Discussion suggests provision of preregistration training should be
integrated into workforce planning
A need to plan the provision of pharmacy preregistration training programmes as part of the workforce planning process was identified during a discussion forum held before the annual general meeting of the Royal Pharmaceutical Society on 12 May.
The issue was raised by Brian Miller (East Metropolitan branch and Hertsmere
Primary Care Trust), who said that a survey within his PCT showed that
few community pharmacists were willing to take on preregistration trainees
in the future. This would present a big problem when students start graduating
from the new schools of pharmacy. He asked whether the Society intended
to change the structure of the preregistration year to encourage independent
community pharmacists to group together and share a trainee.
The Treasurer, Linda Stone, who formerly chaired the Council’s
Education Committee, agreed that there was a potential employment issue.
Every university that approached the Society with a view to starting
a pharmacy course was advised that their graduates could not be guaranteed
preregistration places.
To try to increase the number of places, the Society was having discussions
in a variety of places to improve levels of funding, in particular to
facilitate secondary placements. The Society was aware that it was relatively
expensive to achieve.
Graham Phillips (St Albans) said that a shortage of preregistration places
was not a potential problem but a current one. His business, which had
four branches in Hertfordshire, was continually approached by people
who were desperate for preregistration places. He had not taken preregistration
trainees in the past, but now felt obliged to do so and had trainees
in two branches.
It was not good enough to increase the number of university places with
no guarantee of preregistration placements. The idea was to increase
the number of practising pharmacists, but having people with an academic
qualification who could not practise would not solve the problem.
Philip Green (the Society’s director of education and registration)
said the number of preregistration places was now higher than ever. The
Society was far from complacent about encouraging people to take on trainees,
but it was not something it could control on its own. It had had helpful
discussions with other pharmacy bodies, the major employers and the Government
health departments about the need to take preregistration places seriously.
Those discussions were continuing and there were signs that progress
would be made.
Carwen Wynne-Howells (chief pharmaceutical adviser to the National Assembly
for Wales) said that people fail to appreciate the need to link preregistration
places to workforce planning. A Society group had been looking at workforce
issues and was about to report. The first thing to establish was how
many pharmacists were required, then to create the number of places to
meet that need.
The need for an increased capacity to train was often forgotten. The
preregistration year was now competency-based and needed skilled trainers
to deliver it. Wales, particularly in the managed care sector, had reached
capacity. Until the training infrastructure improved, it would not be
possible to deliver the training that graduates deserved.
Martin Astbury (Wirral branch, and a member of Council) said he was told
that the Society had no power to stop universities from beginning the
accreditation process. He wondered how hard the Society was lobbying
for that power in the Section 60 Order.
The Treasurer said that the Society’s powers were limited to determining
whether a course matched its requirements for an MPharm degree. If it
tried to change those powers while universities were applying for course
accreditation, it might be in some difficulty.
Mrs Stone added that some universities had turned to pharmacy because
they had places unfilled in other science disciplines. They may now be
finding that it is not as simple as they thought. It is not just a question
of picking modules off a shelf, and pharmacy is not as cheap to teach
as they may think. If they realise that they may not attract the students
they want and that there may not be preregistration places at the end,
perhaps they may decide it was not such a good idea. The limit of the
Society’s current power is to make it clear to universities what
is involved.
The Secretary and Registrar (Ann Lewis) said the Section 60 Order would
underpin the Society’s powers to ensure standards. It would not
give it power to stop things happening.
Arnold Beckett (Croydon) said that the number of universities in the
field of pharmacy education can only be increased by lowering standards
as a whole. The fact that universities were moving into pharmacy for
commercial reasons gave him cause for great concern. Would the standards
applied to their courses be equivalent to those in the stronger universities
in this field?
The Treasurer assured Professor Beckett that the standards were maintained
as high as in existing good schools of pharmacy. The point was to ensure
that new courses were taught at an appropriately high level, not at the
bottom end. The University of East Anglia was now teaching its first
year, and the standards there appeared more than adequately to match
the criteria. No other new course was yet running, but two had been permitted
to recruit for September.
Ian Simpson (Oxford) said that until now there had been only one school
of pharmacy in the Republic of Ireland. As a result, there had been more
Irish pharmacy students in Britain than in Ireland. But now there were
two new schools of pharmacy in Ireland and some British schools of pharmacy
might lose large numbers of Irish students. Had that been taken into
account in the calculations about graduate placements?
The Treasurer said that the Society was aware of the risk factor for
schools of pharmacy that took a lot of Irish students, but that was as
far as it had gone.
Wally Dove (member of Council) said that roughly half of all preregistration
trainees went to one large pharmacy contractor. The real problem was
in the independent sector — and it involved funding. The Society
should be working closely with the Pharmaceutical Services Negotiating
Committee, the National Pharmaceutical Association and the Company Chemists
Association to convince the Department of Health to increase funding
in this area. The independent sector had been complacent, feeding off
the large contractors who did the training for them. They should play
their part.
The President, Gill Hawksworth, said that she had chaired a meeting on
preregistration training attended by representatives of the PSNC, NPA,
CCA and Guild of Healthcare Pharmacists. The main points raised had been
passed to the Society’s new head of preregistration and the Pharmacy
Workforce Planning and Policy Advisory Group. That group would report
shortly, and the Society hoped that its recommendations would give ammunition
for the head of preregistration.
Mr Phillips supported the points made by Mr Dove and Ms Wynne-Howells.
The Society had a duty to ensure an adequate supply of pharmacists and
to ensure that pharmacy graduates could qualify professionally. To go
through four years of student debt and not have a preregistration place
at the end was appalling, particularly when there was a desperate shortage
of pharmacists.
Mr Green added that there had been conversations with the multiples,
but he was not aware of any activity to encourage independent pharmacists
locally to increase the number of preregistration places.
Sue Carter (Worthing and West Sussex) said her own PCT was the first
to take part in preregistration training. It was accredited by the Society
to take part in a joint programme with the secondary care trust. It worked
well and was popular with the trainees.
Developing the high quality training to be invested in the trainees had
involved an incredible amount of work. One problem was that some trainees
did not stay on to work in the local workforce development area as pharmacists.
This year, two out of the four had not only left the area but had left
Britain to return to their native countries. She knew that some multiple
companies in the past had a philosophy of pinning people in for a couple
of years. She wondered if the NHS managed service would soon need to
do something similar.
Mr Green said that the number of independent pharmacy preregistration
places had more than doubled since 2002. It was important to note that
the numbers of preregistration places offered by multiples were geared
to their own recruitment and retention issues. It needed to be seen as
part of a bigger picture, that of the whole of the workforce.
The Secretary and Registrar said mention had been made of the Pharmacy
Workforce Planning and Policy Advisory Group. This was an important piece
of work, and a conference was shortly to be held to look at the models
being developed. She hoped that, as a result of the conference, the workforce
report would be finalised later in the summer. It may point to further
work that needed to be done, particularly in tracking people and
in developing even better information about the workforce and how it
was affected,
right through from undergraduate level to employment.
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