Introduction: A study conducted by the University of Manchester in 2002 estimated that there could be a shortage of as many as 1,700 full-time pharmacists in community pharmacy(1). This has led workforce planners to reconsider the roles and activities of the pharmacy team, and review whether the skills and competencies available could be used more effectively, in new and different ways. This will involve developing new tasks, areas of expertise and responsibilities among the pharmacy team. Support staff in some European countries have more advanced training and are used in different ways compared to the UK, so a comparative study was conducted with the aim of exploring the impact of advanced training for pharmacy assistants on the division of tasks, responsibilities and services provided.

Method: Researchers met with 41 representatives from three countries: Denmark, Sweden and the Netherlands. These representatives included key stakeholders from professional organisations, government departments, trade union groups and educational institutions involved in the training of pharmacists and assistants. Researchers also visited 12 pharmacies in the three countries to observe activities and discuss the responsibilities and systems with members of staff.

Results: The scoping exercise identified a range of variables that contribute towards and shape the development of pharmacy assistants, and the range and quality of services provided in community pharmacies. These factors include, the motivation or drive for developments in pharmaceutical care, the system of remuneration, regulation of the profession and sector, training of assistants, size of pharmacies and the use of information technology.

The findings suggest that although more advanced training may contribute to expanding the role of pharmacy assistants; this does not necessarily translate to a parallel development in the role of the pharmacist, nor does a more advanced training guarantee developments in the number, variety or quality of services provided in community pharmacies. These developments will only occur if there is the political will to develop, and staff are motivated to expand their roles. Training is another important factor in the equation, providing pharmacy assistants with additional skills, knowledge and confidence to carry out their extended role. Registration and regulation of pharmacy assistants will help encourage people to perceive pharmacy assistants as belonging to a 'profession' and change perceptions about their role in the pharmacy. Effective systems are also needed to ensure that pharmacy assistants operate within a framework that provides support from individuals with more advanced clinical skills.

Discussion and conclusions: Several useful lessons, both positive and negative, can be drawn from the European experience of expanding the role of pharmacy assistants, which can help inform the regulation and development of support staff in the UK. Some relatively small innovations in pharmacy practice may yield significant changes, which may contribute towards expanding the role of support staff. This would release pharmacists to apply their clinical skills more effectively, and help develop and improve the quality of services offered in community pharmacy.

1. Hassell K. Supply of and demand for the pharmacy workforce in Great Britain. Report for the Department of Health. May 2003.