Health professionals should not be ‘coerced’ into working beyond competence

The Scottish Trade Unions Congress (STUC) has carried a motion which aims to protect the public from ‘the consequences of role substitution in healthcare’.

It was proposed by the Pharmacists’ Defence Association (PDA) at the Congress this week and calls for ‘clear role definition’ of health professionals that it says would benefit both patients and staff.

‘Clear role definition within health and social care reduces risk, improves patient outcomes, and enhances the quality of care while improving worker wellbeing, along with improved work environment and culture,’ the motion suggested.

Patient perception of healthcare roles

The motion warned that patients must be protected from ‘potential harm’ that could occur in ‘situations where there is confusion about the roles a team member undertakes or where underqualified staff are coming under pressure to undertake activity for which they are not suitably competent’.

In order to do so, the motion proposes that the role performed by each healthcare professional is clear to the patient, ‘so that their expectations and confidence in the advice or care provided is appropriate’.

And it stressed that patients should ‘never conclude an individual is qualified in a role, for which they are not’.

Healthcare professionals working within their competence

The motion also stressed that healthcare professionals should work within their competence and confidence, and receive appropriate compensation for their responsibility.

No healthcare workers ‘should be coerced into taking on additional activities or responsibilities beyond their competence and capability to provide safely’, and they ‘must be able to decline duties which they are not competent to undertake’, the motion added.

When developing their competence, healthcare workers must have ‘the requisite education, training, and support to build skills and knowledge before undertaking new activities’ and must have ‘appropriate supervision from a suitably registered health professional’, the motion said.

And ‘credentialed, quality checked training’ must be available for professional development relating to activities that might impact patients, it added.

The motion also said that healthcare workers who were taking on additional responsibilities ‘should also receive financial reward that fairly reflects their capability’, and that ‘junior or less qualified colleagues must not be expected to take responsibility for activities for less money than those currently holding responsibility for those activities’.

Paul Flynn, PDA National Officer for Scotland, told The Pharmacist that 'preventing the exploitation of lower paid workers' was an 'important aspect' of the motion.

'While in pharmacy some individuals and organisations seem very keen to require other members of the pharmacy team to take on more responsibility and undertake more tasks, there has been a noticeable silence about those how much the rates of pay for those roles would increase if they do, when those higher rates would commence, and where that funding would come from,' he said.

And he encouraged individuals in this position to join an independent trade union appropriate for their role.

Role and responsibility changes within pharmacy

Mr Flynn highlighted to The Pharmacist the 'significant concerns' that exist 'across healthcare' about potential role substitution, including the pharmacy technician role 'sometimes being inaccurately considered to be the same as that of a pharmacist'.

He said that the PDA motion on this issue was supported by the hospital doctors’ trade union HCSA.

As a result of the motion being carried, the position on protecting the public from the consequences of role substitution in healthcare is also now the policy of the STUC.

'This is about all roles in healthcare, and the principles of the motion equally apply to those situations where the PDA has previously supported pharmacists in different parts of the health system who have come under pressure from their employers to act beyond the bounds of their current competence,' Mr Flynn said.

The motion comes as pharmacy technicians are to be enabled to supply medicines under a patient group direction (PGD), following a consultation period in which the PDA spoke out against the proposal.

Concerns have also been raised that the lines between pharmacists and pharmacy technicians are being 'blurred', with pharmacy technicians 'being increasingly asked to undertake clinical tasks that hitherto have only been undertaken by pharmacists', according to the PDA.

Following a recent consultation, the sector also anticipates legislation that could allow the delivery and supervision of tasks relating to the preparation, assembly, dispensing and sale or supply of medicines to be delegated via ‘authorisation’ to a registered pharmacy technician.

In response to changing landscape of pharmacy professional roles and responsibilities, the General Pharmaceutical Council (GPhC) has recently launched a consultation on how it will regulate pharmacist and pharmacy technician training, including proposing that it carries out more regular quality assurance of training providers.