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Letters to the Editor
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Technicians
Technicians will leave pharmacists trapped in the dispensary
From Mr A. J. Pothecary, MRPharmS
I am sure I am not the only pharmacist to be concerned at the way pharmacy
technicians seem to be “leapfrogging” pharmacists and taking
on new roles that I would have expected pharmacists to be performing. A
typical example of this is detailed in an article in the latest edition
of Prescribing and Medicines Management (2005;[March]:PM3). The article
describes the trial of a technician-led
benzodiazepine withdrawal clinic in North Eastern Derbyshire Primary Care Trust. The technician was permitted
to amend repeat prescriptions to aid withdrawal, as well as offering ongoing
counselling and support to the patients.
The authors comment that pharmacist-led benzodiazepine withdrawal schemes
may not be the most cost-effective use of resources. However, despite this,
I have grave reservations about using technicians to undertake these roles.
I was under the impression that pharmacy technicians were supposed to be
undertaking dispensary-based roles to enable pharmacists to be released
to perform clinical roles such as that described in the article. My main
concern is that a technician will not have the same in-depth knowledge
of the area that a pharmacist would. Although the more superficial knowledge
of the pharmacy technician might be acceptable in most cases, I am sure
situations would arise when technicians would not be able to answer questions
put to them by the client — questions that a pharmacist would be
able to answer. In this circumstance, the technician will not have a pharmacist
on hand to refer to and would not be able to give an immediate answer,
with a potentially detrimental effect on that patient’s confidence
in the technician. In the pharmacies where I have worked, patients have
often been reluctant to speak to a technician about medicines management
issues, preferring to wait and speak to me when I am free, and I am sure
that the same might occur in clinical settings.
I am also concerned that giving technicians these additional roles might
lead to potential confusion for the public, perhaps causing them to think
that technicians and pharmacists are the same. With the requirement for
both groups to be registered with the Royal Pharmaceutical Society, it
is tempting to think that the boundaries are starting to become blurred.
I think that this situation has arisen for two reasons. First, pharmacy
technicians are cheaper to employ than pharmacists and, as I stated above,
pharmacist-led schemes may not be cost-effective. However, there is probably
not enough data to allow wider comparisons of the clinical effectiveness
of pharmacist-led versus technician-led services. Secondly, pharmacists
are still stuck in the dispensary because the necessary legal and ethical
changes to release them have not been made so they cannot leave their pharmacy
to undertake sessional work unless a locum is employed — normally
at the pharmacist’s expense, which is likely to be greater than any
remuneration received for undertaking the clinical work.
The obvious extension of this is that technicians will take on more and
more roles that could be fulfilled by either themselves or pharmacists,
leaving pharmacists trapped in the dispensary and unable to take on additional
roles. Finally, these new roles for prescribing support technicians are
taking pharmacy technicians out of the area where they are really needed,
ie, community pharmacy, where they can significantly lighten the load for
pharmacists and allow them to undertake the enhanced and additional services
in the new contract. If too many technicians are lost to primary care organisations,
I fear it is likely that pharmacists will not be able to meet the expectations
of the new contract.
Andrew Pothecary
Jersey,
Channel Islands |
The
Pharmaceutical Journal