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A postregistration education and training programme that could serve
as a future model for pharmacist revalidation has been developed by the
Joint Programmes Board (JPB) for London, east and south-east England.
Revalidation will be introduced for pharmacists and other healthcare
professionals at some point over the next four years, according to the
White Paper “Trust,
assurance and safety” published last
year (PJ, 10 March 2007, p274).
There are currently 350 junior hospital pharmacists enrolled in the programme
and the JPB plans to expand its portfolio to include training for advanced
practitioners and those working in primary and community care (in south-east
England) later this year.
The board is a working collaboration between eight universities and senior
pharmacy managers across four strategic health authorities (see Panel)
which cover 40 per cent of the population of England. It has four goals:
• To implement a common, unified post-registration higher education
portfolio across London, east and south-east regions of England, via
the JPB consortium
• To establish an educational infrastructure to support the progression
of pharmacy practitioners, from immediate postregistration through to
consultant level
• To widen access to structured postregistration formal education for
all pharmacists
• To provide an exemplar of a formal postgraduate educational infrastructure
which responds to policy developments within healthcare, in particular
those that relate to fitness to practise and patient safety issues
JPB consortium
The JPB consortium comprises the NHS (Specialist
Pharmacy Services and trust chief pharmacists) across east and
south-east England
and the schools of pharmacy at:
- King’s College London
- Kingston University
- the University of London
- the University of
Brighton
- the University of East Anglia
- the Universities
of Greenwich and Kent
- the University of Portsmouth
- the
University of Reading
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Background
About six years ago, a group of academics and NHS practitioners started
to develop and test general, advanced and consultant level competency
frameworks (PJ, 27 November 2004, p789 PDF 70K), in response
to concerns that postgraduate education and training for pharmacists
in
England
was
not aligned with practitioner development. About three years ago this
group formed the JPB.
Graham Davies (left), head of programmes, and Ian Bates, member
of the Joint Programmes Board executive |
Graham Davies, head of programmes at the JPB and
professor of clinical pharmacy at King’s College London, explains
that the group recognised that there were already many postgraduate programmes
available for pharmacists
but that there were issues with these in terms of access and whether
they were delivering what was needed.
Professor Davies argues that programmes
in the south-east often placed an extra burden on the NHS and focused
on only clinical pharmacy practice rather than on the pharmacist’s
wider role. He explains that the group was keen to harmonise postgraduate
programmes to the concept of pharmacist development.
JPB executive group member, Ian Bates, professor of pharmacy education
at the School of Pharmacy, London, believes that the JPB operates like
a “quasi deanery” to provide a focus for pharmacist development.
Professor Davies adds that the board’s overarching mission is focused
on patient safety and adopts some of the principles outlined in “Modernising
medical careers”. It aims to integrate working and studying in
a way which operationalises continuing professional development and supports
the patient safety agenda. This, he says, will allow employers to know
exactly how good their juniors are and, if necessary, to identify and
manage poor performance.
Current programme
The JPB currently manages a single postgraduate programme, the postgraduate
diploma in general pharmacy practice (DipGPP). The DipGPP is a 36-month
programme for junior pharmacists which aims to equip them with the
core skills and competencies they require to provide pharmaceutical
care in hospitals. It is hoped that eventually every junior pharmacist
employed by the NHS in the region will automatically be enrolled into
the programme.
The programme also provides flavours of specialist areas which, says
Professor Davies, can help drive career aspirations. It is centred around
workplace learning and pharmacists are expected to take responsibility
for managing their learning and achieving their course objectives. The
aim is to create an ethos of self-reliance.
The competencies that need to be achieved to gain the diploma are based
on the General Level Framework (a professional development framework
tested by the CoDEG group), and are mapped to the NHS Knowledge and Skills
Framework so that pharmacists also achieve the relevant gateway competencies
required to progress through the Agenda for Change pay bands.
Assessments are designed to measure competency and performance, and draw
on a range of methods, including multiple choice question examinations,
objective structured clinical examinations and a portfolio of evidence
to describe work-based performance. In addition, a system to monitor
and sign off junior pharmacists’ performance is used (the record
of in-service training assessment [RITA]).
At the end of the programme, successful candidates are awarded a DipGPP
and a “statement of completion of general pharmacist training (SCGPT)”.
It is this statement of completion that perhaps represents the foundation
for revalidation, according to Professor Bates. “In particular,
the new General Pharmaceutical Council might be interested in the active
way this competence-based approach demonstrates the achievements of practitioners
at the end of this experience,” he predicts.
The JPB has no ambition beyond London, east and south-east England but
hopes to serve as an exemplar and work with colleagues in other parts
of England.
The role of NHS stakeholders in the JPB consortium is to ensure that
there is a culture of training in the workplace, to set the curriculum,
to run the assessments and ensure they meet the KSF requirements, to
provide practice tutors and educational facilitators and to award the
statement of completion.
The universities play a key role in quality assuring the experience.
They accredit the NHS training centres, support the tutors, organise
formal assessment days, facilitate learning sets, and award the DipGPP.
It is envisaged that, as more NHS trusts are accredited, participating
universities will phase out their old postgraduate programmes.
Wider ambitions
Ultimately, the JPB would like to make the programme sector-independent. “We
are beginning to test models for primary care and community practice.
We have already tested the competencies and we are now building models
with our partners to develop this,” says Professor Bates.
There are also plans for an advanced practice model to provide training
for consultant pharmacists and pharmacists with special interests. “Both
of these developments will hopefully engage the national players, for
example, the national community pharmacy employers and the United Kingdom
Clinical Pharmacy Association,” says Professor Davies.
The JPB received seeding money from the Higher Education Funding Council
for England to develop the blueprint for the programme but it will need
to be self-funding from next year, explains Professor Bates. Once the
blueprint has been developed it can be rolled out by other collaborations
that want to do so. NHS organisations pay a small fee for each candidate,
he adds.
In terms of getting the key stakeholders to buy into the programme, Professor
Davies likens it to a change management project. “When you bring
together a whole stream of academics and NHS practitioners there are
obviously tensions around letting go of something that people are comfortable
with and also a fear of the unknown,” he says.
“But very
quickly the academics and the NHS staff formed a cohesive unit, trusting
each other relatively quickly so that the traditional model of competition
was replaced by a truly collaborative one.”
There are advantages for schools of pharmacy and their NHS partners in
being part of the JPB consortium, explains Professor Davies. For example,
it is in the interests of the universities to be involved because it
helps them to build links with the NHS. “There could be some payback
down the line with clinical placements,” says Professor Davies.
And for the NHS, association with an academic partner will mean that
senior practitioners can more easily become involved with teaching and
research. Future professional body
Looking ahead to 2010 and the establishment of a professional body
and the GPhC, Professor Bates says: “This approach provides the foundation
to continue this work at a more strategic, national level. We hope
to have a good working relationship with any new professional body.” The
JPB would like to act as an operational interface between individual
practitioners and the professional body, Professor Bates adds.
Professor Davies says: “Pharmacy currently has no system to quality
assure practitioners — it registers people and it has a continuing
professional development commitment but there is no way of knowing what
the quality is within that system.
“If we can make the link for pharmacists between CPD, career development
and doing the job better (both performance and competence), then we will
have a system that tells people that this person has made the grade.”
The programme has been successfully piloted with the Structured Training
and Experience for Pharmacists (STEP) scheme
in south-east London (PJ,
24 November 2007, p578), with 16 junior pharmacists recently being awarded
a statement of completion of training.
The JPB programme will be evaluated as part of the seeding money provided
by HEFCE but will also be subject to the traditional approach, which
is an essential component of the educational process.
“We want
to measure the output of the programme in terms of what it delivers for
the individual pharmacists enrolled, the health care organisations that
support them and, most importantly, for patients,” says Professor
Davies. |
The
Pharmaceutical Journal