ABSTRACT
The United Kingdom (UK) healthcare workforce is changing rapidly and as traditional roles are reshaped, new ones are being introduced to redistribute the delivery of healthcare in more flexible and responsive ways. In England, primary care delivery is being built around local primary care networks, in which the anchor profession remains the general practitioner (GP, or family doctor) but the standard configuration of a GP practice (surgery) with a single professional group is being replaced with networks in which GPs work alongside practice nurses, practice pharmacists, physiotherapists, paramedics and others. Newer professions are joining the healthcare workforce as well – physician associates, pharmacy technicians and nursing associates, for example. Similar realignments are taking place across the National Health Services (NHSs) in the other countries of the UK. A conventional view of the new professions is a vertical one: that while they are professions in their own right, they draw heavily on longer established, cognate roles – doctors (linked to physician associates), pharmacists (linked to pharmacy technicians) and nurses (linked to nursing associates) and that the older roles are their parents. That is true to an extent, but this chapter suggests an alternative, horizontal rather than vertical, approach. In the Office for National Statistics’ (ONS) occupational classifications, doctors, pharmacists and nurses are classed as ‘professionals’, with a shared set of characteristics. Pharmacy technicians, on the other hand, are ‘associate professionals’, with a different set of characteristics, which they share with the very new professions of physician associates and nursing associates (as well as paramedics, dispensing opticians and others). That relationship is horizontal, not vertical. The chapter suggests that the precedent for introducing these roles is now well established but may reshape the healthcare workforce in ways that are not yet fully understood. It uses pharmacy technicians and their working relationship with pharmacists and other healthcare professionals as a case study.
