The Guild of Healthcare Pharmacists day conference took place in Oxford on November 26
Guild members voted against a motion that pharmacists should be re-examined every five years to prove competence to continue to practice.
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Speaking for the motion, Mr CHRIS CAIRNS (director, pharmacy academic practice unit, St George's hospital, London) said that pharmacists existed to help people get better and it was important that patients were given the best possible service. In addition, individual pharmacists had to be responsible for their actions and organisations had to be accountable for the actions of their employees.
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Chris Cairns (left) and Ray Fitzpatrick were in favour of regular examination to prove competence |
Reaccreditation was mandatory for other professions and if pharmacists did not follow, how would they be viewed by both patients and other health professions? It was important that pharmacists were seen to be trying to set up a system for testing competence rather than appearing to be dragged into it by outside forces.
Mr KEITH FARRAR (chief pharmacist, Wirral hospitals) spoke against the motion. A five year test for pharmacists had been proposed "for the good of the general public" but who would do the testing? The Royal Pharmaceutical Society, academics or peer groups? Pharmacists in different disciplines - indeed, even those in the same discipline within the profession - would require different competence measures. How did one compare quality control pharmacists with drug information or community pharmacists? Further questions raised by the motion were why test every five years? Would this be often enough? If a pharmacist failed the examination, would they be barred from practising? How many times could one resit before being struck off completely?
Mr Farrar said that competence was not a problem in the majority of pharmacists but a few "rogues" existed, who were almost certainly out-of-date and were possibly incompetent. He questioned the necessity of setting up a complex examination process in order to catch such rogues, who would probably evade the system anyway. Errors were not necessarily evidence of incompetence but indicated a problem within the pharmacy system. It was not possible to add quality to a product or service upon final delivery; it had to built in right from the beginning.
Mr RAY FITZPATRICK (director of pharmacy, North Staffordshire hospital) seconded the motion saying that pharmacists had a duty of care to ensure that they were up-to-date and competent to practice.
The pharmacy degree course had expanded to four years, and the registration examination had been introduced by the Society to ensure that new pharmacists were fit to practice. For those already registered, there were postgraduate degrees and educational symposia to help individuals keep up-to-date. However, attendance at training events was not compulsory and there was no method of measuring whether they really maintained and expanded knowledge and skills. Currently, no one was really checking to see whether pharmacists were competent. Such checks were vital because the profession was one step away from prescribing and its technical abilities would be relied on heavily by both patients and fellow health professionals. There were advantages to working to a five-year goal and, clearly, regular assessment was necessary if individuals were to remain safe and effective in a fast-moving, high-tech health environment. Only independent appraisal would ensure that individuals remained competent. Examination did not just mean sitting a three-hour written paper now, it meant assessment using a variety of tools. It was important that assessment was not just about examining knowledge but about testing the ability to obtain and use knowledge in practice. He did not believe in the philosophy that initial registration ensured competence for life and said that continuing this belief would be digging the profession's own grave.
Miss CLAIRE GROUT (continuing professional development project pharmacist, Oxfordshire and Berkshire hospitals), opposing the motion, said that one of the main problems with assessing competence was that specialist pharmacists often had to work in generalist settings. Just because specialist pharmacists had been certificated in their own area did not mean that they were competent in others that they might have to cover when other members of staff were absent. Individuals working towards a five year examination would almost certainly be competent throughout the fortnight before the test, while they were revising, but could this competence be guaranteed for the rest of the five year period? It was essential that any assessment was ongoing and individualised to each pharmacist. A portfolio that recorded achievements, weaknesses and training needs was crucial. |
Claire Grout and Keith Farrar argued against five yearly examinations |
Other topics discussed:
Rationing and funding in the NHS
New journal and website
Vaccine storage and prescription legibility
No confidence vote rebuke