What does the Society think?
Views on why pharmacists should prescribe, what training
they should receive, how supplementary prescribing will work in practice
and what
legal responsibilites prescribing brings were all presented at the seventh
annual Hospital Pharmacist conference held in London on 30 October. Gareth
Jones and
Rachel Graham (on the staff of Hospital Pharmacist) report
Peter Wilson: all pharmacists should be able to become supplementary prescribers |
All pharmacists should be able to train and be recognised
as supplementary prescribers according to Dr Peter Wilson, a consultant
to the Royal Pharmaceutical Society on continuing professional development.
Until now, the focus has been on the training needs of those who are
already a registered pharmacist. But part of the long-term plans include
incorporating supplementary prescribing training into the pharmacy undergraduate
course. Work on preparing the training for preregistration trainees and
undergraduates is beginning, and this should be completed within 12-24
months.
Dr Wilson provided an update on the numbers of pharmacists who are enrolled
on the first wave of courses in the United Kingdom. In England, 114 pharmacists
are doing a course, and they are mainly from a hospital or primary care
background. Information about pharmacists doing the courses in London
shows that there is a wide spread of clinical areas (including cardiology,
cancer, mental health and intensive care). In Scotland 41 pharmacists
are on a course, and they are mostly community pharmacists. In Wales,
the introduction of training is not yet complete. In Northern Ireland,
a course was due to start in early November. There are about 25 pharmacists
on the course.
The purpose of the courses is to train pharmacists in prescribing. These
programmes do not exist to train pharmacists in clinical pharmacology,
therapeutics and clinical pharmacy in general, said Dr Wilson. Participants
on a course should develop a competence and sense of responsibility in
prescribing practice. Pharmacists will train to prescribe in the clinical
area where they will work once registered. In the course of their career,
they may work in different areas and become competent in prescribing
different drugs. It is therefore important that they learn to recognise
when they are prescribing within their professional competence, and when
they should refer patients to another prescriber for review. Universities
must ensure that the sponsoring organisation confirm the clinical competence
of trainees before the course, as it is not possible to teach this knowledge
during the prescribing course.
Dr Wilson said that many different groups had been involved in the consultation
on the course content. Experience of prescribing practice from pharmacists,
nurses and doctors had been obtained, and pharmacists who teach prescribing
to nurses had been asked to comment on how the training should be delivered.
This consultation informed both the Department of Health and the Society’s
guidance on training of pharmacist prescribers. The programme also underwent
a review by the Committee on the Safety of Medicines, the Medicines Commission
and the education committee and Council of the Society.
Eight programmes are now accredited as pharmacist supplementary prescriber
courses in Britain. A further seven institutions have applied for accreditation.
The programme at the Queen’s University in Belfast is likely to
be recognised by the Society for the purpose of registering pharmacists
as supplementary prescribers, although the accreditation was provided
by the Pharmaceutical Society of Northern Ireland.
Some institutions are running a uni-professional course, whereas in others
there is a degree of shared learning with nurses. When accrediting the
latter programmes, the Society is considering
whether the differing learning needs of nurses and pharmacists are being
met.
The teaching component of the prescribing courses is equivalent to 25
days learning. The courses use class contact and open learning to varying
degrees, and all require the students to undertake directed private study.
The other part of the training is learning in clinical practice. The
minimum duration is 12 days, but this can be extended if the student
requires more experience. Many of the universities have decided to use
the National Prescribing Centre (NPC) competence framework to assess
the competency of participants.
There are strong reflective elements in the courses. The supplementary
prescribing qualification will allow pharmacists to work in different
clinical areas and prescribe new drugs, so they must be reflective practitioners.
Pharmacists who complete the training will be awarded a practice certificate
in supplementary prescribing, which will be accepted by the Society.
The Society website (www.rpsgb.org.uk) has further information on access
to the programme. Pharmacists must first establish a prescribing partnership
with an independent prescriber,
secure employer/primary care trust agreement, identify a practice supervisor,
apply for funding and apply for the training course. They must have a
prescribing role in which to work once the course is completed.
Duncan McRobbie, one of the other speakers at the conference, had criticised
the requirement for experienced pharmacists to attend lectures on topics
such as basic pharmacokinetics (see p480). Dr Wilson acknowledged the
high level of experience of those in the first wave of the prescribing
courses. It was expected that those prescribing in hospitals under local
arrangements would be among the first cohort. When they have been through,
other pharmacists will be going through the system and presenting different
challenges to the university staff.
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