Later today I have the honour of closing the APTUK conference 2018. I wrote the blog below three years ago and to be honest my opinions have not changed. For pharmacists to progress and for our profession to move forward we (pharmacists) need to work with our technician colleagues to care for patients in an ever-changing healthcare environment.
Let me take you back to 2015 when I still managed a busy rural community pharmacy.
I AM an advocate of pharmacy technicians. It’s important for me to declare that I have probably learned more about pharmacy practice from my pharmacy accuracy checking technician than any other pharmacy professional in my short career.
I tend to feel guilty spending more time with some patients, but I know that my accredited checking technician (ACT) and the rest of the pharmacy team are in the dispensary holding the fort. The environment I work in is such that as the pharmacist manager I am torn between the technical task of safely dispensing prescriptions and the emerging clinical role I am trying to carve out for myself. Without this trust, based on competence, I could not fulfil my clinical role in community pharmacy. I practice many brief interventions in asthma and other areas and without my ACT and pharmacy team, this work would simply not be possible.
So what makes a good pharmacy technician?
I think pharmacists and pharmacy technicians have varying skill sets underpinned by common core areas of competence. In terms of the running of my dispensary, my ACT fulfils nearly all the traditional functions that perhaps a number of years ago would have been the preserve of the pharmacist. Handling controlled drugs, supporting the review of standard operating procedures, reviewing dispensing errors/near misses and of course accuracy checking of prescriptions.
The ability of a pharmacy technician to accuracy check prescriptions, in my practice, has been a revelation. An ACT is no less capable of this, in my view than a pharmacist. To do the clinical check of a prescription and then hand the dispensing process over to the team, lead by an ACT is a key enabler to deliver ever more clinical care in the community pharmacy setting. But we all know pharmacy technicians can do much more than this. At the moment, however, the roles in community pharmacy seem somewhat restricted.
I can only speak from experience, but I do know that the extended roles and opportunities for registered pharmacy technicians are now vast. My local health board employ a pharmacy technician and one of her jobs is to be an authorised witness for the destruction of controlled drugs.
In terms of the future roles for pharmacy technicians, my view would be that the ball is firmly in the court of pharmacy technicians. Just like pharmacists, it’s difficult to find a path to innovative and prove one’s worth to key stakeholders, but innovate you must. I would like to see registered technicians appropriately trained to deliver clinical services in community pharmacy. For example, my ACT is comfortable conducting smoking cessation consultations and will ask for advice if required. Just like being a pharmacist, a pharmacist independent prescriber, or even a general practitioner, pharmacy technicians must be mindful of the obligation to work within their personal area of competence. That said, I think they should be allowed to do more, much more!
Practising as a registered pharmacy technician holds the same legal and ethical requirements of other professions. Protection of the public and improving care remain the priorities. The concept of competence and demonstration of continued professional development is critical to the success of any professional.
My relationship with my ACT is as professional equals. She is registered with the professional regulator and so am I. I do see her as a junior partner in our working relationship, although there is no getting around the fact that the responsible pharmacist holds ultimate responsibility at the end of the day. I am always grateful for her feedback on my practice and hopefully, this is reciprocated. Conversations or queries we encounter when working together often form the basis for both my and her continuing professional development.
If my GP colleagues had been territorial about my independent prescribing rights that I gained a few years ago I would not be able to practice as effectively as I do today. How can I or any pharmacist, therefore, stand in the way the progression towards autonomy of any registered pharmacy technician.
So I say good luck and show us what you’ve got. I will support the progression of any pharmacy technician progression so long as it is based on robust demonstration of continued competence and so long as the activity is in the interests first and foremost of the patient.
Johnathan Laird is a GP pharmacist independent prescriber with a special interest in asthma. He is based in based in rural Aberdeenshire.
Follow Johnathan @JohnathanLaird