Hospital Pharmacist
2007;14:373-374
December 2007

Helping preregistration trainees meet Society and NHS requirements

By Rachel Stretch and Helen Middleton, MRPharmS

The NHS Knowledge and Skills Framework (KSF)¹ defines the knowledge and skills that NHS staff need to apply in order to deliver quality services.

The KSF comprises six core dimensions (which apply to all NHS jobs) and 24 specific dimensions which apply to some but not all NHS jobs. Each dimension of the KSF has four levels, with indicators that describe how knowledge and skills need to be applied at each level.

Since the KSF is a generic framework, it does not describe the exact knowledge and skills that staff need to develop.

In the case of preregistration trainee pharmacists, Royal Pharmaceutical Society performance standards specify the knowledge and skills required to practise competently as a pharmacist.²

It is important that the KSF and performance standards are linked, to ensure trainees are meeting the requirements of both the Society and the NHS, and to avoid unnecessary work.

London Pharmacy Education and Training (LPE&T) have developed a KSF post outline for preregistration trainee pharmacists, and linked the Society’s performance standards to it. This enables trainees to use performance standards as examples of application to demonstrate that they are meeting the defined level and indicators of the KSF.

Developing the KSF outline

The first step in developing a KSF outline for a preregistration trainee post was to decide which dimensions to include. The Guild of Healthcare Pharmacists (GHP) guidance on developing KSF outlines³ was used as a starting point to identify which dimensions apply to pharmacy.

The second step was deciding on the appropriate level for each dimension. LPE&T considered the following:

• The indicators required for each level and specific examples of application for a trainee

• The Society’s performance standards and how these best link to the KSF dimensions and levels

• GHP recommended levels for a band 6 pharmacist post³ (levels set for a preregistration trainee post would not be higher than these)

Since all trainees need to be able to meet all the indicators at the selected level by the end of the training period, it was important to be realistic when selecting the level trainees are required to achieve.

Panel 1 (above) shows the dimensions and levels that we selected for the KSF outline. We consider these levels to be achievable by all preregistration trainees, and some may achieve higher levels. Local opinion may differ resulting in some variability between organisations. The reasons for our recommendations are outlined below.

Communication — level 2 We do not consider this dimension to be level 1 because trainees are expected to communicate with more than a limited range of people and on matters that are not straightforward. However, they would not be expected to communicate about difficult matters or in difficult situations (level 3) without support or supervision and would not be expected to be competent at level 3 by the end of the training year. Level 3 is the GHP recommended level for a band 6 pharmacist.³

Personal and people development — level 2 Level 2 in this dimension requires an individual to take responsibility for their learning and development. It is essential that trainees take this responsibility.

Health, safety and security — level 1 We do not consider this dimension to be level 2, which would involve monitoring the health, safety and security of others. Trainees assist in maintaining their own and others’ health and safety. ³

Service improvement — level 1 Projects undertaken by trainees are carried out under supervision and the trainee does not have full autonomy in implementing the changes (as would be required for level 2). They do not evaluate other’s work or have a strategic role in service improvement. Level 3 is the GHP recommended level for a band 6 pharmacist. ³

Quality — level 1 Trainees are not responsible for monitoring the quality of work in a section of the department (level 2). Level 3 is the GHP recommended level for a Band 6 pharmacist.³

Equality and diversity — level 1 We consider level 2 in this dimension to be difficult to achieve for a trainee, eg, identifying when an individual is being discriminated against and doing something about it, rather than merely reporting it (level 1). However, some NHS organisations have set their minimum level for this dimension at level 2 for all employees, so the decision will depend on local trust policy.

Interventions and treatments (HWB 7) — level 2 A trainee is expected to identify specific precautions or contraindications to treatments, and take appropriate action using their clinical knowledge, with an appropriate degree of urgency. This would be level 2.

We do not consider it to be level 3 because trainees do not perform consistently at this level and are accountable to a qualified member of staff. Level 3 is the GHP recommended level for a band 6 pharmacist who would be acting independently and taking professional responsibility. ³

Products to meet health and well-being needs (HWB 10) — level 3 Level 2 of this dimension involves batch prepared medicines only, whereas level 3 includes dispensed medicines, aseptic and extem- poraneous products. Because trainees do not perform consistently at this level and are accountable to a qualified member of staff we do not consider it to be level 4. Level 3 is the GHP recommended level for a band 6 pharmacist who would be acting independently and taking professional responsibility.

Linking standards to KSF

The third step was to link the Society’s performance standards to the dimensions of the KSF outline. We opted for what we considered to be the best fit for each performance standard. Each standard has therefore been linked to only one KSF dimension even though it is acknowledged that some performance standards may link to more than one dimension.

Panel 2 (below) shows how we have linked the performance standards with the communication dimension (C1). A full list of the performance standards linked to each dimension and level in the KSF outline can be found at the LPE&T website.

It is important to note that some KSF dimensions may not be met by achieving the performance standards alone.

For example, we found no performance standards that are directly related to the “equality and diversity” dimension and few relating to the “health, safety and security” dimension. Where these gaps exist, trainees will need to find other ways of meeting the dimension and examples of application should be developed locally.

Conclusion

By providing direct links between the KSF and performance standards, we have produced a framework to help preregistration trainees meet the requirements of both the Society and the NHS, and to avoid unnecessary extra work.

References

1. Department of Health. The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. London; Department of Health: 2004

2. Royal Pharmaceutical Society of Great Britain. Pre-registration Tutor Workbook 2007/8

3. Producing KSF Outlines for Pharmacists: A guide, The Guild of Healthcare Pharmacists