Safety first. Right?

Everyone in pharmacy knows the risks. Everyone is aware that a methodical system of dispensing exists for a reason.

It’s why there was a mixed reaction to the news that the government would allow pharmacy technicians to carry out one-to-one consultations, prescribe and dispense medication, and give people injections.

Whether that makes you excited or uneasy, you’d likely agree it shifts the level of expertise required to perform these functions.

The PDA is not keen. Mark Koziol, the Pharmacists Defence Association chairman, said it was “extremely disappointed” the government had “pressed ahead” regardless of the “patient safety concerns” it had made clear to them when it was consulted on the plans.

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

He agrees pharmacy technicians have a “key role” to play supporting pharmacists. But the PDA does not support what it says is the “simple role substitution” happening now. 

Also reacting to the news, AIMp CEO Leyla Hannbeck said: “A pharmacist spends five years at university to train and become a medicine expert. A technician’s training is on an NVQ level.”

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

These distanced levels of education are countered by the fact you can have very experienced pharmacy technicians and very inexperienced pharmacists. The roles are different. And Pharmacy First is new to everyone. 

“I know how uncomfortable some pharmacists are doing Pharmacy First consultations,” says locum pharmacist Tohidul Islam. “And now they want technicians to do them? There are lots of people that are not comfortable diagnosing things like shingles.”

He goes so far as to say some pharmacists have felt “forced” into doing them.

“There has been a lot of strongarming, so how this is going to help I don’t know. We were expecting the government to have a bit more discussion with the industry.

“The RPS is going along with what the government and what the large employers want with very little care about what the profession itself wants, or what is good for us. The government wants to cut corners, they want to cut costs.

“It’s cheaper, and it’s one step closer to remote supervision. It’s a disaster waiting to happen. If my family were going to a pharmacy and they were seen by a technician I would be very, very uncomfortable.”

Read more: GPhC pharmacy technician standards must ‘keep pace’ with changing role

After Pharmacy First launched, Islam took his daughter into a pharmacy because she had a sore throat, and he was “not happy with the way it was dealt with”.

He says the pharmacist “admitted he wasn’t really trained, all he did was read out the PGDs, he didn’t know what an affected tonsil looked like, I had to point it out to him. If the pharmacists aren’t confident then I don’t see how technicians with very little training will be.”

It’s an isolated example, and it’s hard to imagine there are too many pharmacist technicians out there that couldn’t recognise tonsilitis, which a child could spot.

But it’s easy to see why an inexperienced pharmacy technician may feel overwhelmed after a long day of one-on-one consultations, diagnosing and prescribing medication for minor ailments, illnesses, and more serious conditions like shingles, in between administering injections to jumpy adults and wriggling children.

“I don’t know how any technician in their right mind would want to take on this role when they have no training, they are on minimum wage, they are already overworked and underpaid,” says Islam. “It’s not looking good.”

But that depends on who you ask.

A lot of pharmacy technicians think it’s excellent news. Confidence is riding high on social media. It’s an overnight upskill, a magic qualification.

The Association of Pharmacy Technicians called it a “landmark moment” and said it would allow technicians to fully realise their potential. Others called it “fantastic news”, a “milestone”, a “pivotal change” and “amazing news”.

The Royal Pharmaceutical Society also offered its support.

“Enabling pharmacy technicians to undertake further services under a PGD will increase capacity for pharmacy teams and further support consistency of services being offered within pharmacy,” it said following the announcement.

“In keeping with wider discussions across pharmacy, it is essential that the accountability and professional responsibility of pharmacy technicians is clearly understood in situations where PGDs are being used.”

The mention of accountability is a crucial point for an industry in reform. The increased safety risks to patients are largely apparent and understood, despite the enthusiasm displayed on social media. Less experience means more mistakes and death is on the line.

As one pharmacist told GMB on the day the news was announced: “We are not getting beans off a shelf. We are dealing with life and death medication. If we make a mistake, there are consequences.”

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

And as much as the safety of patients is paramount, the safety and wellness of these pharmacy technicians – and their long-term careers – is also vital as they are elevated into this new and dramatically more pressurised role.

The PDA has said it will “continue to press the government and the GPhC for a safer approach and much more appropriate training and qualifications for the delivery of PGDs.”

The APT has also launched what it describes as the “first in a series of supportive documents to educate and support” pharmacy technicians in their new roles.

And the GPhC has launched a consultation as it looks to ensure that anyone working in pharmacy is as skilled as they could possibly be.

For the safety of all concerned it’s likely more training opportunities will follow as the reform of pharmacy continues.