Update on Regulation of Pharmacy Technicians

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• Update on Regulation of Pharmacy Technicians

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Evolution of Pharmacy Technicians in Ontario

• Over 30 years of unregistered assistants or
  technicians assisting pharmacists in technical
  aspects of dispensing
• Began with no status, no training, or recognition
• As pharmacists take on more patient care roles,
  technicians take on more technical roles

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Evolution of Pharmacy Technicians in Ontario
(contd)

• Current role
• Assistant to pharmacist
• Fills prescription under direct supervision
• No independent actions or authority
• Every activity requires checking by the
  pharmacist

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Evolution of Pharmacy Technicians in Ontario
(contd)

• Formal training (20 years)
• now a two-year program in community colleges
• Private vocational colleges have developed
  programs
• Gap is now widening between assistants trained on
  the job and those with formal training

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Evolution of Pharmacy Technicians in Ontario
(contd)

• Certification (8 years) since 1977
• - voluntary certification program
  offered by OCP
• Ensure standardization respecting skill set of
  all certified pharmacy technicians
• Standardize practice regardless of variations in
  training and experience
• Promote recognition of credentials within the
  technician profession

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Evolution of Pharmacy Technicians in Ontario
(contd)

• Total numbers unknown (est. 23/pharmacist)
• OCP certified 2,144 (2005)
• Trained on the job and formally trained
• Role assistant changing .... to accountable
  partner

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Why pursue Regulation?

• To support pharmacists in an expanded role
• To support the Standards of Practice created for
  pharmacy profession
• Registered pharmacy technician seen as a valuable
  resource
• Council set priority to seek an expanded role for
  pharmacy technicians

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Pharmacy Technician Working Group Established

• Comprised of pharmacists, technicians, and
  educators
• Make recommendations to Council on steps to
  regulation and report on progress

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Proposed Regulated Pharmacy Technician

• Trained pharmacy technician with enhanced skills
  and ability
• Accountable team member
• Will have to demonstrate certain competencies
  (knowledge and skills) in order to be registered
• Current training programs may not teach to the
  expected role, and technicians may require
  upgrading

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Regulated Technicians would have

• Education requirements (expanded curriculum)
• Entry-to-Practice requirements (fluency,
  practical training, exam)
• Standards of practice
• Accountability and responsibility for their
  actions
• Be subject to complaints discipline processes
• Be expected to keep current and participate in a
  QA program

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Proposed Role under Regulation

• Receive a new/repeat prescription
• Give and receive prescription transfers/copies
• Confirm accuracy and completeness of prepared
  pharmaceutical products
• Check and sign off on the technical accuracy of
  filled prescriptions

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Choice will remain

• To be regulated will be optional
• Choosing to hire a regulated pharmacy technician
  will remain optional for pharmacists
• Pharmacists taking on more primary care role will
  remain optional
• Many assistants and pharmacists expected to
  initially choose to maintain the status quo

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What about the Pharmacists?

• Task Force on Optimizing the Role of the
  Pharmacist
• Created to address areas of primary care reform
  and scope of practice
• Comprised of innovative practitioners from across
  Ontario

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Terms of Reference

• To document the changing roles of pharmacists in
  Ontario
• To determine where pharmacy practice should be in
  Ontario in the next 5-10 years
• To determine the impediments to reaching this
  vision
• To develop short and long term goals to reach
  optimal practice of the profession in evolving
  health care models
• To make recommendations to the Executive
  Committee on optimizing the pharmacist's role
• To propose guidelines, protocols and policies to
  optimize the role of the pharmacist.
• ... for the benefit of the public of Ontario

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Task Force Recommendations

• Proposed guidelines for Medication Reviews
• Developed a Framework for a Medication
  Consultation Service
• Being published in the Nov/Dec issue of Pharmacy
  Connection for consultation and feedback

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Task Force Recommendations (contd)

• Continuing Care Prescriptions
• Consider refill authority for pharmacists to fill
  patient care gaps
• Pharmacists would need to take time to assess and
  monitor patients
• What would be required of a pharmacist in
  assessing and monitoring patients?

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Task Force Recommendations (contd)

• Collaborative Practices
• Delegation of certain controlled acts in specific
  clinical areas with agreement between physician
  and pharmacist
• Dose adjustment and monitoring
• Fits Family Health Team model and supports
  primary care

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Benefits to Pharmacists

• Pharmacists can better meet the Standards of
  Practice
• Accountable technicians allow pharmacists more
  time for patient care duties
• Enhanced individual practices increases profile
  for entire profession
• More available to join Family Health Teams

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Benefits to Technicians

• Current unregulated role of technicians would be
  strengthened and raised to that of a regulated
  profession
• Clearly set professional standards of practice
  and scope
• Increased professional status and recognition
• Would participate in the self-governance of a
  profession already regulated

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Benefits to Public

• Accountability to the public and the College
• Greater access to pharmacists cognitive services
  
• Enhanced safety
• More qualified personnel
• More focus on areas of expertise
• Greater access to pharmacists through Family
  Health Teams

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Choice will remain

• To be regulated will be optional
• Choosing to hire a regulated pharmacy technician
  will remain optional for pharmacists
• Pharmacists taking on more primary care role will
  remain optional
• Many assistants and pharmacists expected to
  initially choose to maintain the status quo

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Current Status

• Competencies developed
• Standards of practice for consultation
• Minister has referred the matter to Health
  Professions Regulatory Advisory Council
• HPRAC reviewing and expected to make
  recommendation next year regarding regulation

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Next Steps

• Further consultation (Regional Meetings)
• Finalize standards of practice
• Seek necessary legislative amendments
• Accredit training programs
• Develop entry to practice requirements, including
  prior learning assessment, national licensing
  exam
• Establish ongoing monitoring and support
  mechanisms