Technicians do it better

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Techs have an integral role to play in the pharmacy team – but how can we make training and certification more consistent, and increase opportunities to advance practice?

The pharmacy support workforce is “very strong” but there is a lot of variation and inconsistency around education, according to Andrew Matthews, General Manager of Workforce Transformation at the SHPA.

“One of our frustrations is that the current competencies are not actually leading to the types of technicians that we want,” he said at the Medicines Management Conference held in Sydney this month.

“Some employers are preferring to take UK qualifications. There’s been a lot of dissatisfaction with the certification right now. So hopefully soon we’ll be revising the standards of practice.”

And while pharmacy techs/assistants are employed in 95% of hospital pharmacies across Australia, there’s a large variation of activities undertaken by this professional group, he added.

Unlike the pharmacist workforce, the pharmacy technician/assistant workforce is not regulated nationally.

According to senior pharmacy technician Lorah Hickman, “there is a very inconsistent baseline for what we expect entry-level technicians to be”.

She said requirements for becoming hospital pharmacy tech in Australia vary from state to state:

  • Some states accept no qualifications;
  • Some states accept overseas qualifications;
  • Some states accept Certificate III or Certificate IV from the health training packages;
  • Some accept qualifications from the retail service training packages.

In Australia, a Certificate III qualification prepares technicians to “provide a range of assistance to pharmacists, including maintain imprest, packing product, dispensing and ordering,” explained Ms Hickman.

Meanwhile the Certificate IV allows them to take on more complex roles.

“Although these qualifications are the most established pathway, there are concerns about what is available,” said Ms Hickman.

“We found there is dissatisfaction about the face-to-face learning that is available, and lack of time spent in workplace environments to complete these qualifications.

“There were also concerns with lack of contact with pharmacists throughout the course.

“We need to look at a way to build a bridge between where we are now and where we want to be.”

Positive changes could allow pharmacists and technicians to take on new roles and improve patient outcomes, she suggested.

“There are very different enterprise agreements in each state about what skills technicians need to have to progress in their career path,” said Ms Hickman.

“There is also a lack of incentive and inspiration.”

She also mentions a turf war between pharmacists and techs, mentioning that some pharmacists may be concerned that technicians will take their job.

Mr Matthews says the SHPA is trying to improve consistency around technician training, and also get vocational courses subsidised.

“We’re hoping that at least in Queensland there’s potential for subsidies for employers and people taking on the courses.”

Technicians do it better

SHPA has also been looking at the role of pharmacy technicians as accuracy checking technicians – something that already occurs in the UK.

Eleanor Kelly, an Australian pharmacist working in the UK as a hospital pharmacy dispensing assistant, told Post Script recently that it is usual practice for pharmacy technicians in the UK to check and issue prescriptions.

“It works like this: once registered, UK technicians can achieve an ‘accuracy checking’ qualification. This enables them to make the final ‘accuracy’ check on a prescription before it is issued, rather than the pharmacist doing this,” said Ms Kelly.

“A pharmacist needs to clinically screen the prescription after it is written though.”

She says the process is as follows:

  • Prescriber writes prescription;
  • Pharmacist clinically checks it, makes any annotations and countersigns;
  • Dispensary staff dispense it (assistant or technician);
  • A technician with an ‘accuracy checking’ qualification makes the final check;
  • Prescription supplied to patient and counselling provided if needed (usually by the technician, sometimes the pharmacist).

“The training for the ‘accuracy checking’ qualification occurs in the workplace, and involves coursework and on-the-job practice,” Ms Kelly continues.

“From my observations, it’s an excellent system. It hugely liberates the pharmacists to focus on clinical care and spend most of their time with the patients.

“I would wholeheartedly recommend this system of having more qualified dispensary technicians for Australia.”

According to Mr Matthews, a new time-in-motion study has been conducted that looked at both pharmacist-only checks and accuracy checking pharmacy technicians.

“To no surprise to anyone in the room, the technicians did it better. There were less errors and they did it faster,” he said.

Lack of opportunity?

There are also reportedly issues with limited career structure and the lack of opportunities to advance practice for pharmacy technicians.

“We’re very keen for that status quo to be changed dramatically,” said Mr Matthews.

He said there is a need to develop an environment where technicians and assistants have a “sound understanding of their role”, with national certification.

“Why do we need to change, to make that step? Clearly the pace of change is quite fast in the world today, and we need to be able to continue to deliver effective healthcare,” said Mr Matthews.

“The pharmaceutical workforce is not just about pharmacists, it’s about the whole pharmaceutical workforce including our technician and assistant colleagues.”

Mark Clifford, a Senior Pharmacy Technician at Westmead Hospital, says there is a need to develop a clear career pathway for technicians.

 “Because there’s such variety, techs don’t necessarily see career progression, they just see it as a job,” he said at Medicines Management Conference.

“There is a need for a ‘cultural shift’ to pull everyone together.”

Mr Clifford said that if overseas patterns are reflected in Australia, “we will have a very different workforce in the future”.

“From a technician perspective this would include registered technicians, accuracy checking technicians and many other expanded roles.

“Let’s not reinvent the wheel here – we know what has worked overseas successfully and what will / will not work here. Let’s embrace the change and build on the momentum we already have.

“Pharmacy is a very small world, but there’s this habit of going back to work and putting our blinkers on, getting on with the day – and things just getting talked about but nothing gets done.

“There’s all this talk of doing more, but let’s not forget the techs and assistants in hospitals that are only ever doing imprest, and we look at ourselves and think we’re way behind.”

“So we need to foster relationships with these other hospitals so that we can talk about what we’re doing, tutor them and bring everyone along together.”

Monash University’s Dr Andreia Bruno, who is a Steering Committee member of the SHPA Technician redesign (phase 2) project, said Australia needs technician guidelines based on the International Pharmaceutical Federation (FIP) global competency framework.

“My take-home message is for competency frameworks to be applied. You have trial them out and see how they work. You need to consider a strategy, not only for development but also implementation.

“It’s time to transform the health workforce.”

See more about the SHPA’s Pharmacy Technician and Assistant Role Redesign within Australian Hospitals Project here.

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