The Pharmaceutical
Journal Vol 266 No 7129 p12
There has been much debate following the publication of the recent discussion
documents on the future of pharmacy. One aspect that appears to have been relatively
neglected in any of the discussions is the potential role of pharmacy technicians.
This may well be because, unfortunately, some senior pharmacists have a rather
negative attitude towards developing the future role of technicians.1
However, I believe that developing the role of technicians is of critical importance
for the future of pharmacy and there are many potential managerial and clinical
roles that technicains could undertake within both the hospital and primary
care sectors.
It is worth remembering that the role of technicians within hospital pharmacy
has changed radically within the past 15 years. Fifteen years ago there was
no career structure for pharmacy technicians. Hospitals tended to employ only
a handful of technicians and no assistants. Pharmacists did almost everything
within hospital pharmacy departments. A technician acting as a dispensary manager
was unheard of. The dispensary would only be staffed with pharmacists whose
roles commonly included filling ward-stock orders and drug boxes. These functions
are now undertaken by technicians or, more commonly, pharmacy assistants managed
by technicians. In the hospital pharmacy of 2001, the rotational technician
has almost completely replaced the rotational basic grade pharmacist of the
1980s. There is now a defined career structure for technicians and the most
able technicians can progress rapidly up the career ladder. Indeed, it could
be argued that there is more of a career structure for technicians than there
is for pharmacists.
Clinical roles for pharmacy technicians within primary care could include much
of the work done with general practitioners, such as the analysis of PACT data.
Work within primary care could also include developing prescribing protocols,
formularies and training.
The role that technicians have within community pharmacies should also be investigated
to see whether they could have a larger management role within the dispensary.
This would free pharmacists’ time so that they could see more patients, thus
relieving the constant pressure on GPs and practice nurses. Increasing the dispensary
role of technicians could also allow pharmacists to spend more time with each
patient, and this will become more important as the range of medicines that
is available over-the-counter increases. An example is the availability of OTC
emergency hormonal contraception, which is likely to increase community pharmacists’
counter prescribing workload substantially.
Current clinical roles that technicians undertake within the hospital sector
include drug information, audit, nurse training and patient education. These
roles should be seen as only a fraction of the potential broader clinical functions
that technicians could undertake.
A suitably trained technician could carry out the traditional ward pharmacy
role. Training could include a formal clinical course and work-related activities,
such as attending consultant ward rounds. There are possible additional benefits
in having a technician on consultant ward rounds, eg, raising the profile of
pharmacy and helping to ensure that evidence-based medicine is practised.
A clinical course has been launched for hospital pharmacy technicians.2
To enable technicians to undertake a clinical role there should be opportunities
for them to gain formal qualifications in clinical pharmacy. To achieve this,
all the certificate and diploma pharmacy courses should be open to technicians.
Within the specific area of mental health, numerous studies have indicated that
concordance with medication is generally poor. A technician-facilitated patient
medicine education group could have a viable future role in improving concordance
and, therefore, outcomes in mental health. Technicians could also run patient
education groups in other areas such as cardiac rehabilitation or asthma.
Within hospital pharmacies, technicians are increasingly undertaking management
roles. It is increasingly common for the dispensary manager to be a technician.
Technicians should be able to manage whole areas within a pharmacy department.
Furthermore, if individuals are suitably trained and accredited, they should
work independently without the supervision of a pharmacist.
If the role of technicians continues to change radically, technicians may routinely
be managing pharmacists. The senior manager in the hospital pharmacy department
of 2015 could well be a pharmacy technician with a management qualification
such as an MBA. With the appropriate support, encouragement and training, there
are many technicians who could undertake these new roles successfully.
In summary, technicians will have a critical role in ensuring that pharmacy
develops in line with the ideas expressed in the Pharmacy in a New Age document,
Furthermore, any new developments must have pharmacy technicians at their centre.
While some articles and conference reports have discussed the potential role
of pharmacy technicians, generally there has only been a limited discussion
in the pharmaceutical press.3,4 Perhaps it is time
that that changed.
Ian Maidment is chief pharmacist (mental health and learning
disabilities) at East Kent community trust, and is an honorary lecturer at the
University of Kent at Canterbury