A call for the registration of pharmacy technicians was made by the chairman of the Royal Pharmaceutical Society's Hospital Pharmacists Group Committee (Dr Norman Lannigan) on October 28.
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Norman Lannigan: technicians' knowledge and skills need to be recognised |
"I feel very strongly that the biggest problem facing hospital pharmacy is not dispensing errors. It is adverse drug reactions, waste, patients not understanding their medication, and doctors not understanding the role of other professionals. There is a role there for the wider profession.
"If we want a future we must develop and use pharmacy technicians. My advice to the rest of the profession is to develop your clinical skills, develop your technicians, develop your teamwork and then the profession will flourish."
Dr Lannigan set out his views on pharmacy technicians during the course of a "state of the (hospital pharmacy) nation" speech delivered at a dinner arranged by the Hospital Pharmacist journal in association with Faulding Pharmaceuticals Ltd. The "Faulding dinner" was a curtain raiser for a conference on clinical governance the next day.
Dr Lannigan began his speech by saying that he had been a hospital pharmacist throughout his career and was proud to be so, since he felt that hospital pharmacy was at the leading edge of the profession. However, he recognised that there were significant problems.
Pharmacy in a New Age had been an excellent initiative which had encouraged the profession to move away from a product base to a patient base. Hospital pharmacy had developed the concept of pharmaceutical care and had applied it in practice. He had been told by a visiting American that nowhere were they doing what was being done in Britain and showing that it could work.
Hospital pharmacists were welcomed as part of the multidisciplinary team and seen as equal with the other members of that team. He had been informed by a senior house officer, "I can sleep better at night because you are part of the team."
Dr Lannigan continued, however, with a reminder that it was not all good news, as practice varied across the United Kingdom. There were some centres of excellence and Scotland seemed to have got it right, in terms of the arrangement, standards and systems which had been in place for years and were working. The Scots had developed clinical pharmacy guidelines which defined what clinical pharmacy was. Scotland could offer that to the profession nationwide. Indeed, Dr Lannigan reminded guests that Scotland's Clinical Resource and Audit Group (CRAG) had published "The hospital service: a framework for practice", which had been adopted by the rest of the United Kingdom as a national standard for clinical pharmacy practice.
The clinical expertise that hospital pharmacists had could be used to develop formularies and medicine management policies. It was hardly surprising that experienced and trained clinical pharmacists were in demand within primary care.
Dr Lannigan added that the profession should sell itself as improving the quality of patient care, not as savers of money. He felt that, with an aging population and with new technology, quality and added value was the future, not saving money.
Turning to standards in hospital pharmacy, Dr Lannigan reminded the audience that they all had had to suffer efficiency savings which were beginning to bite. He asked if anybody had evaluated the effect this had had on the secondary care sector or whether anyone cared about what had happened in terms of patient care. When he began in hospital pharmacy there used to be 30 beds on a ward with perhaps five very ill patients. Now that ward would have 20 to 25 very ill patients with the same number of staff looking after them. He stressed that it was important that professional standards were not allowed to be compromised. The profession's Code of Ethics demanded it and now so did the requirements for clinical governance.
Referring to the relationship between hospital pharmacists and those in primary care, Dr Lannigan asked what it was that patients needed. He thought that very soon diseases which at the moment were treated in hospital, such as diabetes and ulcers, would only be treated in primary care. Shorter stays in hospital meant that more treatment would be carried out at home and hospitals would become large intensive care units. It was, therefore, important to work with colleagues in the community by building links to share with them the care of patients. Pharmacists should see themselves as pharmacists, not the hospital or community varieties.
Discussing the manpower crisis, Dr Lannigan said that the Hospital Pharmacists Group favoured the overproduction of pharmacy graduates so that there was an excess and therefore a choice of candidate for a job. This would meet the demand and improve the quality of the hospital pharmacy service.
A further problem in relation to the manpower situation was the difficulty in getting people to take on positions of leadership. This was very worrying and he hoped that the proposed salary settlement might make a difference to this.
Concluding, Dr Lannigan said that hospital pharmacy was well placed to meet further challenges if it could cope with the manpower crisis. He declared: "What hospital pharmacy does today the wider profession does tomorrow. It is in the profession's best interests to sustain and nurture the hospital pharmacy profession. The Hospital Pharmacists Group and the Guild of Healthcare Pharmacists looks forward to working with the Society's Council to ensure this happens."