The conjunction of the recent article in The Pharmaceutical Journal about clinical technicians (PJ, September 23, p435) with the arrival of a visitor intent upon comparing her role as a ward-based technician with that of the technicians in our pharmacy prompted me to think about the future role of pharmacy technicians. Coincidentally, I had also recently had a conversation with a colleague of old at which I had told him of my new role of dispensary supervisor. He said, "That's a job for a technician ". To which I laughingly replied, "There will always be a job for a pharmacist in a dispensary. " But will there?
Frivolity aside, though, what are the roles for pharmacy technicians in the future? Years ago I defined the role of a pharmacy technician as anything for which membership of the Royal Pharmaceutical Society is not legally required. I made several suggestions at that time and received several responses:
A technician in drug information? Inappropriate. Insufficient breadth of knowledge to do anything except undertake basic clerical and filing duties. Easier to train a pharmacist in library skills than a technician in therapeutics.
A technician as dispensary manager? Inappropriate. Insufficient breadth of knowledge to undertake such a duty effectively. What would pharmacists think having to take instructions from a technician?
A technicians undertaking final checks in a dispensary after a pharmacist has given a prescription intellectual approval? Inappropriate. Much better to have someone in post who is able to fulfill both the pharmacist and the technician role. Would you be prepared to risk your number on someone else's checking ability?
A technician undertaking a patient's drug history interview? Inappropriate. How can a technician be expected to comprehend all of the nuances of problems associated with a patient's polytherapy?
At a time when multidisciplinary team working and value for money are at the top of every management agenda the bottom line has to be "is it legal? ".
Pharmacists must only expect to be paid for their intellectual contribution, not there manipulative skills. We should be proud to think that we cost too much to be employed solely for our manual dexterity, our legal status and our understanding of logistics.
There will always be arguments about any general change in the role and job descriptions of a group of individuals. But if the necessary planning is undertaken, the roles specified correctly and appropriate staff selected and trained such changes can be liberating for both parties. For technicians there is the increase in their job satisfaction with the accompanying rise in their self-esteem. For the pharmacist there is the release of time to undertake other more demanding and, dare I say it, more appropriate tasks.
But where to now for technicians? I suspect that the answer to this question is as diverse as it is for pharmacists because, we must never forget, we are dealing with individuals' predilections. And given that the constraint in any organisation is the availability (or lack of availability) of intelligent time, who should be denying any competent individual the ability to further their competencies and their interests? There will be those technicians who came into pharmacy because of what they saw in the dispensary and have no aspirations to progress any further. We have a responsibility to keep such people happy and motivated because someone has to do the dispensing. But inevitably there will be those who will want to fly. There will be those technicians who are caring, empathetic individuals who will want to be ward-based and who will wnt to carry out patient counselling. There will be those technicians who are managerially orientated and who will want to run sections and even departments. Should we stop them?
There are now technicians in almost every position in pharmacy and I would suggest that those who have been bold enough to appoint them would be at a loss to know where a suitable replacement will be found. We should, I think, regard such worries as an indictment on the senior members of our profession who have, by and large, resisted progression for technicians.
So where have they yet to conquer? I can think of two places, both equally controversial.
First, how about starting at the top. Have there been many technicians as head of department in a pharmacy. Not many I guess. But why not? Any respectable tome in management will suggest that the boss need not be the expert on everything and anything. It is the team that counts. There is now a salary scale for medical technical officers which would enable a suitably qualified individual to be paid appropriately for undertaking such a role. I suggest that it is time that the profession began not only to make plans to facilitate such an event but also to lay out the ground rules for what would be expected of such an individual. There are several management courses up and down Britain offering senior management training for pharmacists. How many exclude pharmacy technicians almost as a matter of principle. Second, how about a technician offering prescribing advice or even writing prescriptions.
And that begs the question of where pharmacists are going. In the Nursing Standard of November 1 there is a report of a Government consultation document setting out five options for nurse prescribing including one option where the suggested nurse's formulary for those who regard themselves as appropriately qualified to do so includes the Controlled Drugs necessary for palliative care. If its good enough for nurses to choose for themselves, surely it is good enough for appropriately qualified and interested technicians.
My first job as a preregistration trainee in London about 30 years ago was to prepare, with the senior pharmacist in production, a talc and cotton wool filter bed to clarify the glycerin of thymol mouthwash which he had made. Thankfully, pharmacy has come a long way since then. Long may the process of change continue.
Peter Farley was previously chief pharmacist at Birmingham City hospital. He currently works at Sandwell general hospital, Birmingham