Technicians — include or exclude?
| In this article, Steve Morris, chairman
of the Faculty of Prescribing and Medicines Management board, asks
who will support pharmacy technicians |
The Faculty of Prescribing and Medicines Management
(FPMM) was the first faculty set up under the College
of Pharmacy Practice (CPP)
to support the development of specialist areas of pharmacy practice.
Created in 2001, it provides a strong and influential professional support
body for UK pharmacists working, or with an interest, in prescribing
and medicines management.
Current membership of the FPMM mainly consists of pharmacists working
in primary care, either in GP practices or primary care organisations,
but the faculty’s
appeal to community and hospital pharmacists has the potential to increase
as demonstration of competence becomes imperative to career development
and remuneration.
As roles within pharmacy start to change, the skill mix debate is picking
up momentum. Causative factors include the new community pharmacy contract,
Agenda for Change and problems with
recruitment and retention. Along with the development of new roles for
pharmacists, the contribution of support staff will also change, with
the possibility of relaxation of supervision at the forefront of the
debate.
Extending faculty membership
The FPMM is starting to address the implications of altering
the demographics of the pharmacy workforce. The articles of association
of the CPP currently
only allow UK registered pharmacists to join it. The question is, therefore,
should the CPP open membership to pharmacy technicians or keep it within
the preserve of pharmacists practising at the cutting edge of medicines
management. The CPP has decided to consult on
extending its membership base and this consultation with its members
will take place in the next few months.
There are arguments both for and against allowing technicians to join
the CPP. Many would argue that the pharmacist in charge of a pharmacy
should be able to delegate control of the pharmacy to a responsible person
(such as a pharmacy technician). And this person should be registered
with a professional body. Registration of the delegated person will allow
standards for conduct and responsibility to be developed. The Royal Pharmaceutical
Society has already started to register technicians. Like pharmacists,
the delegated person should be trained, accredited and reappraised annually
via nationally-agreed competency frameworks.
Clinical governance arrangements should underpin community pharmacy developments
and pharmacies must actively engage with primary care organisations to
develop new approaches and to become accredited. Loss of registration
must be the ultimate
sanction for the responsible pharmacist or delegated person, or both,
if clinical governance standards are not adhered to, with
the pharmacist in charge of a pharmacy taking overall responsibility
for events in the
pharmacy.
If pharmacists are allowed to devolve a
degree of responsibility to properly trained and registered technicians
for the dispensing process or if technicians are to play a substantial
role in medicines management, it would seem logical that they be supported
by organisations, such as the FPMM — increased
responsibility cannot be expected without substantial support arrangements
being put into place. The FPMM supports pharmacists through workshops,
accreditation of events and materials and conferences, and it might not
be much harder to provide for non-pharmacists within these support arrangements.
This might also foster closer working relationships and enhanced recognition
of roles
between the different people working within the medicines management
arena.
Conversely, would opening doors to a wider membership diminish the appeal
of the FPMM to its core members? As a fledgling organisation, the infrastructure
of the faculty and its capacity to provide core services for its current
members need to be considered. Although the role of technicians is, without
question, recognised and valued, it is a different one from that of pharmacists.
As such, different views and different support requirements would need
to
be accommodated. Technicians might
require representation at board level and this could lead to a dilution
of existing resources. Some think that the FPMM should consolidate its
support for pharmacists before trying to stretch itself (too thinly)
across other professions. Competencies
Underpinning faculty membership is a set of competencies
centred on medicines management. To achieve full FPMM and CPP membership,
associates must
demonstrate attainment of these competencies. Continuing professional
development and reflective thinking around competencies is something
that all pharmacists are having to come to terms with and the FPMM
is currently reviewing its competency framework to ensure it is both
relevant and congruous with other nationally recognised requirements.
Should non-pharmacists working within medicines management be assessed
against the same competencies as pharmacists or should a different
set of skills be demonstrated? If the same, then it could be argued
that
there is no difference between pharmacists and non-pharmacists. Conversely,
some would say that the public have a right to expect standardisation
of skills if limited responsibility is to be devolved. In any event,
if non-pharmacists are to be supported by the FPMM then should demonstration
of an alternative set of competencies result in full FPMM (and hence
CPP) membership or should that remain the right of pharmacists only?
Moving forward
In summary, the CPP’s options are simple: · Retain the status quo and allow only pharmacists to become associate
and full FPMM members
· Allow non-pharmacists to become associate FPMM members only
· Allow non-pharmacists to become both associate and full FPMM members
We will either end up with a specialised pharmacist workforce within
medicines management, supported in depth by its own faculty, or a multifaceted
team with, perhaps, a stronger focus on breadth rather than depth of
support. Consultation will be the key. |
