The Pharmaceutical Journal
Vol 273 No 7315 p312-315
4 September 2004

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· The Charter
· Charter ballot
· Volunteer agencies
· Voting
· Personal control
· Medicines and devices
· Simvastatin
· Ward technicians
· CAM
· Remuneration
· The Profession
· Education
· CRCS
· Retention fee
· Onlooker

Letters to the Editor

Ward technicians

Good opportunities can be missed

From Mr D. R. Green, MRPharmS

I read the recent news story regarding a pharmacy-led drug round by a technician (PJ, 7 August, p177) with a combination of dismay and optimism. The optimism came from seeing the role of technicians being developed beyond the traditional role of supply, and at ward level. In Colchester we have been following this path for some years now and our team of clinical technicians are all considered to be at the leading edge of technician development.

My reason for dismay is that this is another example of well-intentioned development but in the wrong direction. Why are we spending time and effort in perpetuating a system of drug administration that is now considered to be unsatisfactory? The ward system of choice has got to be a bedside storage locker with one-stop dispensing dedicated to individual patient needs. The logical outcome should be self-administration of medicines on every ward by as many patients as possible. The fact that the ward in question is a surgical ward adds to my feelings of despair since these are the patients that would normally be capable of self-administering their drugs if appropriate assessments were in place.

The technician could have achieved all the benefits highlighted in the news story without the need for her own trolley. Her activities could include a review of medication on admission. This is successful at identifying a range of anomalies in how patients take their drugs compared with how we think they take them. It is also an opportunity to ensure that prescribing on admission is correct. Throughout the patient pathway the technician could assess the patient, decide on fitness to self-administer and look at the reasons why not. In some patients this will give an opportunity to contribute to discharge planning well in advance of the date of discharge. The supply role will still be significant but with one-stop dispensing and use of patients’ own drugs the workload will be manageable. Relationships with the ward staff will also improve because the technician is seen as an essential member of the team.

We are a trolley-free trust with all medicines dispensed ready for discharge and in appropriate quantities. The exceptions to this are injections, short-term medicines and “specials”. Although the system is not perfect it does give us time with patients. We consider this to be a better use of time and it reflects the national service framework agenda plus patient empowerment with choice.

My vision of the future does not include drug trolleys but it does include well-trained and qualified technicians working with patients at ward level. The news story demonstrates how good opportunities can be missed if the direction of progress is wrong.

David Green
Interface Development Pharmacist Essex Rivers Healthcare NHS Trust

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