Documenting the evolution of the relationship between the pharmacy support workforce and pharmacists to support patient care

Since 2009 there has been a focus on the relationship between pharmacy technicians, pharmacy support workforce cadres and pharmacists in the literature. 2009–2011 saw a framework of role evolution develop, with publications from 2012 to 2015 documenting further maturity in the development of practice models for improved patient care and optimal use of personnel. The dominant narrative in the published academic literature has been made by certain high- income countries (mainly Canada, Denmark, United Kingdom and the United States of America). In these countries there are significant numbers of pharmacists available and there has been an increasing interest to utilize pharmacy support workforce cadres to allow the extension of clinical roles of pharmacists in these contexts. This is not a systematic presentation of all the literature available but rather a commentary overview supported by key papers. Key points from this literature include: • The initial interest in this area resulted from a growing desire to increase the visibility of the pharmacist in line with the evolution of pharmacy practice, investigating how to move the pharmacist away from administrative roles and more towards clinical care. In this context the optimal use of other pharmacy cadres has gained momentum with numerous examples provided where pharmacists have been able to extend their clinical role with greater use of pharmacy technicians or other pharmacy support workforce cadres. • As an expanded role for a variety of pharmacy support workforce cadres has developed, issues around education, regulation and registration have been discussed. As has the importance of clearly defining the role of both the pharmacist and other pharmacy cadres in specific practice settings. Where these partnerships have been developed successfully there has been detailed attention to change management and stakeholder engagement, with improved patient care as the focus. Significant guidance has been provided to aid implementation. • In more recent years, pharmacy support workforce roles have expanded in some country practice settings, moving from administration and supply functions to independent checking of prescriptions by cadres and more recently to the management of patient adherence programs (e.g. United Kingdom, USA). • With a continued focus on freeing up the pharmacist for expanding clinical roles, the most recent literature (USA), explores the need to further develop the leadership skills of the pharmacy support workforce. (To allow the reader to clearly understand the country of origin of the themes presented, care has been taken to note the country of origin of the papers used in this commentary).