Expertise developed after registration will soon be recognised on New Zealand pharmacists' practising certificates, as a new system of competence accreditation comes into effect later this year.
The new system means that the days of "once a pharmacist, always a pharmacist" in New Zealand are over. The term "pharmacist" now encompasses a diverse range of specialist health professionals. Furthermore, competence accreditation, launched at the recent national pharmacy conference in Wellington, will use a standards-based model to grade skills at three levels.
The standards describe what competent pharmacists actually do, instead of setting a theoretical model of what they should do, according to the Pharmaceutical Society of New Zealand's manager for professional development and competence (Mrs Diana Drumm).
She said: "By taking the initiative and setting up its own competence project, recognised by the government, the society has ensured professional control of pharmacists by pharmacists rather than waiting for standards to be imposed by outside agencies."
The origins of competence-based accreditation for pharmacists lie in a competence-based preregistration programme for New Zealand pharmacy graduates, which was introduced in 1997.

A pharmacy in Napier, a North Island city famed for its Art Deco architecture

The competence framework builds on the same seven standards used for initial registration, in order to define the higher level skills pharmacists develop with time and experience (see panel). Three levels of competence are set for each standard. They are: pharmacist (entry level); practitioner; and specialist. The practitioner level is expected to follow by natural progression in expertise from the pharmacist level.
The specialist level is slightly different. It is intended to recognise pharmacists who have developed particular skills in their defined area of practice and who may not necessarily be involved in the day-to-day details of pharmacist and practitioner level practice. This level describes the competent practice of pharmacists whose work encompasses responsibilities beyond those generally recognised as part of the pharmacist's traditional role and often beyond an individual pharmacy workplace.
The competence framework allows all pharmacists to have a practising certificate irrespective of where they are working. For example, pharmacists employed by the New Zealand Pharmaceutical Society may not need competence in dispensing or preparing pharmaceutical products but they do need management, organisation, information and research skills and must behave in a professional and ethical manner. Their practising certificates would detail the standards and levels describing these skills. If they wished to become dispensing pharmacists again they would have to become competent in the necessary standards in order to practise.
Entry or re-entry to the register requires the applicant to be competent in all seven standards at the pharmacist level. After registration, the only absolute requirement for a practising certificate is competence (at any of the three levels) in professional and ethical behaviour.
Pharmacists can select the mix of the standards and levels which best describes their own pharmacy work and role. A structured self-assessment, including a professional portfolio, will be the primary source of evidence of competence. Practising certificates will be issued for different time periods, according to the circumstances of the pharmacist and the quality of the assessment evidence. Competence accreditation will be introduced gradually in order of ascending age groups over the next five years.
Australia is to gop down the same route. In a recent strategy paper the Pharmaceutical Society of Australia indicated that it was to begin initiatives to introduce competency-based mechanisms for pharmacist re-registration. - Jane Caldwell

Seven competence standards

The seven competence standards for New Zealand's pharmacists are:

• Practise pharmacy in a professional and ethical manner
• Facilitate the rational use of medicines
• Provide primary health care
• Apply management and organisational skills
• Apply information and research skills
• Dispense medicines
• Prepare pharmaceutical products