Benchmark professions, say law and medicine, are metaphorically “fully-fledged”. The path to such prestige is long and hard. Researchers suggest typical step order.
Start by moving to full-time work within the occupation. Presently, pharmacy technicians work full and part-time.
Then, training schools and curricula with increasing standards and a distinct knowledge base are established. The existing NVQ Level 3 qualification or equivalent is only of A level standard. The degree level seems more appropriate.
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Third, creating a professional body to represent and lobby. The Association of Pharmacy Technicians United Kingdom (APTUK) agreed its name in 1966. Pharmacy technicians’ title became restricted in 2011 and registration with the General Pharmaceutical Council (GPhC), mandatory.
In the fourth stage, universally adopting the new title “pharmacy technicians” distances them from previous titles such as “dispensers”. But even “technicians” sound subordinate to “technologists”. Technicians excel in manual dexterity; technologists (including pharmacists) apply more underlying science.
Pharmacists' restricted title of “pharmaceutists” might be well-suited for pharmacy technicians. Note name agrandissement in (medical practitioner-led) hospital pathology laboratories: laboratory technicians became medical laboratory scientific officers, medical laboratory scientists to, today, biomedical scientists.
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The fifth stage is task delegation: sloughing off less technical duties to subordinates.
Next, restrict entry so newcomers must complete the new training. Pharmacy technicians have not yet constructed the pathway to that graduate-level qualification. One difficult area is to decide, negotiate and control how the knowledge base differs from that of pharmacists.
In the seventh stage, generational conflict arises between seasoned veterans and the new blood. Misunderstandings between generations are commonplace.
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Stage eight establishes autonomy. Separate from the parent profession. Become truly independent. Pharmacy technicians, long stultified in pharmacists’ shadow, no longer need pharmacists. Rewrite history so they become bit players.
The ninth stage is legal recognition: lobbying for legislation to establish a monopoly: “occupational closure”—a prize worth many battles. Pharmacists have long attempted for dispensing. They have failed.
Surely, dispensing by pharmacy technicians alone would benefit patients: pharmacists are too busy with face-to-face clinical practice to have time for dispensing and have forgotten how to dispense.
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The final stage is a code of ethics: the GPhC already provides. But those for pharmacists and pharmacy technicians do seem mingled; forensic separation seems advisable.
The aspirations of pharmacy technicians have parallels with the ongoing debate between medical practitioners and physician associates. In some guidance from the General Medical Council, medical practitioners and physician associates (typically with masters after bioscience degrees) were conflated as medical professionals. The British Medical Association objected through the courts.
Medical practitioners appear to be attempting to “clip the wings” of partially fledged physician associates before they can become a “fully fledged” profession. Similarly, the Pharmacists' Defence Association is considering legal action against the General Pharmaceutical Council about pharmacists and pharmacy technicians being amalgamated as “pharmacy professionals”.
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All around, other groups are jostling. Examples are anaesthesia associates and “first contact practitioners (FCPs)”. Typically, they started as physiotherapists, paramedics, occupational therapists, dietitians or podiatrists.
Requirements for FCP qualification include a postgraduate certificate or master’s, supervised practice and a portfolio of evidence. Nurse practitioners also need a masters. Within such congested territory, friction is predictable. Blurred boundaries may perplex patients about their present, face-to-face healer’s qualifications.
Pharmacy technicians do perform better than pharmacists in accuracy-checking proficiency. International meta-analysis suggests some evidence. However, pharmacy technicians aspire to extend their role to areas where they are underprepared. Significant untoward events involving pharmacy technicians operating within those areas would attract considerable public and regulatory attention.
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Jostling between pharmacists and pharmacy technicians may become sharp-elbowed. But no matter the difficulties, pharmacists and pharmacy technicians are stronger cooperating than fighting. They need each other.
“Dispensing 101” retains a double-checking system. Making errors is a consequence of being human. If the probability of person 1 making an error is p1 and person 2 making the error p2, the probability of both making the error is p1p2.
So, if say, one error in 100 (1/100) improves after the double-check to one in 100 X 100 = one in 10,000 (1/10,000). Such standard practice catapults patient safety upwards.
Pharmacists and technicians have long prevented career-limiting errors by working well with each other. And patients have benefited.
Dr Malcolm E. Brown is a retired community, hospital and industrial pharmacist, and is a sociologist and honorary careers mentor at the University of East Anglia.