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Make supervision law ‘less inflexible’, says Wales’s chief pharmacist

Community pharmacies need the law on supervision to be “less inflexible”, and certain activities could continue under the supervision of pharmacy technicians, the Welsh chief pharmaceutical officer (CPhO) Andrew Evans has said.

“We need legislative change around supervision,” Mr Evans told delegates at the Pharmacy Show in Birmingham earlier this week (October 17).

Pharmacists should “understand and work with pharmacy technicians, who would be very happy to carry on much of the business of the pharmacists without them being directly supervised”, he said in response to a question from the audience following his keynote address.

It seems “completely wrong” that “autonomous” registered professionals such as pharmacy technicians need to be supervised by a pharmacist, Mr Evans added.


Law needs to be clarified


Speaking to C+D after the session, Mr Evans said that pharmacy technicians are often “appropriately trained” and work under established procedures and systems.

“Provided that the responsible pharmacist in the pharmacy is comfortable, then activities within the pharmacy should be able to go on under the supervision of pharmacy technicians,” Mr Evans added.

“Supervision can be in some circumstances interpreted too literally,” he continued.

Read more: ‘Daft bureaucracy’: Shadow health secretary questions supervision rule

While he believes that every pharmacy should have a pharmacist, he thinks “we should be open” to the possibility of pharmacy technicians carrying out certain activities when the pharmacist is away on a professional visit or in the consultation room.

But he feels that the law on supervision needs to be clarified further, suggesting that the Department of Health and Social Care (DH), NHS England (NHSE) and the Pharmaceutical Services Negotiating Committee (PSNC) are looking at making changes to the law “before the end of the five-year agreement”.

PSNC was unable to comment. C+D has approached the DH and NHSE for comment.

Under current legislation, pharmacies can only continue to sell general sale list (GSL) products in the absence of a responsible pharmacist.


Supervision law updates

Conversations around pharmacy supervision resumed in early 2021 with the formation of a Community Pharmacy Supervision Practice Group.

Meanwhile, in April this year, the DH published its response to a consultation on rebalancing medicines legislation and pharmacy regulation programme, in which it wrote that, subject to parliamentary approval, the power to decide when a responsible pharmacist can be in charge of more than one pharmacy should lie with the regulators.

Those who disagreed with the proposal “repeatedly” cited concerns about remote supervision and fears over patient safety, the DH noted.

But it wrote that supervision will be subject to further discussion under the cross-sector supervision practice group.

However, Association of Independent Multiple pharmacies (AIMp) CEO Leyla Hannbeck told C+D yesterday (October 19) that the group is still in the process of appointing a chair, and there have been no official meetings yet.

Pharmacy technician workforce support


Mr Evans and his deputy CPhO Lloyd Hambridge laid out the Welsh government’s priorities for how community pharmacy should be transformed in Wales during their address at the Pharmacy Show.

Mr Evans stressed how important it was to “build capability” to ensure both pharmacists and pharmacy technicians are equipped “to deliver for the NHS and patients”.

Meanwhile, Mr Hambridge said that as pharmacists are asked to take on more clinical roles, it is important to ensure that “pharmacy technicians and the wider pharmacy workforce is supported”, too.

They should be able “to either take on roles that were previously undertaken by pharmacists or develop services and supporting those in their own right”, Mr Hambridge continued.

This is why the government has worked with Health Education and Improvement Wales to provide community pharmacy employers with access to pre-registration pharmacy technician training – part of a two-year incentive scheme to encourage contractors to embrace the skill mix in community pharmacy – he added.


Technicians could safely hand out “majority of medicines”


Liz Fidler – senior professional advisor for pharmacy technician practice at NHSE, who also attended the Pharmacy Show – told C+D that pharmacy technicians could safely hand out the “majority of medicines”.

“They are registered healthcare professionals and work within a scope of practice,” she said.

They are able to identify and action a referral, if required, she noted.

“Complex regimens may be identified at the clinics screening stage as requiring a pharmacist but the majority of medicines could safely be handed out,” she said.

“Pharmacy technicians are well placed to support more clinical services, which could be enabled by changes to supervision and other areas of legislation,” Ms Fidler added.

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