The Pharmaceutical Journal
Vol 273 No 7322 p618
23 October 2004

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Skill mix and technician checking are key to many pharmacy developments

The 2004 British Pharmaceutical Conference and Exhibition “Medicines: from cell to society” took place at Manchester International Convention Centre from 27–29 September

BPC 2004 summary

Skill mix is at the heart of many developments in pharmacy, such as delivering the services included in the new contract, according to Jane Blackburn, head of professional capabilities at Boots The Chemists, and Lesley Johnson, head of education and training at the National Pharmaceutical Association.

With this in mind, Boots The Chemists set about designing and delivering a model for pharmacy support roles to meet future commercial and professional requirements, Mrs Blackburn explained.

The “old world” of dispensers, health care assistants (medicines counter staff) and pharmacy assistants (who basically split their time between working as health care assistants and dispensers) has been replaced by the “new world” of health care assistants, health care managers, dispensers and senior dispensers. A new course (NVQ2 level) is being developed for dispensers. To become a “senior dispenser”, a dispenser will need to undertake an advanced-level course (NVQ3 level), become a registered technician (the register opening in 2005) and become an accredited checking technician. It is expected that these changes will release pharmacist time to provide services by, for example, allowing the final check of prescriptions to be carried out in batches.

It is early days yet for the new roles, Mrs Blackburn explained. Twenty staff are currently in training as senior dispensers, with numbers expected to increase to 150 by the end of March 2005. Mrs Blackburn’s tips to others thinking of bringing in new types of career structures for support staff include not underestimating the time researching, planning and implementing the changes will take and questioning the validity of what is being done at all stages.

NPA view

Skill mix and accredited technician checking will help community pharmacists provide first class services to the local community, according to Mrs Johnson. Concentrating on accredited checking, she explained that there is not a “one size fits all” method of introducing the process. It is based on trust between the pharmacist and technician, which tends to develop over time, she added, and competence, not certificates, is key. Business needs and staff structure are also considerations — for example, accredited checking is only suitable where there are at least two support staff dispensing, so that an independent check can be made. Standard operating procedures also need to be drawn up. Whether or not accredited checking is right for a particular pharmacy, pharmacists need to “use pharmacy technicians or lose them”, Mrs Johnson concluded.

Horizontal skill mix

Delegates heard from Sue Ashwell, clinical director of pharmacy at Hinchingbrooke Healthcare NHS Trust and director of medicines management for Huntingdonshire Primary Care Trust, about how horizontal (ie, between professions and sectors), as well as vertical (ie, within professions and sectors) skill mix is key to delivering effective and affordable patient care in the managed sector. For example, team working with other health care professionals such as doctors and nurses is essential. “Pharmacy staff should be part of each therapeutic team,” she stressed.

Her role as head of pharmacy services at both a PCT and acute trust gives her a particular insight into the benefits of skill mix, Ms Ashwell explained. This type of cross-sectorial working required not only new systems of working, but changes in staff attitudes and behaviour. Staff need to learn to talk about those working for the “other” sector as “we” rather than “they”, she pointed out.