Hospital Pharmacist
2008;15:220-224
June 2008

Guild of Healthcare Pharmacists / UK Clinical Pharmacy Association

Modern regulation requires a greater emphasis on education

The General Pharmaceutical Council cannot simply “root out poor practice and behaviour”, but must also enable the pharmacy profession to develop its practice, said Peter Noyce, professional adviser to the Professional Regulation and Leadership Oversight Group.

The GPhC, the new regulatory body for pharmacy that will be in place by January 2010, will need to operate as a modern regulator, according to Professor Noyce. It will need to develop high quality practice and foster innovation, while ensuring patient safety and maintaining public confidence.

A regulator should not create an unnecessary burden for practitioners, but will need to vary its level of activity in proportion to the risks associated with practice. “This is particularly important for those who deliver advanced levels of practice,” he said.

It will be important for the new regulator to communicate its work to members.

Professor Noyce hopes that future communication from the GPhC will not simply be restricted to reports on disciplinary hearings in The Pharmaceutical Journal.

There will be several challenges for the GPhC to overcome. The first surrounds the regulator’s increased role in education, and Professor Noyce highlighted the absence of any joint forum for pharmacy education in the UK. “The idea that schools of pharmacy get together and discuss pharmacy education in a mature, non-competitive way, is a long way from reality,” he said. “This is a serious gap that the pharmacy profession urgently needs to fill.”

He asked conference attendees: “Can you imagine medicine not having a professional forum that reaches across the whole [field] of medical education?”

Another challenge is the lack of integration between education and pharmacy practice, says Professor Noyce. He believes that 50 per cent of pharmacy practitioners need to be involved in education. At present, he estimates that only 10-15 per cent are involved. “We need to transform pharmacy into a coherent, clinical profession … and make sure the public know what pharmacists are capable of contributing [to patient care].”

Finally, he said that putting in place a process of revalidation would perhaps be the biggest challenge. “In the UK, we will need to revalidate about 7,000 pharmacists a year — that is a tall order.”

Advanced E&T framework launch

A professional development framework that defines levels of expert practice for pharmacy staff who are involved in the education, training and development of others (Hospital Pharmacist 2008;15:175) was officially launched during the conference.

Catherine Duggan, chair of the UK Clinical Pharmacy Association, commended the UKCPA education and training committee for the lead they have taken in developing the framework, which will facilitate the future regulation of advanced pharmacy practice.

Wikis: a tool to aid collaboration

Collaborative websites known as “wikis” could be a useful tool for pharmacists to use when developing services. So believes George Gannon, pharmacy operations manager at University College Hospital Foundation Trust, London.

A wiki is a website that can be edited by all those who are invited to do so. This makes it more useful than e-mail in some circumstances, because it brings together the opinions of all parties in one place, rather than being scattered across an e-mail inbox.

The idea was popular among the workshop attendees, who proposed that a wiki could facilitate collaborative projects such as designing a new drug chart, planning an out-of-hours rota or communicating supply problems.

Back to basics for diabetics

Natasha Jacques, principal pharmacist for medicine at Heart of England NHS Foundation Trust, won the Sanofi-Aventis diabetes award.

Ms Jacques has set up a pharmacist-led clinic called ABC (action on diabetes, blood pressure and cholesterol) for diabetic outpatients.

Science must be the bedrock of pharmacy education

Pharmacy undergraduates must learn to integrate the science of medicines into healthcare practice to guarantee the future of the pharmacy profession, said Anthony Smith, dean of the School of Pharmacy, University of London. The recent pharmacy White Paper (Pharmacy in England: building on strengths — delivering the future) suggested that the pharmacy degree and the pre-registration year might be integrated to ensure pharmacy knowledge was put into a clinical context.

Professor Smith said that the pharmacy profession should outline the competencies that need to be developed during undergraduate education to facilitate post-registration development. “What knowledge, skills, attitudes and behaviours does a pharmacist need at the point of registration?” he asked conference attendees.

To develop the pharmacy degree successfully, there will be several problems to overcome. There is currently a lack of communication between academics and clinical practice said Professor Smith. He was “ashamed” to admit that, at present, there is “frighteningly little discussion” between those who are involved with undergraduate education and those who are involved with delivering pre-registration training. “That has to change,” he added.

Professor Smith believes that integration of the pharmacy degree and the preregistration year could reduce some of the inconsistencies that currently exist in the standard of training delivered to preregistration trainees. However, he added that the issue of funding would need to be addressed, because clinical education is “extraordinarily expensive”, and schools of pharmacy are not currently funded to organise it.

However, clinical training should not replace the teaching of fundamental scientific principles that currently provide pharmacists with a complete understanding of the science of medicines, he said. Such principles include knowledge of pharmaceutics and the physical characteristics of drugs, such as their half-lives, compatibility and stability.

He believes that for pharmacists to prove they are experts on medicines, a vast amount of background knowledge is required. He emphasised this with the example of imatinib, saying that it is not acceptable for a pharmacist to “blag their way through” simply by knowing that the drug is a tyrosine kinase inhibitor. Pharmacists will need to do “some hard work” to be able to prove their expertise, he added.

Oppose industry and you will face a dull and boring future

The pharmacy profession is at risk of becoming an opponent of the pharmaceutical industry, warned David Taylor, professor of pharmaceutical health policy at the University of London.

“People who believe their job is to keep costs down slow innovation,” said Professor Taylor. Unless you support advancements in practice, the future will be very limited and your role as a pharmacist will be “boring and dull”, he added.

He also urged leaders of the pharmacy profession to focus on what the profession can do for the public.

Nobody outside of the pharmacy profession cares about a General Pharmaceutical Council or the new Society, he said.

“All that matters is that you do something useful for others.”

Framework for consultant level practice

Research to develop an assessment model for pharmacists who wish to declare advanced or consultant level clinical practice was presented by consultant pharmacists Mark Borthwick (Oxford Radcliffe Hospitals NHS Trust, Oxford) and Cathrine McKenzie (Guy’s and St Thomas’ NHS Foundation Trust, London).

The research was conducted on behalf of the UKCPA by a group of pharmacists who specialise in critical care, but the model is intended to be applicable to other clinical specialties. The final model involves three tiers of assessment:

• The submission of a portfolio of evidence to be assessed against a set of agreed standards and discussed in a viva voce

• Peer review at a central location, performed by a team of pharmacists (including external moderators and facilitators) through the use of case-based discussions and clinical evaluation exercises

• A 360 degree appraisal completed by managers and members of the wider professional team with whom the candidate works

Mr Borthwick suggests that assessment days could initially be run twice a year and could be linked to conferences. However, he warned that the issues of funding, validating the process with higher education institutes and the new pharmacy bodies, and marketing the benefits of the accreditation process to relevant stakeholders had not yet been resolved.

A full report on the project and its findings is being prepared and updates will appear on the UKCPA website