Pharmacists could authorise pharmacy technicians to carry out “the preparation, assembly, dispensing, sale and supply of medicines”, under the government’s long-awaited proposals for the overhaul of pharmacy supervision.
The Department of Health and Social Care (DHSC) published a consultation document on 7 December 2023. This also recommends that pharmacists could authorise any member of the pharmacy team to “hand out checked and bagged prescriptions in the absence of a pharmacist”, and “allow pharmacy technicians to take primary responsibility for the preparation, assembly and dispensing of medicinal products in hospital aseptic facilities”.
The DHSC estimates that the changes could provide efficiencies of more than £380m for community pharmacies over the next 10 years.
The consultation document says: “Our proposals will enable pharmacists to authorise (without directly supervising) registered pharmacy technicians to perform tasks that would otherwise need to be performed by or under the supervision of pharmacists — and for registered pharmacy technicians to take primary responsibility for the preparation and assembly of medicinal products in hospital aseptic facilities, and in doing so, supervise non-registered members of staff.
“These proposals are designed to allow pharmacists to spend less time on tasks that can be safely delegated to pharmacy technicians, who are registered and regulated health professionals in Great Britain — capable of working more autonomously, referring to a pharmacist only where necessary.”
The document adds: “These proposals are not a move towards allowing pharmacists to remotely supervise a community pharmacy. Physical presence of the responsible pharmacist in a retail pharmacy as the default is enshrined in primary legislation that is not being changed as part of this reform.”
An impact assessment published alongside the consultation document says: “Reform will enable pharmacy technicians to take greater responsibility for running dispensaries, allowing pharmacists to spend a greater proportion of their time delivering patient-facing clinical services, using their training and expertise, including prescribing — to release capacity in the wider NHS.”
A pharmacy cross-sector group published a report in August 2023 that concluded that supervision in a community pharmacy “should no longer be interpreted to mean [a pharmacist] supervising individual transactions”.
The Supervision Practice Group, made up of seven community pharmacy sector organisations — including the Association of Independent Multiple Pharmacies, the Association of Pharmacy Technicians UK (APTUK), the Company Chemists’ Association, the Pharmacists’ Defence Association, and the Royal Pharmaceutical Society (RPS) — submitted its report to the DHSC, suggesting that the government could “draft specifically worded revisions to legislation and regulatory rules and standards” that would be “subject to a full consultation process”.
In the report, ‘Supervision in community pharmacy’, all parties agreed that supervision meant that a pharmacist should be present in the pharmacy and accessible to patients, and recommended that public, primary and secondary legislation should be “clarified” and “updated” to reflect this.
There have long been attempts to clarify rules around pharmacist supervision of community pharmacies. A document on the future of supervision, prepared by a working party of the Rebalancing Medicines Legislation and Pharmacy Regulation Programme Board, was leaked to the press in 2016, but subsequent discussions on an overhaul of supervision did not lead to any concrete proposals.
Commenting on the government’s latest consultation document, Nick Kaye, chair of the National Pharmacy Association, said updates to supervision legislation was “well overdue”.
“Any changes to legislation or regulations should maintain or improve, not diminish, the public’s access to a pharmacist in a community pharmacy. As pharmacies deliver more and more clinical services, it becomes ever more important to have the clinical skills of the pharmacist readily available,” he said.
Malcolm Harrison, chief executive of the Company Chemists’ Association, said the proposals could “provide the basis for the greatest evolution in pharmacy practice for 70 years”.
“The proposals will free up pharmacists to spend more time with patients and deliver more NHS services,” he added.
“Once implemented, patients will no longer have to wait for a pharmacist to be present to receive prescribed medicines that have already been bagged up, checked and are ready to go.”
Gordon Hockey, director of legal at Community Pharmacy England, said: “As the clinical skills of community pharmacists are put to greater use through services such as Pharmacy First, it is important to ensure that pharmacies can make best use of skill mix across the whole team. We will consider the proposals and respond to the consultation.”
In a statement, the RPS welcomed the announcement and encouraged RPS members to share their insights and perspectives on the consultation by emailing: firstname.lastname@example.org
“RPS will build on these together with the expertise of its board members, who serve as elected representatives, to further shape its response to the DHSC consultation,” the statement added.
The consultation closes on 29 February 2024.