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Some think the difference between the pharmacist and the pharmacy technician is too great to allow the latter to use PGDs. But it very much depends on the PGD itself, says Nick Kaye…

As I have said many times, with community pharmacies, the clue is in the title. They are absolutely part of the communities they serve and one of the many things that make them special is the teams within them.

The teams in our pharmacies often stay with us for many years and the trust they build up with the people who come to use the pharmacy’s services really is an important part of what we offer.

That trust helps teams push back against vaccine hesitancy, it helps them increase awareness about new services. And let’s face it, raising awareness is very important because we all believe that our contracts, whichever of the four nations we sit in, will become service-driven.

An increasingly service-based contract is a great thing for patients and the wider healthcare system because the more consultations we can perform in community pharmacy, the less demand moves into places like general practice and urgent treatment centres.

It is also the case that all pharmacist graduates will soon become independent prescribers and I’m sure this will open up more services and treatments in community pharmacy, increasing the clinical care we provide.

But lots of us have not, or will never be, independent prescribers and, therefore, the use of patient group directions (PGDs) is a way of allowing us to provide medications when before we could not.

PGDs are not new and most of us will have been using them for well over a decade. The younger generation qualifying will also have never known a world without them. PGDs are a vital tool in a pharmacist’s treatment option toolkit.

However, the world of PGDs is now changing and pharmacy technicians will, as registered professionals, be able to use them in England, Scotland and Wales as other jurisdictions, such as Northern Island and the Isle of Man, do not yet recognise pharmacy technicians in the legal sense.

This has been met with mixed views, some very positive and some not so positive. Some have said the difference between the pharmacist and the pharmacy technician is too great to allow them to use PGDs.

My view on this, which is a very personal one, is it very much depends on the PGD itself. For example, in Cornwall and the Isle of Scilly, we have a walk-in emergency medication supply PGD which has been operating for 15 years. Because of the high number of tourists we have in the area, the integrated care board greatly values the service, as I am sure the patients who receive the roughly 15,000 that occur every year do.

Personally, I really cannot see any reason why a pharmacy technician could and should not use a PGD. It would be speed up the delivery of the service and my pharmacy technician would be much more efficient at it than me.

And yet we’ve had some people say it becomes trickier when you bring Pharmacy First into the equation. ‘What about the clinical service training gap between pharmacy and pharmacy technicians?’ they say. ‘The gap between the two professions is too big!’

My view here is a simple one. Surely, it must be based on the skill-set of that individual within either a self-declaration or training that is set by the commissioner of the PGD.

Let me give you an example. My eldest son is now training as a paramedic at Swansea and through his training, he we will able to use medication such as oxygen, Entonox, heparin through an intravenous route and ketamine.

Now, there is no way I would feel, even as a Masters-qualified independent prescriber who has worked across multiple care settings, that I would want to administer ketamine to someone without some additional training.

I think this comes to the heart of the issue. It’s great to think that all pharmacy team members can use their skills to help the pharmacy and multiple members of the team being able to use PGDs is great.

I am also thinking of contraption services. I am a 48-year-old overweight male and I’m aware that I may not be the face that women looking to access contraception services may want to see. My female pharmacy technician, however, may well be and that increased patient choice can only be a good thing.

I think this will ultimately make community pharmacy more efficient and give people better access to care. But, as with every new innovation, it will need to maintain patient safety.

It is now up to those commissioning services to add ways for all of us to use our training to benefit the communities we serve.

Nick Kaye is a community pharmacist based in Newquay and chair of the National Pharmacy Association. These are his personal views.