In writing this article I discovered that pharmacy technicians have been around a long time. According to the archives at The Worshipful Society of Apothecaries of London, as a result of the Apothecaries Act in 1815, the Society of Apothecaries instituted an examination that led to qualification as “assistant to an apothecary”. By July 1985 the qualification had become that of the “dispensing technician” and stayed as such until the Royal Pharmaceutical Society stopped offering it in 1998.
By this time the nationally recognised BTec qualification was being offered throughout many colleges with subjects such as pharmaceutical technology and pharmacy services. This BTec course is now offered alongside the level 3 national vocational qualification and completion of these together leads to qualified pharmacy technician status and registration as a pharmacy technician with the Society. The Society opened a voluntary register of pharmacy technicians in January 2005 with registration for technicians to become statutory in the near future. I should point out here that we are purely registrants with the Society. We are not members. We can however, be members of our own association, the Association of Pharmacy Technicians United Kingdom.
Technician education and training
These days there are more opportunities for career development available to technicians than ever before. As pharmacists have developed their roles to take on more clinical work such as supplementary and independent prescribing, the need for technicians to develop alongside has become apparent.
Accredited checking technician
One of the most useful additional qualifications that a technician can obtain is that of the accredited checking technician (ACT). To be accepted on the course, the technician needs to have been qualified for at least two years, have spent at least six of the previous 12 months in the dispensary where they will be carrying out the final accuracy checking and must have completed a 200-item accuracy log for dispensing.
The training usually involves a two-day course which sees technicians improve on their pharmacy-practice and communication skills, learn about the legal and ethical implications for dispensing and checking of medicines and medicinal products, understand the checking process and appreciate their limitations, ie, know when to refer a problem or query on.
Once technicians have attended the training they have to check accurately 1,000 items and pass a practical checking examination at 100 per cent. No errors are allowed. ACTs can provide invaluable help to a pharmacist (or student) new to the department where they work. ACTs can go through their own personal checking procedure with the pharmacist (everyone checks in a slightly different way), and they can offer advice on cost-centre codes and specific trust label idiosyncrasies.
To participate in this course the student must have a qualified ACT facilitator and this is usually a technician who has been qualified as an ACT for some time and who can assist and support the student with their learning.
Accredited medicines management technician
The accredited medicines management technician (AMMT) qualification is also useful for a technician to have. It usually involves a three-day course where technicians build a portfolio of research and documentation on detailed medication histories from patients.
Technicians also have to undergo an objective structured clinical examination (OSCE) where they participate in various role play situations, which are assessed. Preregistration trainees also undergo OSCEs and an AMMT can provide practical advice on how to survive this process. OSCEs can be stressful and the scenarios are never quite the same as if you were working on the ward or in the pharmacy in reality.
An AMMT can also accompany preregistration trainees to wards and assist with patient own-drug assessments, drug history taking, and contacting GPs and nursing homes to discover any relevant information which might be missing for a patient.
To participate in this course (and many others) the student must have a qualified facilitator and this is usually a technician who has been qualified for some time and who can assist and support the student with their learning.
Accredited medicines information technicians training scheme
The accredited medicines information technicians training scheme (AMITTS) is a nationally recognised qualification which allows technicians to deal with medicines information queries to a specific level. Technicians must respect the limitations of their knowledge and also that of their responsibilities and they have to understand fully the importance of referring on calls with queries outside these remits.
Topics covered in the scheme include tablet and capsule identification, availability of medicines, formulation and stability of medicines (excluding parenteral administration), interactions, adverse drug reactions, complementary medicine and travel medicine. Topics not covered in the scheme include urgent or clinical enquiries, drugs in pregnancy, drugs in breast milk, paediatrics, renal function, liver function, unlicensed medicines, choice of treatment and medicines of abuse.
A student or preregistration trainee can benefit from the abilities of a technician who has completed this qualification. This technician will have up-to-date clinical knowledge and can help the pharmacist with various searches, be they internet searches from reputable sites or something as simple as a database or book search. The technician can take the preregistration trainee through paperwork and can work alongside him or her.
In and preprocess accuracy checking accreditation
The “In and preprocess accuracy checking accreditation” (IPPC) is a course that allows technicians to check total parenteral nutrition, cytotoxics, centralised intravenous additive service or all three in an aseptic suite.
The scheme does not accredit staff to undertake the final release check since this remains the responsibility of the authorised pharmacist.
An IPPC technician can be a crucial source of assistance to students or preregistration trainees on their rotation through an aseptics suite. Aseptic production is fast becoming a dying “art” and the majority of aseptics technicians I have met over the years love their work and have extensive knowledge of it. Their work is highly skilled and they work in an area where attention to detail and accuracy is paramount.
Several universities are now offering foundation degrees for pharmacy technicians.
I recently graduated from Kingston University where I studied for a foundation degree in pharmacy services. This degree covered pharmacokinetics, resource management, teaching skills and more. There are some foundation degrees that specialise in medicines management and others that offer pharmacy practice. The choice of degree depends on the needs of the student’s employer and the student. I decided with my (then) employer that a degree in pharmacy services at Kingston University was the degree for me and I do not regret having made that choice.
How technicians can help you
Imagine the help you can elicit from technicians who have worked in their area for a while. I work with some technicians whose clinical knowledge and expertise has developed over a period of years and they seem to know the answer to everything.
At trusts where I have worked before, preregistration trainees are assigned to one of the more senior technicians while in their induction period. They work with the technician, learning the basics right through to the more complex processes that the trust may have. For example, technicians responsible for stock ordering can take students or preregistration trainees through activities such as ordering contract items and specials, invoicing, booking stock into and out of the system, handling drug recalls, checking emergency boxes, etc.
Senior medicines management technicians can work with students or preregistration trainees on wards, showing them how to check inpatient drug charts (they tend to differ for each trust), order inpatient medicines and take a detailed drug history.
Senior cancer services technicians can explain the wonders of chemotherapy and TPN from a prescribing and dispensing point of view. They may also work with students or preregistration trainees on oncology wards to show them the safe storage and handling of the cytotoxic drugs at ward level.
IT technicians can help with more than just “my screen froze” type queries. They can run detailed searches for you, should you need to carry out assignments and audits. They can manipulate and manage pharmacy data like nothing on earth and can be a real asset.
Accredited checking technicians can help students or preregistration trainees with their checking technique. Sometimes technicians can be easier to approach than senior pharmacist colleagues about this subject. ACTs can help with suggesting their own procedure for accuracy checking, they can assist with additional BNF warnings if missing, and test your clinical knowledge with regard to mode of action and side effects. The list is endless. I have really undersold the help we can give you here although I am sure you can appreciate what I am trying to say.
The next time you think that technicians are only good for showing you where the canteen is and how to access the “for sale” pages on the intranet, think again. We have a wealth of information at our fingertips and are only too happy to share it with you and anyone else who would take the time to ask us a question. After all, we are working together as a team for the health and wellbeing of patients — why would we not want to help each other?
|Helen Knipe is chief pharmacy technician for education and training at Ashford and St Peter's Hospitals NHS Trust in Chertsey, Surrey|