GP partner and PCN leader Dr Helen Maxwell-Jones and team explain the benefits and practicalities of employing a pharmacy technician in general practice
The role of the pharmacy technician (PT) is complex and diverse.
A PT working in general practice will assist with strategic and operational planning of medicines and chronic disease management services, and support pharmaceutical care of patients by working with the pharmacy team to deal with medication issues, such as identifying discrepancies in medication histories and ensuring drug monitoring is actively managed. They contribute to processes that help to maximise benefit and minimise risk to patients from their medicines, and ensure the smooth transition between primary and secondary care.
More specifically, the PT can:
• Undertake some medication reviews (guided by standard operating procedures).
• Transcribe medications from discharge summaries and clinic letters.
• Answer drug-based queries from patients and health professionals.
• Undertake shared-care drug monitoring, for example for DMARDs, NOACs, and high-risk medications such as amiodarone.
The role of the PT can also be expanded with supervision and protocols to include chronic disease management, immunisations and phlebotomy.
The main difference between a PT and a pharmacist is that a PT cannot become an independent prescriber and therefore cannot conduct structured medication reviews (SMRs). However, in our PCN we haven’t found this to be limiting as PTs can perform simple medication reviews and support with SMRs.
What qualifications, experience and personal skills does a PT need?
The role requires a pleasant manner and an ability to work across different teams. A PT must therefore must be adaptable.
They will need qualifications such as the City and Guilds Level 3 NVQ diplomas in pharmacy services skills and pharmaceutical science. We have also found it advantageous for the PT to have a good knowledge of secondary care medicine, especially from working on wards, and experience of handling discharge summaries.
A ward-based medication management technician with ample face-to-face patient experience is the closest secondary care role to that of the PT in primary care. They are experienced in transcribing discharge summaries and clinic letters, and have detailed knowledge of the shared-care pathways, so they are used to dealing with such drugs and can navigate the hospital systems.
The job is a patient-facing role. PTs are vital in improving patient compliance, so good consulting skills are essential. And as primary care is constantly evolving, a PT needs to be adaptable and forward thinking.
Practices should expect to pay a PT at Agenda for Change band 6-7 in line with their experience and responsibilities.
Currently, practices can choose to recruit a PT themselves or access one through the PCN DES additional roles reimbursement scheme (ARRS).
As with most ARRS roles, the maximum reimbursement rarely covers salary plus associated employment costs. Adequately experienced PTs will usually be recruited from ward-based medicines management roles or CCG medicines optimisation teams and this raises recruitment issues with the move to hire staff in general practice roles at scale. The pool for recruitment is therefore limited and starting salaries are likely to be at the higher end of band 6 for retention purposes.
PTs carry out medication reviews, and their expertise in specific drugs also improves patient safety. They also help with monitoring and compliance issues, as well as overuse or over-demand for medications, and give another layer of risk assessment and response.
Therefore PTs can significantly reduce day-to-day workload for GPs.
PTs can also increase practice income by improving QOF compliance and flu vaccination uptake.
Dedicated GP time will be required to develop protocols and processes for the PT to work within. The PT will also require some ongoing GP supervision. Overall, as with any new role, the time invested tends to correlate with the benefits seen.
• A PT can do much of the work a clinical pharmacist would do, except prescribe.
• You will need to factor in training and supervision.
• The PT can free up GP time and help improve QOF and other enhanced service performance.
Dr Helen Maxwell-Jones is a GP at Henmore Health – The Surgery in Derbyshire and CD for the Henmore Group, Sarra Hardy is clinical PT at The Surgery, Samantha Fitchett is operations manager at The Surgery and Danny Smart is CEO of the Henmore Group
For a pharmacy technician case study as well as a range of practice business and financial advice, visit pulse-intelligence.co.uk