The Pharmacists’ Defence Association (PDA) has told MPs that there are “significant parallels” between proposals to allow pharmacy technicians to use patient group directions (PGDs) and the controversy over physician associates working in the NHS.

In a recently published written submission to the parliamentary health select committee’s inquiry on pharmacy, the PDA warned that in its view there is a risk that the PGD proposals – which formed the basis of a six-week consultation that ran last autumn – could “blur the distinction” between pharmacists and pharmacy technicians.

The organisation also argued that the increasingly commonplace use of the term ‘pharmacy professional’ to refer to the two workforces “gives the impression that they are one homogenous group” and could create “concerns around competency and expanding technical roles beyond capabilities,” which in turn may result “in professional tension rather than collaboration”.  

Noting that a healthcare professional using a PGD works independently without oversight or delegation, the PDA said there are “significant parallels to be drawn on this issue and the current debate around physician associates (PAs) and concerns from the medical profession” – an issue that has generated national headlines as some doctors express concerns around the use of PAs, who cannot prescribe medicines but can take medical histories, perform physical examinations, make an initial diagnosis and refer patients onwards.

Urging the select committee to “give serious consideration to the issue of patient safety and appropriate skill mix,” the PDA also claimed that around half of all current pharmacy technicians were ‘grandparented’ into a professional role when the register was created in 2011, and argued that this decision raises questions around the safety of giving pharmacy technicians greater responsibility.  

Professional representative body the Association of Pharmacy Technicians UK (APTUK) has in the past criticised these arguments as “misleading,” noting that all registered pharmacy technicians have completed a nationally recognised course including mandatory evidence of post qualification work experience.

The PDA’s evidence continued: “Pharmacy technicians are valuable members of the pharmacy team and whilst the PDA did not support the proposals around PGDs for the reasons outlined in its response to this consultation, it is keen to work with stakeholders to find a solution which meets the needs of patients and provides professional fulfilment for both pharmacists and pharmacy technicians. 

“These issues are particularly apposite since the newly launched Pharmacy First service in community pharmacy in England is entirely a PGD driven model.

“If the current DHSC proposals on pharmacy technicians being allowed to deliver PGDs go ahead, the PDA believes that this leaves patients structurally exposed to safety and quality concerns.”

Responding to similar concerns in 2018, APTUK argued: “The whole process of developing PGDs, including the risk management element, would ensure that appropriate training would be part of the evidence required for individual pharmacy technicians to be authorised to deliver the service. This is the same as any other clinical service delivered in pharmacies and is an employer responsibility.

“There is strong evidence from the hospital sector, primary care and forward-thinking community pharmacies that pharmacy technicians, when empowered, trained and supported can deliver safe services. This does, of course, place an onus on the employer to support staff appropriately.”

APTUK also dismissed concerns around a “blurring” of professional roles, arguing: “Patients want and need a safe service; they often do not understand the exact role or profession of the person dealing with them. The patient’s normal interface in any pharmacy is normally not a pharmacist.”