The Pharmaceutical Journal
Vol 274 No 7332 p39
15 January 2005

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Skill mix decisions must be made locally

Decisions on how to use dispensary support staff need to be made in individual community pharmacies, but within a fixed regulatory framework where roles are clearly defined and there are clear lines of accountability, according to the latest published research (PDF 1.1MB).

Rachel Mullen, who was awarded the Royal Pharmaceutical Society’s 2002 Sir Hugh Linstead Fellowship to carry out the work into the use of support staff, concludes that incorporating her findings into planned regulatory reforms is likely to prove a challenge to the Society.

Dr Mullen’s report says: “In the process of implementing the regulatory framework, caution should be exercised to avoid stifling good examples of skill mix models. Clearly, pharmacists value other factors that assure competence of dispensary support staff, such as experience and trust, as equally, or more important than simply holding a dispensing qualification or a ‘piece of paper’.”

The research examined in detail the roles of different staff at six community pharmacies and found that both qualified and unqualified support staff were involved with operational aspects of a range of services and that the activities undertaken were not always linked to qualifications. For example, some staff were checking the accuracy of dispensed medicines without any formal accreditation.

The report says: “There appears to be a trade-off between ensuring safe practices and stifling innovative models of skill mix. This is demonstrated in the community pharmacies where accuracy checkers were operating. The restrictive and, one could argue, safer systems that were in place for the accredited checking technician prevented her from functioning as an accuracy checker. Where the accuracy checker roles have developed in the other two pharmacies in the study, this has not been accompanied with the implementation of safe systems.”

Janet Flint, the Society’s head of support staff regulation, said: “The Society will consider this research as part of its work in developing policies and reforms in this area.”