The debate around pharmacy supervision laws has been rumbling on for years. The rationale for change often cited is to allow a better skill mix and to maximise the full range of skills within pharmacy teams. This poses several questions, which we wish to give our views on:

1.  Do current supervision laws maintain a safe mechanism for supply of medication to patients?
2.  Do the current supervision laws prohibit the full use of a pharmacist’s skills and inhibit the use of the full range of skills within the pharmacy workforce?

We have the greatest respect for our pharmacy technician colleagues. However, it is important to note that the training offered by a four-year MPharm degree is not the same as that for a NVQ3 technician, and it most certainly does not confer the same ability to oversee pharmacy sale and supply. This is rather obvious, but the point needs stating as some people in authority appear ignorant to this fact. This is most probably due to having never (or not for a long time) worked in a community pharmacy.

Pharmacies have a vital patient safety role, which has been well served by pharmacies operating under the supervision of a pharmacist. Pharmacists, with their high level of expertise, overall accountability and ability to have input into the supply function at the point of supply for every transaction, ensure this safety. We must maintain a pharmacist presence as a red line for protecting patients.

As form follows function, so to the reason to change the supervision law should match any proposed change. What is the overarching strategy that amending supervision law is trying to achieve? There are barriers stopping pharmacists taking on new, more clinical roles, but supervision law is not one of them. The reality is that the barriers include, for example, up-skilling for more clinical services (training) and resource to free-up time for pharmacists (skill mix). The lack of momentum following the Murray review and the apparent lack of faith in pharmacy by those in NHS England are far more significant factors.

We would argue that the appropriate use of the skill mix within pharmacies is driven by financial priorities, not by supervision laws. Funding for pharmacy services through the contract framework does not incentivise or drive pharmacies to do anything other than supply medicines to patients in the most cost-efficient manner possible. It is this efficiency, driven by funding demands and constraints, which can perversely inhibit skill-mix utilisation. It is not supervision in pharmacies creating the barrier. The solution to this part of the debate is to make changes to the funding model, to provide funding which demands that the under-utilised resource of community pharmacists is freed up.

It follows from this that we should couch our discussions around skill-mix utilisation in terms of funding and service delivery, not in terms of supervision. Full utilisation of all team members is a big part of the solution. Indeed, having a General Pharmaceutical Council-registered checking technician in every community pharmacy, completing the technical roles in the dispensary, should be the goal.

Conversations about technicians supervising pharmacies are a distraction from what we really need to be talking about: skill mix and new service delivery. This is the most important conversation we need to be having right now.

Martin Astbury is vice president of the International Pharmacy Federation’s community pharmacy section and has twice served as Royal Pharmaceutical Society (RPS) president

David Gallier-Harris is a pharmacy manager for a large multiple in the West Midlands, and a member of the government’s board to “rebalance” medicines legislation and pharmacy regulation. He is also running as a candidate for the RPS’s English pharmacy board