MAY,Edition # 26, 2001

The recent government-led reports into Pharmacy ownership and product scheduling showed that as a profession we were falling down in providing sufficient levels of service.
Unless we lifted standards, our protected status would be taken away, was the message.
The Guild and Society led Practice Standards seem designed to appease regulators, but have been criticised for the cost of implementation and a perceived lack of flexibility. The upshot is that the pharmacist still now bears greater responsibility for every transaction that takes place under his charge. They need to be able to delegate responsibility for S2 sales to trained staff with appropriate training to feel secure.
It is really the policies of pharmacies that are being put to the test by the standards, and pharmacists need to know that their staff are able to meet and implement the policies they decide upon.
At the moment Dispensary Technicians can gain a certificate to prove their competency in the dispensary, but what options exist for Pharmacy Assistants to prove their competency in providing S2 medications?
Most of the training available is provided on the job, and outside assistance comes in the form of product training provided by manufacturers.
The challenge is there for educators to formalise the role of Assistants as providers of medications.
This would recognise them as professionals in their own right.
Despite the good intentions of the S2/S3 standards, most S2 sales are unsupervised. Pharmacists are busy in the dispensary and assistants carry out business, only deferring to the pharmacist when they find themselves out of their depth or when an S3 product is required.
If proper training and recognition was in place, is there any reason why another pharmacy position couldn't be created between pharmacist and assistant who fills this role of providing non-prescription medicines?
The reality of modern pharmacy (with the exception of Queensland) is that S2 items sit alongside toothpaste, moisturiser and vitamins in the front of shop.
This is currently the pharmacy assistant's domain.
A greater distinction could be made, with S2 items stored together in one part of the pharmacy and controlled by a Self-Medication Consultant, specially trained to understand the therapeutics of these drugs, and provide a more in depth consultation to each customer.
As this staff member would be appropriately trained, they could operate independently, and allow the pharmacist to concentrate on other medications. These staff, as trained professionals, would ensure that the service a pharmacy offered was more greatly distinguished from the product provided by a supermarket or other retailer.
All staff filling this position across the nation would need to hold the same qualification, probably some form of Diploma from a recognised School of Pharmacy. The development of this position might create a strengthened career path for pharmacy assistants.
Those that start work after leaving school and gain experience in a pharmacy, could decide to undertake the course to become a recognised Self-Medication Consultant.
After such a scheme had been operating for some time, if it showed improved performance for pharmacy in providing these services it could be extended to Schedule 3 medications. This move would require regulatory changes and the blessing of Official Pharmacy because it would represent a change.
One of the ideas floated in the Galbally Report was the merging of Schedules 2 and 3, so perhaps we could be beaten to the punch anyway. If this was to take place, the educational standard required would have to be increased to recognise the increased risks associated with S3 medications.
It may require a change in the focus of the S2 and S3 schedules to ensure medications are aligned to suit a changed workplace structure.
For example Ventolin should be sold only by a pharmacist because it treats a chronic medical condition, but a self-medication consultant may be able to sell hydrocortisone cream for minor skin problems. The education that would be required for these positions would obviously go beyond that currently undertaken by most pharmacy assistants.
Charles Sturt University already offers one course for Pharmacy Assistants which goes into extensive detail about medications and their use.
Those occupying these Self-Medication Consultant positions would require sufficient drug knowledge to operate with minimal supervision from a pharmacist. They would be trained in a degree of differential diagnosis and when to refer patients either to the pharmacist or a doctor.
These staff would be responsible in conjunction with the pharmacist for the management of the S2/S3 medications in the pharmacy, so an amount of management training would be needed.
It should be emphasised that this idea does not devalue the role of the pharmacy assistant as they currently stand, but would offer many the chance to formalise the role they already hold, and gain recognition. It would provide more of a career path for assistants who don't wish to take up a dispensary assistant's role.
While it may be impractical for smaller pharmacies, large pharmacies would appreciate the chance to accredit staff for the specialist role they already hold. Many pharmacists would appreciate the chance to lessen their burden of supervision for S2/S3 sales, knowing that their staff are trained to meet professional standards and internal policies.
Ends

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