Health Education England cuts funding for hospital pre-registration pharmacists in England

Health Education England has announced a decision to cut funding for hospital pre-registration pharmacist placements by up to 25% from 2020 onward.

Fri 11th January 2019 The PDA

The PDA was extremely disappointed not to be consulted and struggles to understand the rationale underpinning the decision. It is also deeply concerning that it appears from the article in the Pharmaceutical Journal that Schools of Pharmacy have not been consulted and that hospital chief pharmacists learnt of the decision in a letter dated 4th January 2019. The HEE workforce consultation from 2018 dedicated just two and a half pages (out of 142) to pharmacy and made no suggestion of reducing pre-registration placements in hospitals.

This decision will have a direct impact on both the Schools of Pharmacy and on third and fourth-year students since they are part of an intake based upon current pre-reg placement figures and overnight there may be 25% fewer pre-registration placements in English hospitals.

When approached by the Pharmaceutical Journal the HEE stated that it had decided levels of salary support “did not appear to be evidence-based or demand-led”. We find the suggestion that salary support for hospital placements is not “demand-led” somewhat curious since the pre-registration recruitment evaluation report published by HEE in March 2018 stated that 91% (n=1928) of pharmacy pre-regs preferenced a hospital training place as their first choice and out of the 734 available places in NHS hospitals (as at January 2017), every single one was filled. The role of hospital pharmacists in NHS care needs to be developed and expanded, not curtailed – and our members already report understaffing of pharmacists in some NHS hospitals. This would suggest that if there is an imbalance in the distribution of funding across pre-reg training sites, the remedy would be to increase funding to allow more sites to provide placements, not decrease it.

This move appears both short-sighted and incompatible with:

  • NHS 10-year plan. The DHSC stated the need for significantly more ‘clinical’ pharmacists in primary care. These pharmacists will require a firm foundation of clinical pharmaceutical skills training.
  • Carter Review. This called for an increase in hospital pharmacists spending time on patient-facing medicines optimisation activities. Feedback from our members would suggest that hospital pharmacists are so over-stretched that they are unable to carry out the clinical activities they would like to.
  • GPhC consultation on Initial education and training standards for pharmacists. This document states: “The pharmacist’s role as a front-line healthcare professional has continued to develop…………… Pharmacists need to be equipped to play a central role in providing clinical services to people in ……………. diverse working environments”. Wherever pharmacists practice in future, they are very likely to require excellent clinical pharmacy skills to underpin their daily work. At least part of the pre-reg year or ‘learning in practice’ part of integrated pharmacy undergraduate courses should surely include hospital placements to ensure well-rounded graduates who are prepared for flexible careers and portfolio working across all sectors.
    The PDA is reviewing the information available and seeking further clarification to ascertain the numbers who may be affected. We will be in touch with our student members in due course since we are keen to consult with those affected by this decision.
    This appears to be another example of the government and arms-length bodies imposing pharmacy policy whilst failing to initiate sufficient (if any) dialogue with those on the front-line, and their representative organisations such as the PDA.

References:

Pharmaceutical Journal, Funding for preregistration pharmacists to be cut by up to 25% across England, HEE announces: Read more

HEE review of pre-registration pharmacist placements: Read more

HEE workforce planning consultation document: Read more

PDA consultation response to HEE workforce planning document: Read more 

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