The Pharmacists Defence Association (PDA) has said that it ‘cannot support’ the government’s proposal to allow pharmacy technicians to supply medication under a patient group direction (PGD).

It has raised concerns that the move could pose an issue to patient safety, and queried whether the current pharmacy technician workforce would be ready to safely supply or administer medicines under the existing PGD criteria.

In particular, the PDA suggested that not all pharmacy technicians would have the appropriate knowledge base to do so.

It challenged the government’s proposal that the decision to allow a pharmacy technician to supply or administer a medicine under a PGD be taken by an employer organisation, rather than the responsible pharmacist (RP).

‘The PDA believes that when patient safety is at stake, proposals must be based on a strong foundation of proper skill mix, education, training and governance, and not purely ideology and cost saving,’ the organisation said in a statement on its website.

It added that the core issue related to the ‘underpinning education’ of pharmacy technicians.

The PDA highlighted that the other healthcare professionals currently authorised to operate under a PGD ‘have a minimum underpinning education at level 5 (with the majority having a level 6 or 7 qualification) whereas pharmacy technicians only have a basic level 3 qualification’.

And it said that around half of the current pharmacy technician workforce ‘entered the register via a grandparent clause and the GPhC [General Pharmaceutical Council] does not hold the education records for this group’.

The PDA added that ‘a substantial balance of the remaining 50%’ had trained under older pre-2017 standards, while ‘even the 2017 revised standards only require a level of knowledge equivalent to a basic level 3 in biology, chemistry, microbiology and physiology and a knowledge of basic pharmacological principles’.

Any healthcare professional operating under a PGD would need to be able to make a clinical decision on whether the product is safe and suitable for any individual patient, ‘following a full and comprehensive history taking, including an analysis of underlying medical conditions, contra-indications and dose adjustments’, noted the PDA.

‘Whilst PGDs can stipulate additional training requirements before a healthcare professional undertakes using the PGD, this is not a substitute for the underpinning level of knowledge required to make this clinical decision on whether to supply or administer the medicine identified in the PGD,’ the PDA added.

It also said that the decision for a pharmacy technician to use a PDG resting with the employer organisation ‘based on clinical or business need’ ‘confuses the positioning and authority of the responsible pharmacist’, who is responsible for ensuring the safe operating of the pharmacy.

‘This appears to be a basic role substitution based on cost-cutting and not the pharmacy skill mix which has in the past been central to DHSC policy,’ the PDA said.

It also raised concerns that the proposals related to all four UK nations, despite pharmacy technician not being registered professionals in Northern Ireland.

‘Pharmacy technicians are valuable members of the pharmacy team and whilst the PDA does not support the proposals around PGDs for the reasons outlined in its response to the consultation, it is keen to work with DHSC, NHS policy makers and other stakeholders to find a solution which meets the needs of patients and the NHS, provides professional fulfilment for pharmacists and pharmacy technicians utilising their own unique skills and training, and which above all is based on safe practice and good governance,’ the PDA added.

Other pharmacy organisations, including the Royal Pharmaceutical Society (RPS), have supported the government’s proposals.