The Pharmaceutical Journal
Vol 268 No 7194 p543
20 April 2002

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  Supervision
  Checking technicians
  Drug-herb interactions
  NHS
  Community pharmacy
  Hospital pharmacy
  Prison pharmacy
  The Profession
  Wholesaling
  CPD
  Pharmacy practice
  Dispensing
  The Society

Letters to the Editor

Checking technicians

Technicians have legitimate aspirations

From Mr T. Delaney

Philip Trafford is off the mark (PJ, 6 April, p468) when he compares using accredited checking technicians in the dispensing process with allowing a stewardess to fly an aeroplane. Stewardesses do not regularly fly aeroplanes under pilot supervision, but pharmaceutical technicians dispense the vast majority of prescriptions in hospital under pharmacist supervision.

In recent years, pharmacy practice has moved away from dispensing and focused more on so-called clinical pharmaceutical activities. This shift, which has been acknowledged recently by the Audit Commission as being in the interests of patients, could not have happened had pharmaceutical technicians not taken over the bulk of dispensing work. We have reached the point where many supervising hospital pharmacists have far less practical exposure to the skill of dispensing prescriptions accurately than pharmaceutical technicians. The cognitive professional check is still done by the pharmacist, but the skill-based activity of dispensing an approved prescription accurately is the responsibility of the technician.

In cognitive terms, dispensing prescriptions accurately is skill-based. There is no reason to expect that pharmacists will be any less susceptible to human error in the skill-based activity than technicians. It is arrogant to presume that pharmacists are better than technicians at this activity. What is important is that a second, independent dispensing accuracy check is done by a competent individual.

Recently we have allowed nurses to administer drugs in most hospitals without the benefit of an independent accuracy check. This development was an expedient because of staff shortages in nursing and, so far as I am aware, has never been supported by research demonstrating that it is safe to eliminate the check. Yet some pharmacists are reluctant to allow checking by accredited technicians in the dispensary. Far better to have a technician checking another technician, than to have a pharmacist dispensing unchecked.

Pharmacy technicians are developing their skills and have a right to expect that their roles and responsibilities will develop in tandem. Many influential doctors still do not accept the expertise of the clinical pharmacist, despite the great improvements in training and knowledge in our profession. We all have experience of how frustrating this has been and is for pharmacists, and how damaging it can be for patients. We should think of this when considering the legitimate aspirations of hospital pharmacy technicians to develop their role in medicines management. How much better the quality of medicines management would be now, if all doctors embraced and acknowledged the role of clinical pharmacists. How much better the dispensing process will be if we do the same for our technician colleagues.

Tim Delaney
Head of Pharmacy, Adelaide and Meath Hospital, Dublin

Short-termism versus professionalism

From Mr P. D. Brassington, MRPharmS

I read with interest Andy Murdock's defence of the use of accredited checking technicians (PJ, 6 April, p468). I can appreciate the commercial interest such a move generates for his organisation. I have spoken to many pharmacist colleagues; we are of the opinion that this can only produce short-term results. With the use of ACTs, the same conclusion would be derived as was with parallel imports: there is a long-term danger that this provides the Department of Health with a reason to reduce our professional fees, and weakens the Pharmaceutical Services Negotiating Committee's negotiating stance forever.

The profession of pharmacy needs to be strengthened through more use of second pharmacists (which interestingly is what Mr Murdock espoused before his current change of heart) and continued training, not by abdication of our primary duties.

Paul Brassington
Sedgley, West Midlands

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