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Pharmacy Technicians in Canada:

Regulatory Update

Kim McIntosh

Assistant Registrar

The Manitoba Pharmaceutical Association

Acknowledgements • Very special thanks to the following individuals:

– Shawn Bugden, Past President, The Manitoba Pharmaceutical Association

– Ronald Guse, Registrar, The Manitoba Pharmaceutical Association

– Susan James, Manager of Registration, Ontario College of Pharmacists

– Sue Sampson, Project Director, Nova Scotia College of Pharmacy

– Michelle Wyand, Assistant Registrar, PEI Pharmacy Board

Objectives Upon the completion of this presentation, participants will be

able to:

• Examine the status of regulation of pharmacy technicians across the Canada

• Explain the purpose and benefits of regulating pharmacy technicians

• Describe the components of the national regulation model

• Describe pharmacy technician regulation in Manitoba and contrast its model with the other provinces

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Introduction to Regulated Pharmacy

Technicians in Canada

Regulated Pharmacy Technicians National Overview

Current Status:

Technicians in Workplace: - BC - Alberta - Ontario - Nova Scotia

Regulation Pending: - Manitoba - New Brunswick - Newfoundland

Regulation in Consideration: - Saskatchewan - Quebec - PEI

Green •Pharmacy Technicians (PT) are currently regulated

Yellow •PT legislation changed or proposed; awaiting final approval

Blue •Examining issues related to PT regulation

Red •No plan to regulate but “keeping an eye” on changes

Red Light Green Light

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Why Regulate Pharmacy Technicians?

• Best interest of the health and well being of the public

• Enhanced delivery of more effective pharmacy care

• Support Pharmacists

– Focus on areas expertise/ optimizing competencies, expanded scope

– Increased Safety

• Technician’s practice in drug preparation and distribution becomes accountable by legislation, standards of practice and code of ethics

– Formal complaints and discipline process (in most provinces)

Considerations for Techs/Assistants:

• Regulation is not mandatory

• Role strengthened / raised to that of a regulated profession (ownership, autonomy, independence)

• Increased professional status and recognition by the public

• Higher credentials →increased job opportunities

• Job requirements and employer support

• Financial and time costs

No Grandfathering

• With additional responsibilities comes the need for additional knowledge and training to ensure everyone is performing at least at the minimal level of required competence

• Without the exam process regulatory bodies cannot measure competence at entry to practice and assure the public of their competency

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National Regulation Model

National Entry to Practice

Exam (PEBC)

National Scope of Practice

(NAPRA)

Regulated Pharmacy Technician

National Competencies /

Educational Outcomes

(NAPRA / CPTEA)

Bridging Program and PEBC Evaluating Exam

Accredited Programs (CCAPP)

Current Technicians

Future/Recent Students

NAPRA

• The National Association of Pharmacy Regulatory Authorities (NAPRA) is an umbrella association of the pharmacy regulatory authorities in Canada

• Enabled provincial regulatory members to take a national approach in addressing common issues

NAPRA’s Vision for Pharmacy Technicians

• Pharmacy technicians will work in collaborative relationships and will be committed to patient-centred, outcomes-focused care

• Their expertise will focus on the knowledge, skills and abilities related to technical aspects of prescription and patient information, and of product and drug distribution

• Pharmacy technicians will be responsible and accountable for ensuring patient safety and for the accuracy and quality of product preparation and release

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Professional Competencies for Canadian

Pharmacy Technicians at Entry to Practice

NAPRA Competencies

• NAPRA presently updating national entry-to-practice competencies for pharmacists and pharmacy technicians

• Developed in response to changing pharmacist role and need to provide pharmacists with competent, standardized personnel to whom they can legally delegate technical activities

• Representatives of the pharmacy profession from all Canadian provinces participated in the process

• Nine competencies identified for pharmacists and pharmacy technicians

NAPRA Model Standards of Practice

• NAPRA developed Model Standards of Practice for Canadian Pharmacy Technicians (MSOPPT).

• Includes four domains related to medication expertise, collaboration, safety/quality and professionalism/ethics.

• The current standards were approved by the NAPRA Board of Directors on November 5, 2011.

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National Regulation Model

National Scope of Practice

(NAPRA)

National Competencies /

Educational Outcomes

(NAPRA / CPTEA)

Accredited Programs (CCAPP)

Future/Recent Students

• Responsible for accrediting pharmacy and pharmacy technician programs in Canada

• The accreditation process ensures that accredited programs contain the necessary content to teach the competencies necessary for successful graduates to safely and effectively do the job of a regulated pharmacy technician

National Regulation Model

National Entry to Practice

Exam (PEBC)

National Scope of Practice

(NAPRA)

National Competencies /

Educational Outcomes

(NAPRA / CPTEA)

Bridging Program and PEBC Evaluating Exam

Accredited Programs (CCAPP)

Current Technicians

Future/Recent Students

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PEBC • The Pharmacy Examining Board of Canada (PEBC) is

the national certification body for the pharmacy profession

• Purpose is to assess the qualifications and competence of candidates seeking to become licensed by provincial regulatory authorities

• Award certificates of qualification to pharmacists and pharmacy technicians who demonstrate that they have the necessary knowledge, skills and abilities to practice safely

Direct Eligibility Criteria: •completion of a CCAPP program

•pass OCP Cert. Exam (2008)

•pass PTCB-AB Cert. Exam (2008)

•pass PEBC Evaluating Exam (PT or

pharmacist)

•completion of an accredited pharmacist

degree program in Canada or U.S.

Eligibility Criteria: 2,000 h of work and/or

teaching in the past 36

months

Evaluating

Exam

Qualifying

Exam

Dec 31st, 2018 Deadline

PEBC Exam Eligibility Criteria for Pharmacy Technicians

Bridging

Program* JP*

SPT*

Registration

PEBC Evaluating Exam

• Those “technicians” currently in practice now wishing to become regulated must write Evaluating Exam

• Candidates are permitted to take the PEBC Evaluating Examination by providing evidence of a minimum of 2,000 hours of work and/or teaching in the past 36 months in the field of pharmacy

• Special application process if some or all work experience occurred outside Canada

• PEBC Evaluating Examination will be available until December 31st, 2018

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Evaluating Examination and Then…

• Bridging Program

– National program available in Fall 2013

– Gives the opportunity for those working as a pharmacy assistants to pursue becoming a regulated/registered pharmacy technician

– Serves to raise the knowledge and competency level to that of an accredited program graduate

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Overview of Bridging Program

• Provide a means for individuals already working in the role of “technician” to upgrade their skills to align with changes in the scope of practice prior to sitting the national qualifying examinations (PEBC) without returning to school to complete a full-time training program

• Offer an updated, national version of the program currently offered in three jurisdictions (BC, AB, ON)

Continued… • Program consists of four specific courses (~35 hours

each)

– Pharmacology

– Professional Practice

– Product Preparation

– Management of Drug Distribution Systems.

• Available in English and French through authorized educational institutions in two possible formats: traditional classroom or on-line

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PEBC Qualifying Exam • National entry-to-practice examination for the assessment

and certification of the competence of Pharmacy Technicians for purposes of registration

• Rolled out nationally in August 2010 with sites across country

• Format identical to pharmacist format

– Two parts

• Part I MCQ

• Part II Objective Structured Performance Exam (OSPE)

National Regulation Model

National Entry to Practice

Exam (PEBC)

National Scope of Practice

(NAPRA)

Regulated Pharmacy Technician

National Competencies /

Educational Outcomes

(NAPRA / CPTEA)

Bridging Program and PEBC Evaluating Exam

Accredited Programs (CCAPP)

Current Technicians

Future/Recent Students

Structured Practical Training (SPT)

• Technician works under a trained preceptor

• Content based on NAPRA Competencies

• Provides the opportunity for practical hands-on application of skills in a supervised structured environment

– Objective is to verify competency in the final check of product

– Technician must accurately check a defined number of consecutive prescriptions over a minimum period of time (in some provinces)

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Jurisprudence Exam

• Designed to test knowledge of relevant provincial and federal legislation

• Some provinces are only requiring the completion of the professional practice module of the bridging program

• Mirror exam for pharmacists?

Pharmacy Technicians in Manitoba

Manitoba’s Regulatory Framework • Bill 41 –The Pharmaceutical Act - Passed December 2006

• Regulations Development – the long and winding road

– Defeated March 2008

– Revised Regulations Document – October 2010

– Approval of members - November 9th, 2010

– Updated Regulations Document – July 2013 after redrafting by Manitoba Health and Manitoba Justice

– Approval of members – July 29, 2013

– Forwarded to the Minister of Health

• Bill 18 – Regulated Health Professions Act (RHPA)

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Pharmacy Technicians in Manitoba

• In order to be considered under the definition of a pharmacy technician, the applicant will need to have:

– Graduation from CCAPP approved program (or bridging)

– PEBC Qualifying Examination status

– Provincial Jurisprudence (written examination)

– Structured Practical Training Program

– Complete application information 31

Manitoba’s Regulatory Framework: Act

• Act s.73(1) The council may make regulations:

– (h) respecting pharmacy technicians, including establishing the qualifications, experience and other requirements that must be held by a pharmacy technician;

• Manitoba is different from most of the other provinces in that our Act does not allow us to register or license pharmacy technicians

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A Closer Look at the Regs…

Pharmacy technicians

60(1) In a pharmacy, a pharmacy technician who is qualified under subsection (2) may perform the following tasks under a member's supervision:

(a) review the information in a prescription for compliance with federal and provincial law;

(b) before a drug is dispensed, perform a final check when the process of preparing the drug for dispensing was performed by another technician, student, intern or a person referred to in section 64, but only if the pharmacy manager has applied to the council for approval of the drug packaging preparation processes used in the pharmacy and the council has approved them;

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Continued… c) dispense a drug, if a member has approved filling the prescription and the

standards of practice related to a member's counselling the patient are met;

(d) identify drug-related problems that require referral to a member;

(e) give instructions to a person about how to operate a medical device, but not an explanation involving the interpretation of the results or value of the device;

(f) ask a practitioner and receive his or her instructions as to whether an existing prescription can be refilled as previously prescribed and without any change to the prescription;

(g) perform necessary tasks at an external dispensing site.

Questions?

For Further Information:

• NAPRA - www.napra.ca/docs/0/95/777.asp

• PEBC - www.pebc.ca

• Manitoba Pharmaceutical Association - www.mph.ca

• Canadian Association of Pharmacy Technicians www.capt.ca