pharmacists and patients. In terms of a pharmacist’s role alone, a cut in dispensing staff would increase his or her workload significantly, leaving much less time for direct patient care.

“A pharmacist’s team is the heart of the pharmacy and builds long-term relationships with patients, who come to depend on them for help and support with their health. Cutting staff would also mean fewer opportunities to rotate team members for training, so it becomes more difficult to provide the training in the first place.”

It is more important than ever for the profession to safeguard its reputation if the role of pharmacy is to expand, says Liam Stapleton, superintendent pharmacist at Warman-Freed Learning Pharmacy. “Success on this front depends on ensuring we have the trust of consumers, healthcare professionals and indeed politicians. We need to consistently demonstrate that pharmacy can add even greater value to the NHS and to the communities which it serves.”

To support these efforts, pharmacy teams must show how they are investing beyond mandatory training, says Stapleton. They should be proactively identifying training needs to support the growth and capabilities of the business to deliver good customer service every time.

While the ‘go-to plan’ when funding cuts hit might be to slash staff numbers and adopt radical new strategies, this would be counterproductive for a successful, sustainable business, argues Mandeep Mudhar, director of marketing at Numark. Businesses have a lot to gain from upskilling employees to deliver more services which, over time, could win more business in different sectors and have a direct impact on the bottom line, he says.

Vital element

Skilled support staff are a vital element in delivering added value for customers and gaining a competitive edge in the market, says Mudhar. Running a successful pharmacy business requires strategic planning, and pharmacists need the head space to plan properly. “Having support with managing the day-to-day business, running retail offers and setting up services like MURs will help free up pharmacists’ time to do this,”
he says.

Tight budgets are already a reality, but the sector has to steal itself for tough times ahead, says Sue Hobdey, head of professional development at the NPA. “Pharmacies will be looking for efficiencies and need to have an eye to the financial bottom line as well as continuing to deliver excellent service. The pharmacy business, as well as pharmacy practice, is some-thing that everyone in the team needs to be conscious of.”

Well-trained staff are a worthwhile investment, says Hobdey – and they could become increasingly valuable as pharmacy moves away from a supply model and focuses on service delivery. Pharmacists should be asking themselves whether they have offered a MUR to all patients who would benefit. Support staff have an important role in drawing patients’ attention to such services, she says.

Difficult to recruit

Recruiting and retaining patients for many services can prove difficult but this can be a good opportunity for staff to become more engaged in service delivery.

To maximise the number of services completed, pharmacies should have clear systems and procedures in place to identify eligible patients, get them to take part and then complete the necessary follow-up and records, says Hobdey. She suggests that staff familiarise themselves with various aspects of services, such as eligibility or referral criteria.

GPhC consultation

The GPhC ran a consultation last year seeking views about how the education and training of the pharmacy team should evolve to meet current challenges. Responses were published in November in ‘Tomorrow’s pharmacy team’ and highlighted a number of themes.

Respondents stressed the importance of consultation skills for all members of the pharmacy team. Celesio UK, for example, said in its response: “We believe that principles around patient-centred care and outcomes for patient benefit would be useful additions. Key elements of this are the skills and the ability to consult with patients effectively about their care and treatment.”

When asked what additional skills should be covered by the initial education and training of medicines counter assistants, the main areas identified were customer service skills and the ability to work within their own limitations.

“An MCA is often currently the first person the patient speaks to in a community pharmacy. In hospitals, pharmacy assistants dispense prescriptions and prepare aseptic products. If this role remains in this form, the skills of MCAs should include customer service in all settings and professionalism informed with some level of medicines knowledge.” (The University of Nottingham)

Respondents thought that knowledge about medicines, pharmacy law and disease prevention were important in the initial education and training of MCAs. Respondents also saw the role as important to delivering the present public health agenda.

Special nature

“All members of the pharmacy team must be aware of the special nature of medicines, their place in healthcare and the reasons why medicines sales are restricted and controlled to protect the public. This is especially true for medicines counter assistants, who will generally be drawn from a pool of local workers who could be (or may have been) employed in other retail and service businesses.” (Walgreens Boots Alliance)

The company went on to predict that members of the pharmacy support team would increasingly take on public health roles, acting as health trainers, coaches or champions. These roles would involve greater communication skills and a broad understanding of the impact of lifestyles and environments on health.

“Developing skills that support behaviour change and the long-term maintenance of healthy lifestyles will be vital to achieving an engaged population and reducing future pressures on healthcare.“ Many respondents identified funding as a major barrier to implementing revised standards. “Lack of funding is likely to set the overall limits in terms of the number of pharmacists, pharmacy technicians and other support staff who can or will be trained,” said Walgreens Boots Alliance in response to the consultation.

In its response, the Royal Pharmaceutical Society said that the initial education and training of the pharmacy team is having to take place in an extremely challenging financial environment. “One of the key barriers to implementation [of training] will be funding. More education in the clinical setting and more education of
a multi-professional format will inevitably result in increased costs.”

The profession can ill afford another damning report from Which?

An inspector calls...

Well-trained staff are an important element of the General Pharmaceutical Council’s standards for pharmacy premises. Principle two states that staff should be empowered and competent to safeguard the health, safety and wellbeing of patients and the public.

GPhC guidance states: “The staff you employ and the people you work with are key to the safe and effective practice of pharmacy. Staff members, and anyone involved in providing pharmacy services, must be competent and empowered to safeguard the health, safety and wellbeing of patients and the public in all that they do.”

Inspectors will speak to all members of the team, observe their interactions with each other, with patients and with members of the public. They will also observe the roles and functions the team are carrying out. Pharmacies that achieve higher ratings will typically have staff who are clear about their roles, understand when they need to involve the responsible pharmacist and demonstrate how they are improving outcomes for individual patients, says the GPhC.

“Our inspectors will be looking to see how staff identify and learn from any mistakes and how they are encouraged to put forward suggestions for improvement. They will also look at how pharmacy staff work in partnership with other healthcare providers and whether they are able to raise concerns about safety.”

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