The recent study by Pharmacy Research UK has thrown into question the roles and responsibilities of pharmacy support staff, and in particular pharmacy technicians

Anyone who has worked in a pharmacy for even half an hour knows the difference good support staff make. In a pharmacy where everyone knows what they are doing and does it well, and understands and trusts everyone else’s roles and responsibilities, the business runs smoothly. Everybody in the team feels motivated and happy, and enjoys their work. Customers and patients pick up on this, and have faith in the services and advice they receive. It’s a win-win scenario.

Yet in many pharmacies, this isn’t the case. There is confusion over who does what, and staff members feel uncertain about their colleagues’ knowledge and capabilities. This leads to a reluctance to delegate tasks, and a tendency – particularly for the pharmacist – to double check everything that goes on. This duplication of work leads to stress, poor morale and an unenjoyable work environment. Chances are, the customers pick up on the tensions that exist between staff, which may lead to them having doubts about the pharmacy. It’s a vicious cycle.

Study insights

This latter scenario was laid bare in research recently published by Pharmacy Research UK. A team at the University of Manchester’s Pharmacy School interviewed and surveyed pharmacists and support staff working in hospital and community settings, and the differences were startling. Community pharmacists appeared reluctant to relinquish control, voicing concerns about staff competence and their ability to recognise their limitations. Hospital pharmacists, who tend to work away from the dispensary on a regular basis, appeared much more open to certain activities taking place during their absence.

Uncertainty was not restricted to community pharmacists. While hospital pharmacy technicians embraced the responsibilities that accompany being a registered healthcare professional, many support staff in community pharmacy seemed unsure. There was also dispute between the various groups (in terms of sector and qualification level) over the tasks that could be safely performed in the absence of a pharmacist (see box).

One task in particular that has caused controversy is the accuracy checking of prescriptions. Steve Acres, president of the Association of Pharmacy Technicians UK (APTUK), commented: “I am very surprised that this came out as a ‘borderline’ task when it is part of a pharmacy technician’s core role. In hospital pharmacy, this task is almost always carried out by pharmacy technicians.”

Ellen Schafheutle, principal investigator of the study and senior lecturer in pharmacy law and professionalism at Manchester University’s Pharmacy School, comments: “An interesting finding of the study was that familiarity with the team influenced opinion. A locum pharmacist who only worked occasionally in a pharmacy had very different views to an employee pharmacist who worked in the same pharmacy all of the time. It shows how familiarity and experience is gained by working with a team on a regular basis.”

Perhaps more surprising was the discovery that those working in community pharmacy seemed unclear on who could do what. Dr Schafheutle says: “There seems to be a lack of distinction in the roles of technicians and other support staff in community pharmacy, unlike in hospital, where roles, accountabilities and responsibilities seem much better understood.” This confusion extended to the level of training that various members of staff had undertaken, with the study authors highlighting the need for clarity on this topic.

Right here, right now

Heidi Wright, Royal Pharmaceutical Society practice and policy lead for England, agrees with this recommendation:

“I think every community pharmacist would agree that having the right team around you makes working in a pharmacy much, much easier, and we need to overcome any uncertainty about the knowledge and skills of, say, a medicines counter assistant compared to a dispensing assistant. I think there is a willingness profession-wide for this to happen.”

The publication of this research is timely, in light of the debate currently bubbling about revising models of supervision in community pharmacy. The study rightly points out that pharmacy technicians – as registered healthcare professionals – are the appropriate people to be in charge of a pharmacy if the pharmacist is absent (as is allowed under the Responsible Pharmacist regulations). However, the research highlighted that more clarity is needed on various support staff qualifications and related competences as well as the required responsibilities and accountability of support staff.

And with pharmacists finally getting recognition for being the experts in medicines that they are, they need to get out to patients, wherever they are. Understanding and trusting the staff who remain in the pharmacy during their absence is the only way this new model of care can work.