The Pharmaceutical Journal
Vol 268 No 7189 p355
16 March 2002

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Is central funding of pharmaceutical postgraduate training the best way?

The Government currently funds postgraduate professional development for practising pharmacists in Britain through three national centres. Each home country has national co-ordination and consistency in the training provided, but does the system offer the degree of flexibility needed to develop local initiatives? Michael Thompson investigates

Related websites
Scottish Centre for Post Qualification Pharmaceutical Education [www.scppe.strath.ac.uk]
Centre for Pharmacy Postgraduate Education [www.cppe.man.ac.uk]
Welsh Centre for Post-Graduate Pharmaceutical Education (www.cf.ac.uk/phrmy/WCPPE)

Practising pharmacists employed by, or providing services on behalf of, the National Health Service get most of their postgraduate practice-related training or professional development courses through the Centre for Pharmacy Postgraduate Education (CPPE, England), the Welsh Centre for Postgraduate Pharmaceutical Education (WCPPE) or the Scottish Centre for Post Qualification Pharmaceutical Education (SCPPE).

A key difference between the three countries is that the CPPE is funded only to train community pharmacists, while the Welsh and Scottish centres provide courses for hospital pharmacists too.

An issue in professional development that has been raised within a number of English health authorities is whether such a centralised system is flexible enough to allow the development of services to meet specific local health needs.

Guy Thompson, deputy director at WCPPE, explained that the WCPPE had to provide face-to-face courses amounting to 60 hours of teaching for each of the five health authorities (HAs) in Wales.

Within that central framework, there is flexibility around where, when and what courses are run. A major contribution to identifying training needs comes from national drivers, such as the national service frameworks. However, course programmes in each area are also developed by local tutors, one for each HA, who liaise with their client groups and identify needs arising from specific service development projects local health groups (LHGs) have, or are looking to develop.

"That gives us a nice combination of top-down and bottom-up drivers," Mr Thompson said. "Generally, we are able to react quite quickly, and within three to four weeks on some occasions, but we are finding it more difficult to react to LHGs. We certainly do collaborate with health authorities and have provided specific training courses outside our planned programme."

In Scotland, postgraduate training has been provided through the SCPPE since 1989, but significant changes are about to be made. The Post Qualification Education (PQE) Board for pharmacy, which was briefed to assess, advise on, and meet the needs for post-qualification training, is to be subsumed within a new special health authority, the Special Health Board for Education in NHS Scotland, from 1 April. This health board will bring under single governance the Scottish Council for Postgraduate Medical and Dental Education, the National Board for Nursing, Midwifery and Health Visiting and pharmacy's PQE Board.

Dr Gordon Jefferson, chairman of the PQE Board, said that the SCPPE provides direct learning courses and distance-learning materials as well as funding postgraduate courses for hospital and community pharmacists at the request of individual health boards and trusts. Like its equivalent in Wales, the SCPPE provides courses that have their roots in national plans. "Some courses are national, taking cognisance of national plans, others are run in specific areas though local tutors," Dr Jefferson said. "We seek annual input from pharmacy stakeholders about what is needed and have links with the Scottish chief pharmacists' vocational training scheme."

So far as the coming year is concerned, Dr Jefferson believes that matters will continue much as before. "My guess is that courses for pharmacy next fiscal year will continue much as they have in the past," he said. "I have asked the new board chairman that SCPPE should continue to be used as an operational name. It is going to take some time for the new board to bed in."

This seems likely, as consultation on the structure and function of the new board does not come to an end until June, some two months after the PQE board for pharmacy ceases to exist.

Peter Wilson, director of England's CPPE, is satisfied that the system works well for community pharmacists and meets local needs. Each of the 91 part-time CPPE tutors is expected to run six workshops a year, half of which are chosen following discussions with pharmacists in the locality so that they can focus on local needs.

"If health authorities want further training in addition, we can put on workshops in partnership with them — we run the workshop and they pay for the venue," Dr Wilson said. "CPPE also has an assistant director and a full-time tutor who can devise or modify courses to meet the needs of the people who commission them."

There had been positive results when the CPPE had been called upon to support anti-smoking or coronary heart disease campaigns. "I am satisfied that we can respond to unmet needs," Dr Wilson said. "It does depend on the availability of people, but we can do it."

Because the CPPE is funded only to provide training for community pharmacists, hospital pharmacists in England have to fend much more for themselves. Access to training budgets depends on where they are based — pharmacists in the London region and those based at teaching hospitals are acknowledged to have a better deal than pharmacists who may work in a department with fewer than 10 pharmacists. (Where hospital pharmacists in England can go for money for training will be the subject of another article.)

Clearly, those responsible for the national centres believe that centralised funding for postgraduate training works. Nevertheless, that still leaves the question open whether or not it is the best way forward, given that decision making in the NHS is being driven down to increasingly local bodies and it these bodies that may decide on widely differing service priorities which demand training.