Government and NHS officials have refuted a suggestion that the lines between pharmacists and pharmacy technicians are being 'blurred'.
Speaking at the Health and Social Care (HSCC)’s pharmacy inquiry this week, Birmingham (Erdington) MP Paulette Hamilton said she was ‘concerned’ about the way pharmacy technicians were being represented to the public, and claimed some were potentially ‘doing more than they’re qualified to do’.
Ms Hamilton compared the issue to recent concerns around physician associates (PAs) and suggested that the use of the term ‘pharmacy professionals’ for both pharmacists and pharmacy technicians may be ‘blurring the lines’ in the eyes of the public.
But pharmacy minister Dame Andrea Leadsom and chief pharmaceutical officer (CPhO) for England David Webb told the committee that this was not the case.
Ms Hamilton said: 'My concern is, [pharmacy] technicians are being represented to the public and to us as parliamentarians in the generic term pharmacy professionals, which I believe is blurring the lines.'
And she suggested that ‘too much’ might be being asked of pharmacy technicians.
'I'm just concerned with what we're trying to do with pharmacy, at the pace we're going, what we're asking of technicians - it's just too much at this point,' she said.
Ms Hamilton added: 'And what are you going to do with these independent practices that have got people lining up outside to pop in, they haven't got enough staff, you've got pharmacy technicians asking to do more and more, they're coming out, maybe doing more than they're qualified to do. How are we going to stop the same thing happening in pharmacy that happened with doctors?'
The Labour MP compared the issue to recent concerns around PAs, asking officials to listen to the concerns of pharmacists.
Ms Hamilton suggested that when PAs were introduced to work alongside doctors, 'after a little while, the roles were blurred and it did create a problem'.
Her comments follow concerns raised earlier this week by The Pharmacists' Defence Association (PDA) around pharmacy technicians 'being increasingly asked to undertake clinical tasks that hitherto have only been undertaken by pharmacists'.
In a letter to pharmacy minister Dame Andrea Leadsom, the PDA said that less than half of registered pharmacy technicians have taken the General Pharmaceutical Council (GPhC) approved NVQ level 3 qualification route to registration, with many existing pharmacy technicians having joined the register under a 'grandparent' clause when the profession became regulated in 2011.
'Our concerns about the rapid role expansion for pharmacy technicians mirror those raised by the BMA around the emergence of Physician Associate roles,' the PDA said.
And it added: 'The common use of the terminology "pharmacy professional" has the potential to mislead the public, it is neither appropriate nor helpful in taking pharmacy practice forward in a positive direction.'
In response to Ms Hamilton's comments at the pharmacy inquiry, Dame Andrea denied any ‘blurring of the edges’ between the two pharmacy professions and said: ‘There isn't an intention, or even a carelessness, that would enable pharmacy technicians to start practising above their training.
‘The idea is to improve patient access and patient convenience whilst retaining patient safety and therefore, to make the maximum use of the training levels of different professional people.’
Dame Andrea added: ‘It’s extremely unhelpful when parliamentarians somehow suggest that this is some kind of wild west or free for all, because that simply couldn't be further from the truth.’
Ms Hamilton responded that Dame Andrea was 'jibing' her and putting words into her mouth, saying that it was pharmacists that had raised concerns on this issue.
She added: ‘We have recently had an issue with our doctors with the [physician] associates … are we listening to what our pharmacists say?’
‘Please, let us work together, and listen to what other people are saying, to ensure the same mistakes aren't made that [were] made with the doctors, so we start off the way we mean to go on, and we don't just push people into doing things that perhaps they're not ready to do, or perhaps can lead us down the road where we are with the doctors right now,’ Ms Hamilton said.
Also speaking to the panel, chief pharmaceutical officer (CPhO) for England David Webb explained that the term ‘pharmacy professionals’ was used collectively as both pharmacists and pharmacy technicians are regulated by the General Pharmaceutical Council (GPhC) and subject to regulatory fitness to practice standards.
And he suggested that a recent government consultation on supervision may have ‘triggered some of the some of the feedback’ Ms Hamilton was referring to.
He said that with regards to pharmacy, ‘supervision’ was framed within a legal description of which activities must be undertaken by a pharmacist rather than other members of the team.
‘That's a very unusual position to be in and in most professions related to medicine, the bulk of that definition is held in regulatory standards not in the law,’ Mr Webb added.
And he said that the proposed changes ‘would enable supervision to be more of a matter for regulation and professional standards than being a matter of law, because case law tends to interpret supervision very narrowly’.
Mr Webb also said that a pharmacists’ role in making a clinical judgement about whether a prescribed item is appropriate ‘isn’t threatened by this change’.
‘This change, if it goes ahead, is about enabling oversight of the technical elements of a process to be appropriately delegated,’ he said.
‘It's not about blurring that clinical interface that the pharmacist may have with the patient,’ Mr Webb added.
He also said that the proposed changes around allowing pharmacy technicians to operate under patient group directions (PGDs) were ‘about appropriately skilled people being empowered to do the right thing’, ‘not about blurring boundaries’.
And he added that these would be roles that pharmacy technicians could take on over time as their competence develops.
‘These are not about day one roles, these are about roles that one develops into through a course of professional development, that you can then undertake at some point in the future when you have the necessary knowledge, skills and qualifications to do that.’
Nicola Stockmann, president of the Association of Pharmacy Technicians UK (APTUK), emphasised to The Pharmacist today that pharmacy technicians have been regulated and registered by the GPhC for nearly 13 years.
'During this time, pharmacy technician roles have evolved to recognise the changing healthcare landscape,' she said, adding that the Initial Education Training standards for pharmacy technicians were modernised in 2017 'to provide public assurance'.
'In addition, many pharmacy technicians have also undertaken post-registration education to reflect their scope of practice and contributions to patient services,' Ms Stockmann said.
'As the scope of practice for the entire pharmacy team expands with pharmacists’ independent prescribing and the potential impact of proposals on recent pharmacy consultations, autonomous registered pharmacy professionals are responsible for their practice and their continued professional development.
'Skills and competence of individual development to reflect the demand and expansion of scope must also be supported in the workplace environment,' she added.
And she advocated for the use of the protected title 'pharmacy technician' to 'encourage awareness of the valuable contribution pharmacy technicians make and provide assurance to the public of their regulated position'.
Ms Stockmann recently addressed ‘fearmongering’ around proposed changes to the role of pharmacy technicians, suggesting that proposed changes to supervision and PGDs will deliver increased access to care ‘for the patient’ and relieve pressures on the workforce.
In contrast to pharmacy technicians, PAs are not currently a registered profession, although plans are being made for them to be regulated by the General Medical Council (GMC).
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