Recognise skills of experienced dispensers

Dr Phillip Koopowitz calls for clarity on training exemptions for experienced dispensers.

Last year, the dispensary services quality scheme (DSQS) launched in England and Wales. Like the GMS quality framework, it rewards dispensing practices when quality targets are achieved. The section on training sets out the requirements for unsupervised practice dispensing staff. Unfortunately, this has caused confusion about experienced dispensers.

As a result, some primary care organisations (PCOs) have not paid practices their DSQS payments if any of their experienced dispensers have not or are not undertaking training for an NVQ2 or equivalent qualification.

Acknowledged expertise

When the DSQS was being negotiated it was pointed out that, because pharmacy technicians were allowed 'grandparenting rights' when they joined the Pharmacy Technicians Register, experienced dispensers should have the same rights.

These grandparenting rights, as understood by the Dispensing Doctors' Association (DDA), would allow existing dispensers with more than 1,000 hours' experience to work unsupervised without having to undertake an NVQ2 equivalent. They would however require an annual assessment and certificate of competence signed by a dispensing doctor.

However, ambiguity in the interpretation of the scheme has caused some panic and there is a risk that some of these highly experienced dispensers will leave their job rather than being forced to jump through hoops to achieve qualifications.

Additionally, because the DSQS is an all-or-nothing payment, practices that fail to satisfy the PCO that their dispensing staff have suitable qualifications, risk missing out on payments that would have helped to offset recent pay freezes.

It also puts at risk the implementation of another part of the DSQS, the dispensing reviews of use of medicines. These reviews are greatly valued by patients in their management of medicines. They also help to reduce wastage in the practice by ensuring concordance and compliance. But, they increase dispenser time, and without the DSQS payment, many practices will not have the resources to continue them.

Dispensing doctors risk losing valuable, experienced dispensers because of a misinterpretation of the regulations. I have been contacted by a number of dispensers, some of whom have been in dispensaries for up to 25 years, who are now considering early retirement because they feel that they are being discriminated against and have no wish to undertake an NVQ2. The equivalent for doctors would be the expectation that all GPs would have to take the MRCGP examination, regardless of having years of experience.

While dispenser training is essential, this can be fulfilled by the continuing professional development that dispensers undertake annually. It seems daft to make them go back to basic training.

Without experienced dispensers available to supervise trainee dispensers, we risk more dispensing practices not providing the DSQS and all its benefits in ensuring high-quality dispensing.

Dispensing doctors are caught between a rock and a hard place. They may be taken to an employment tribunal for insisting that their staff undertake non-statutory training or risk losing a substantial amount of money.

The DSQS and a dispensing register

DSQS - what is it worth?

The scheme rewards practices for providing high-quality services to their dispensing patients. Practices that achieve all the standards set by the scheme will receive £2.58 for each dispensing patient on their list.

DSQS payments withheld?

Those practices that have had their DSQS payments withheld because of dispenser training issues are being encouraged to challenge the decision via the NHS Litigation Authority. The DDA will provide advice and help to practices wishing to do this.

New Register of Dispensers

There is currently no nationally recognised register of dispensers. The DDA is setting up a voluntary Register of Dispensers from January 2008, that will recognise all dispensers, especially those with years of experience yet no formal qualification. The DDA hopes that in time PCTs will be able to use this to verify DSQS training requirements. Go to

- The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit

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