What is a pharmacist’s job nowadays? Yesterday, it included phoning a manufacturer because my ‘quota’ for a not uncommon antipsychotic was one box for the whole month, countersigning the balance in today’s volume of five CD registers, persuading a patient to sit in a room with me while I tell her what she already knew about her medicines so I can claim £28, and so on and so on, and that’s before I’ve made a single clinical decision!I thought that after training up pharmacy technicians and ACTs, this utopia of skill mix would mean we could properly fulfil our professional, clinical roles. “Don’t be an overpaid dispenser,” they said, “get the staffing skill mix right and the services will follow.” Well today I was the one at a training event, but when I got back in the evening I was greeted by Mrs Xrayser who said: “I did an MUR this afternoon!” I frowned – as she is a pharmacy technician – and waited for her to explain.“Well, this patient came in, and he had this script for bisoprolol, and he said ‘Am I going to die because I’ve got heart failure, and my doctor didn’t tell me anything..?’, and as we’d been on this CPPE course on heart failure I explained what his bisoprolol did, and about his statin, and his ACEi. Then I reassured him he was at a very early stage, and he said I’d been so much more help than the locum GP, and... why are you looking at me like that? What’s that if not an MUR.”Of course, I was looking pleased for her, proud that she had done so well to help that patient, and frustrated that the ludicrous MUR regulations mean that the work she had done was worth nothing in the eyes of the NHS. Whereas if I had sat in a room just to tell someone about their aspirin, that’s 28 quid thank you very much. And strangely, I had had just the same conversation during the day with the nurse training us to administer flu vaccination. When I asked her how the GPs can get a nurse or healthcare assistant to give the flu jab – but for us it has to be under a PGD and only pharmacists could do it, not pharmacy technicians – she agreed it was a nonsense, but all to do with insurance.Now I realise it’s also to do with statutes, and acts of parliament, and so forth, but I don’t know if it’s down to the DH or PSNC or even our PLB to sort this mess out. All I see is that Mrs Xrayser as an ACT is checking prescriptions and fielding clinical queries – including now supporting heart failure patients – while I’m shut in a room doing what a healthcare assistant should be doing. Am I the only one who thinks this is back to front? It seems skills in pharmacy are definitely mixed up.