Major reforms to the initial education and training of pharmacists

The NHS and GPhC have recently announced plans for new regulatory standards for the five years of initial pharmacist education and training. These major reforms will affect how future pharmacists become qualified. The PDA has provided a response to this new announcement.

Tue 4th August 2020 The PDA

The PDA was genuinely surprised to see the recent letters that were issued regarding these reforms, having attended meetings convened by the GPhC to allow key stakeholders to participate in discussing the reforms before they were finalised. Ongoing stakeholder meetings are still scheduled with the GPhC and no firm conclusion or agreements have yet been reached.

The PDA agrees that the introduction of foundation training is a hugely important development which is essential to ensure that future pharmacists obtain the clinical skills they require. However, such changes cannot be done in isolation or with a degree of haste which risks failing to provide the robust supporting framework within which the programme should operate.

The changes also need to be fit for purpose with time spent in both primary and secondary care and periods of supervised prescribing similar to those provided to doctors. These changes will take time and meticulous planning. In addition, making such a huge blanket change which appears to remove the choice on whether to prescribe or not, from future pharmacists seems somewhat unfair. Finally, whatever changes are implemented, the overriding concern must be to ensure that patient safety is not compromised.

We welcome:

  • the acknowledgement that major reform of the Initial Education and Training (IET) is needed
  • the acknowledgement that a foundation period is needed following registration to enable all students to practice in safety and with confidence
  • the acknowledgement that all future pharmacists should be able to independently prescribe (prescription-only medicines).

We are concerned about:

  • The lack of detail in the proposals
  • The seemingly rushed decision to introduce the programme in a few weeks
  • The lack of consideration to major reforms of the IET at universities
  • The lack of consideration of how quality can be assured especially for independent prescribing where emerging evidence clearly points that a structured supervised and step-wise process is required to assure patient safety
  • The lack of consultation with students and pre and provisional registrants, i.e. those that would be impacted the most by these proposals
  • The failure to set out how current students, provisional registrants and pre-regs will be supported to ensure they receive suitable clinical experiential training before the new IET courses are rolled out
  • The lack of proposed support that will be needed for such a programme
  • The failure to engage with stakeholders prior to making major announcements timetabling when the proposals will be implemented
  • The lack of acknowledgement that not all student pharmacists may want to be IPs given the huge medicolegal responsibility which accompanies prescribing.

The PDA has previously advocated major structural changes both to the Initial Education and Training of pharmacists and the pre-registration year.

We explicitly say “both” above, as there has been a fundamental disconnect at the point of graduation and entrance into the pre-registration year.

That disconnect has been graphically highlighted during the current pandemic crisis as the GPhC has been unable to allow current pre-registration students to enter the full GPhC register. The creation of the Provisional Register has been a de facto acknowledgement that the current disjointed incoherent system is not working for stakeholders including the public, students and the profession.

The GPhC statement issued on 28th July on this matter noted:

“… the importance of students having a coherent and connected “continuum” of five years of education and training with greater application of science in clinical practice and development of skills in decision-making, risk management and patient consultation…”

Whilst we have always advocated major reform, we believe that the current proposals need detail, structure and evidence before they are implemented.

We would welcome a full discussion paper and subsequent stakeholder engagement before these major reforms move forward. In a world connected by video technology, this process of engagement is far simpler than convening face to face events.

The pandemic has graphically highlighted the need for major reform in the IET and initial foundational development within the profession, especially the lack of structured support and mentoring.

For example, Wales has proposed a change to the pre-registration year but has allowed a 2-year lead time for quality assurance.

Similarly, Scotland is gradually implementing major changes to the experiential learning component of the IET of pharmacists as part of an overarching plan including doctor and nurse training.

The rushed nature of these proposals has the potential to embed further poor practice into the IET and early years of practice rather than enhance it.

The PDA would like to see the Department of Health in England acknowledge and follow the lead provided by Scotland and Wales in developing a meaningful vision for pharmacy and then working to implement it through appropriate planning and widespread consultation.

 

 

The Pharmacists' Defence Association is a company limited by guarantee. Registered in England; Company No 4746656.

The Pharmacists' Defence Association is an appointed representative in respect of insurance mediation activities only of
The Pharmacy Insurance Agency Limited which is registered in England and Wales under company number 2591975
and is authorised and regulated by the Financial Conduct Authority (Register No 307063)

The PDA Union is recognised by the Certification Officer as an independent trade union.

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