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Letters to the Editor
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Pharmacy technicians
Ridiculous argument
From Mr C. O. Agomo, MRPharmS
Jackie Bayley’s argument (PJ, 23 April, p490) that, after 20 years
of working as a technician, she now has a greater knowledge than a newly
qualified pharmacist is ridiculous. Is her acquired knowledge in the
form of work procedures and operating certain gadgets which, as would
be expected, a newly qualified pharmacist will be lacking, or is she
telling us that after acquiring an NVQ 3 or even an NVQ 5 certificate
she knows more about the application of pharmacology, pharmaceutics,
clinical pharmacy, biochemistry, physiology, anatomy, pharmacognosy and
pharmaceutical chemistry to deliver the right medicines to a patient?
Such comparison is like convincing the public that after 20 years of
work, a nurse becomes equivalent to a newly qualified doctor, or that,
after about the same period, a court secretary becomes equivalent to
a newly qualified lawyer. I do not think people will be convinced as
it is only in pharmacy that such beliefs seem to exist regularly.
I recently had a situation in which a pharmacy assistant who may soon
become a technician dismissed a patient who requested treatment for ringworm
because she thought ringworm was similar to hookworm. When I explained
that ringworm is a fungal infection that could be treated over the counter
without referral to a GP she was surprised. This goes a long way to show
the limitations and differences in training and, if I am right, the argument
which Andrew Pothecary (PJ, 9 April, p42) was trying to convey.
There is no doubt that technicians are useful in any pharmacy set up,
but their knowledge and training should be considered before allocating
jobs to them. Maybe it is the similar positions and salaries offered
in the public sectors to pharmacists and technicians that is helping
to create this illusion, not to mention the lack of a body solely in
charge of projecting the worth of pharmacists to the public without the
handicaps of regulatory duties.
Whatever happens, patients seem to know the difference.
Chijioke O. Agomo
London
Technicians must work with pharmacists to benefit patients
From Ms S. Vize
It is reassuring to know there are pharmacists and technicians who enjoy
successful professional relationships as part of a team, rather than
competing against each other — the situation that some recent letters
would suggest. I agree with Anthony
Young and Joanne Cant (PJ, 23 April,
p490): much of the recent correspondence has been disappointing. As stated,
it should not matter who does which role, as long as personnel are qualified
and competent.
Jackie Bayley (ibid, p490), speaking up for technicians, states that
they would not perform a role outside their area of competence “without
having knowledge to do so”. Then, however, she goes on to declare
that she has “more knowledge” than a newly qualified pharmacist.
I qualified as a technician in 2002 and I am now half way through the
MPharm course. It goes without saying that technicians will have more
work experience than a newly qualified pharmacist, especially if they
have been doing the job for 20 years. This is not helped by the lack
of practice placements on most undergraduate courses.
On the question of knowledge though, I cannot agree. There is little
point to a four-year degree at university if technicians have enough
knowledge to do the job “as well as a pharmacist”. From the
position I am in now, I can say that while I was competent enough to
perform an efficient technical role, I had not received training that
gave me the required skills or in-depth knowledge to perform the role
of a pharmacist.
Maybe Ms Bayley should start to think outside the scope of her own practice,
and consider the variety of roles that pharmacists now train to undertake.
The boundaries are fuzzy, but technicians and pharmacists can both explore
new roles and this should be welcomed. Rather than declaring war on each
other, we need to be working together and recognise what each other can
do, for a common purpose — the benefit of the patient.
Sarah Vize
Southsea,
Hampshire
Experience as part of a pharmacy team is not enough to make you a pharmacist
From Mr B. Doro
I read with surprise recent comments by some pharmacy support staff,
more so that such comments come at a time when the Royal Pharmaceutical
Society is developing a laudable framework for this group through voluntary
registration and co-ordinated training. Some overzealous members of this
group seem to be moving faster than their feet already. I am concerned
because any form of pressure from within is a potential threat to the
profession’s effort to advance the course of pharmacy, and may
impede moves to develop roles to make use of the skills that pharmacists
already possess.
In one letter (PJ, 16 April, p452), J.
Gibbs concluded that she is well
positioned to perform the role of a pharmacist. And Jackie Bayley (PJ,
23 April, p490) insinuated that having practised as a technician for
20 years, she is more capable than a newly qualified pharmacist. I find
this claim unwarranted.
No amount of experience can make pharmacy support staff fit to assume
responsibilities of a pharmacist. There is a laid down professional requirement
and this is open to all. Other health professionals I know will not let
go of this insult without an official response. All newly qualified health
professionals (doctors, pharmacists, nurses etc) are bound to face challenges
when they start to practise. This does not suggest lack of relevant knowledge,
but the need to practise applying it to situations. But this transition
does not take ages.
Pharmacists who only see themselves as professional dispensers must learn
from these challenges and take advantage of the current move towards
skill mix to trust others with the act of dispensing and to prepare themselves
for the new roles evolving through the new pharmacy contract.
Bernard Doro
London
What data suggest technicians can do job as well as pharmacists?
From Mr A. J. Pothecary, MRPharmS
After reading some of the responses to my
letter regarding the extended
roles for technicians (PJ, 9 April, p421), I believe that I should defend
my position.
My original letter did not mention technicians working in a hospital
environment at all, and some of the responses seemed to have missed this
point. Irrespective of how many years’ experience a pharmacy technician
has, at the end of the day whether a mistake is made it is a pharmacist
who will ultimately be held accountable, regardless of if they have been
qualified for 10 years or 10 days.
J. Gibbs (PJ, 16 April, p452) points out that technicians are keen to
perform some of the tasks of pharmacists, yet readily accept the lower
wage.
The point is, technicians only perform some of the tasks — hence
the lower wage. They cannot, legally, perform many of the tasks that
pharmacists can.
I may not have made it clear that my concerns specifically related to
technicians working, without pharmacist supervision, in extended roles.
Jackie Bayley comments (PJ, 23 April, p 490) that she would not counsel
patients without having the knowledge to do so, yet she claims to have
heard newly qualified pharmacists “bluffing their way through queries”.
Exactly how and why are technicians now qualified to make a judgement
on whether or not a pharmacist knows what he or she is talking about?
As I suggested in my earlier letter, if a technician is asked by a patient
they are working with (eg, in a benzodiazepine withdrawal clinic) a question
which falls outside their knowledge, what do they then do? In a community
or hospital pharmacy setting, it is only a minor inconvenience to refer
to the ever-present pharmacist who currently is legislatively chained
to his or her dispensary bench. In a GP surgery, this support will not
be at hand. I am convinced that this will damage the image of that technician,
the profession of pharmacy, and whatever project is being undertaken
in the eyes of the patient.
I am sure that if a patient attends a technician-led clinic and presents
a query that the technician is unable to answer, but which a pharmacist
could have answered, that patient is unlikely to be willing to participate
in future pharmaceutical care initiatives.
Jackie Bayley said she would like to see data that suggest that technicians
cannot do the job as well as a pharmacist. I would like to see data that
suggest technicians can do the job as well as pharmacists. Furthermore,
I do not feel insecure about technicians taking over (I have actively
encouraged technicians I have worked with to train as accredited checking
technicians) but I am concerned about the potential impact that using
technicians in these newly developing areas may have on the future development
of the pharmacy profession.
Andrew Pothecary
Jersey, Channel Islands
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