Reforming Post-Registration Pharmacy Education
Until recently, there was no systematic provision of postgraduate education for pharmacy practitioners in England. This poses a significant problem for career development, which in turn impacts on current health care reform policy, improved provision of public health and patient safety. The level of currently available post-registration pharmacy education has evolved from the need for development of clinical pharmacist skills and knowledge which are not adequately catered for within either the undergraduate MPharm degree or the pre-registration curricula. There is an educational gap that recent NHS reforms have highlighted. The recently published document from the Department of Health – “The regulation of non-medical healthcare professions” (aka the “Foster Review”) further emphasises the need for competence linked with performance assessment and is in effect a recommendation for postgraduate educational reform to reflect these priorities.
Recently, a number of issues have been raised relating to the delivery of formal postgraduate educational programmes. Within the NHS practitioners are now expected to take responsibility for ensuring that their practice is informed by recent developments in order that they are “fit for practice”. Furthermore, the concept of Clinical Governance demands that individuals engage in continuous professional development so that they identify any gaps within the knowledge or skill required to discharge their clinical role. In addition, the results of a Pharmacy Workforce project recently undertaken by the South East London Education Consortium (SELEC) provided a comprehensive analysis of the state of recruitment and retention in NHS pharmacy services. The report advised SELEC organisations to develop a collaborative strategy, which would enable them to secure a high-quality, multi-skilled pharmacy workforce for the future.
This strategy identified that any future postgraduate programme, designed to address the challenges outlines above should:-
- Focus on the knowledge and skills essential to produce effective practitioners,
- Improve access to a formal postgraduate course for all junior pharmacists,
- Ensure the introduction of a quality assurance process to provide students with an appropriate educational experiences within their workplace,
- Formulate a generalisable competency based model for the future education of junior pharmacists.
In identifying the need for developing the competence of pharmacist practitioners, members of the JPB consortium, in conjunction with the NHS, have developed and validated a competency framework for use within the hospital sector. This framework has now been widely adopted across England, Wales and Northern Ireland with much interest now being shown by other countries (including EU and Australia).
The JPB is spearheading research into adapting the existing evidence-based competency frameworks for use across health care sectors, thus negating the need for separate, and different, post-registration education models.
How the new Diploma and competency frameworks fit into pharmacy training and career progression:
The NHS and health care reform is a government priority. For the postgraduate pharmacy sector there are significant educational challenges if the workforce is to meet these new standards and improve health care and patient safety. Agenda for Change (AfC) , the NHS Knowledge and Skills Framework (KSF) and the Kennedy report (2001) are strongly indicative that postgraduate educational reform is key to any subsequent improvement in pharmacy health care delivery for the UK. It is time to address this lingering problem, and the JPB consortium aims to do so.
Development of the Postgraduate Diploma in General Pharmacy Practice
The JPB enlisted the collaboration of NHS trusts and PCTs in South East London as a pilot site for the validated programme. These Trusts collaborate as a single Training Centre so that the work-based programme is managed by a key individual acting on behalf of 12 organisations. The pilot started in January 2006, and was jointly funded by the local NHS trusts and the JPB. Feedback in relation to the impact of the new curriculum was very positive with both managers in the participating Trusts and practitioner-students enthusiastic about the benefits offered by the new curriculum.
The pilot sites for joint curriculum testing were:
- Guys’ & St Thomas’ NHS Trust
- King’s College Hospital NHS Trust
- University Hospital Lewisham NHS Trust
- Queen Elizabeth Hospital NHS Trust
- Queen Mary’s NHS Trust
- Bromley Hospitals NHS Trust
- Mayday Hospitals NHS Trust
Information relating to the new curriculum was disseminated to other Trusts across the consortium geography and an open invitation was extended to become early implementers in September 2006. The JPB quickly received firm offers from the next wave of NHS trusts who wanted to be early implementers of the new programme. There was significant support within the NHS for early engagement with the curriculum primarily driven by the obvious benefits offered by the programme.
Early implementers:
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Early testing of the curriculum has resulted in 16 student-practitioners graduating with the PG Diploma (General Pharmacy Practice) and a Statement of Completion of General Pharmacy Practice Training in October 2007. These student-practitioners have originated from the ‘STEP’ group of NHS Trusts who were the pilot sites for early testing of the JPB programme.
From October 2007 the DipGPP was rolled out to the south of England geography. New Training Centres (local NHS Trust collaborations working in partnership with JPB) are continuously being developed and accredited. A large cohort of regional based, trained and accredited tutors now exists, and continues to grow.
For more information visit Diploma General Level Programmes.
Development of Advanced Practitioner Programmes
The next phase of Higher Education provision for pharmacy practitioners will encompass postgraduate Masters and Higher degrees (new types of PhD and other doctorates).
This will complete the vision of an integrated learning pathway for practitioners from undergraduate to Consultant level – a whole career pathway supported by HEIs in conjunction and partnership with NHS agencies.
We envisage that subsequent reformation will continue after the establishment of this integrated pathway. This subsequent wave of reformation will seek to widen access further to include the community/primary care sector (which is currently just beginning to engage with policy change). We seek to expand taught postgraduate HE provision, using our network and model, from 2009 onwards.
For more information visit Advanced Pharmacy Practice Programmes.
- There is a growing dislocation between education (in a wider sense) and pharmacy practice. A glance at many formal post-registration programmes shows a reliance on orthodox academic approaches to an educational problem that is inherently career and job focussed. Some sectors of practice have, in addition, been poorly served by educational providers.
- Mostly, and for historical reasons, formal post-registration education provision has not been designed on a competency-based approach. In a post-Bristol era, this needs to be urgently redressed
- The provision of formal education is inequitable, and access to educational programmes is dependent on geography and availability of local resource. If we are to take the practitioner development strategy seriously, then all post-registration practitioners should have equal access to formal educational support and opportunity.
- Little evidence exists that clearly links current formal educational awards with practitioner development. Are you a better practitioner if you hold a Diploma? A new design, with a competency-based approach will be able to address this issue.
- Working in partnerships. There is an opportunity for the service sector and higher education to establish a new working relationship, based on the common goal of improving health services through workable practitioner development strategies. Cooperation across sectors, geographical boundaries and institutions is a sensible way forward that has great potential for moving the profession forward.
- Competence and fitness for practise as postgraduate educational remits
- NHS career reforms
