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PDA: Pharmacy technician qualification levels ‘too low’ to handle PGDs

The PDA has raised “safety” concerns with MPs about allowing pharmacy technicians to supply medicines under PGDs.

Allowing pharmacy technicians to use patient group directions (PGDs) would leave patients “structurally exposed”, the Pharmacists’ Defence Association (PDA) said on Thursday (March 15).

The PDA has come out strongly against proposals from the Department of Health and Social Care (DH) that would allow pharmacy technicians to supply medicines under PGDs, in supplementary evidence for the health and social care committee’s (HSCC) pharmacy inquiry.

The pharmacists’ union urged the HSCC to give “serious consideration” to the effect on patient safety that may follow from expanding the professional competencies of pharmacy technicians to allow them to use PGDs, particularly given the launch of the Pharmacy First service.

Read more: UPDATED: DH launches consultation for pharmacy technicians to use PGDs

In August, the DH published a consultation proposing to allow registered pharmacy technicians in England, Wales and Scotland “in any setting” to supply and administer medicines according to the instructions of a PGD.

The DH is yet to respond to the consultation, which closed in September.


“Patient safety”


The PDA told the HSCC that its response to the consultation focused on issues of “patient safety” and whether the pharmacy technician workforce is able to “safely supply or administer medicines under the existing criteria for using a PGD”.

It told MPs that letting pharmacy technicians use PGDs like pharmacists would "blur the distinction between the two roles”.

Read more: GPhC publicly apologises after ‘pharmacist technician’ gaffe

And it warned that “role substitution” rather than skill mix could result, leading to “professional tension rather than collaboration".

"There are significant parallels to be drawn on this issue and the current debate around physicians associates [PAs] and concerns from the medical profession," the PDA said, referencing the recent upswell of sentiment against PAs from within the ranks of doctors in the UK, including from the British Medical Association (BMA).


Level 3 “just too low”


The PDA’s evidence acknowledged that pharmacy technicians are “valuable members of the pharmacy team” and stated that it supports a “skill mix model” in which a pharmacist’s “clinical training and expertise” is matched by a pharmacy technician’s “technical training and expertise”.

However, the PDA noted that pharmacy technicians “only have a basic level 3 qualification”, which is less than the “minimum” level 5 national vocational qualifications (NVQs) held by other healthcare professionals that use PGDs.

Read more: Pharmacy technicians granted powers to deliver more clinical services

The trade union said that “additional training requirements” a healthcare professional must complete before using a PGD are “not a substitute” for the knowledge required to make a “clinical assessment” on whether to supply or administer the medicine.

Pharmacy technicians’ “underpinning knowledge” is “just too low” to safely use PGDs, the PDA added.


Grandparent worries


Meanwhile, the PDA also told the committee that “around 50%” of the pharmacy technician workforce were registered using a “grandparent” clause, according to a freedom of information (FOI) request that it had submitted. 

It said that when the register was created in 2011, pharmacy technicians were entered into it if a pharmacist had signed off that they were “competent to be registered”.

However, it noted that there were no records of “any assessment” of pharmacy technicians’ qualifications used during this process.

Read more: UPDATED: DH launches long-awaited pharmacy supervision consultation

It said that the “vast majority” of pharmacy technicians working in community pharmacy were “predominantly ‘grandparented’”.

The PDA drew the committee’s attention to remarks from 2014 by the former chair of the General Pharmaceutical Council (GPhC) that pharmacy technicians had “very variable standards” because of the grandparenting process.


APTUK: “Same professional standards”


President of the Association of Pharmacy Technicians UK (APTUK) Nicola Stockmann told C+D that permitting pharmacy technicians to use PGDs would be a “welcome systemic change”.

Ms Stockmann emphasised that pharmacy technicians are “held to the same professional standards as pharmacists” as a “registered autonomous healthcare profession”.

She said that the proposals would allow “widening of healthcare access” and the “professional recognition of pharmacy technicians”, adding that the consultation “must be recognised for the opportunity it is”.

Read more: Nicola Stockmann takes up ‘prestigious’ role as APTUK chief

The proposals would allow a pharmacy team’s skills to be “utilised fully”, leading to “an expanse in potential delivery and access of pharmacy services”, she told C+D.

It comes as the DH is also considering responses to a consultation on plans to grant more authority to pharmacy technicians in dispensing and refer to pharmacists “only where necessary”.

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