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Should the profession retain the 2-year foundation period before expectation of becoming an IP?

A PDA member survey suggests the majority of those who understand the frontline of pharmacy want to keep the 2-year qualifying period before a pharmacist becomes an Independent Prescriber (IP).

Fri 17th December 2021 The PDA

The PDA has consistently advocated for the introduction of independent prescribing for pharmacists, however the organisation is continuing to raise the other side of the debate about how soon recently qualified pharmacists should be expected to develop their early practice experience before becoming Independent Prescribers.

Inevitably the PDA, as a defence association, sees what can happen when errors occur, and the consequences for patients and the professional. From that position, the PDA recognises the significant benefit of allowing newly qualified registrants to develop the fundamentals of their practice first, before adding the factor of independent prescribing. Due to the shorter course length, a typical prescribing pharmacist will be younger than every prescribing medic in the UK and will have had less supervised work-based training.

To test the views of the profession, the PDA undertook a member survey which received over 1,000 responses. The PDA continues to believe that for patient safety, reasons the two-year period should remain and/or an initial period of additional support through supervision should be implemented for new IP pharmacists.

For some time, some students and trainee pharmacists who are looking forward to many decades of practice ahead, have voiced concerns that they will be rushed into this additional activity. As the new student cohorts will be expected to have IP from the start of their practice, the level of questioning about safety implications has declined, but as a risk management organisation, the PDA is aware that the introduction of enhanced areas of practice should not be hurried.

Although embarking on an IP qualification can be framed as an optional step, unrealistic expectations from employers and the sector may force early years pharmacists to step forward before they are ready, potentially leading to a higher risk of incidents. Some new pharmacists may find IP initially challenging alongside the need to develop their confidence and competence in practice. The current 2-year period protects patients and new professionals and ensures those moving to IP courses are building on a firm foundation of two years practice and experience.

Consequences for the established profession

Recent developments around pharmacists’ education and IP matter to all pharmacists, not just those currently in higher education or considering joining the profession. There has also not yet been sufficient communication about what the drive for IP status means for the established profession, though a programme of events is planned for into the new year. Some PDA members have expressed their offence at being referred to as “the legacy workforce” and even more ask “what does this mean for me?”. It is understandable for those who have a small number of years before retirement, but also for others who simply do not wish to get IP status, to want to understand what a sector with many more IP means for them.

The desire to significantly grow the numbers of IPs is clear, however the strategy around how pharmacists will use those skills in practice across all parts of the profession is not clearly defined. This is a vitally important element in enabling prospective IPs to see where their skills may be deployed, therefore understanding the level of risk that they are undertaking, as well as bringing those established professionals along into a future vision.

The practicalities of securing sufficient DDPs for all future IPs, ensuring those individuals asked to support the learning of others are being properly remunerated for doing so, and that individuals and pharmacies have the capacity to add the activity to an already busy workload also need to be worked through and agreed.

The risk of creating a two-tier profession and damaging morale at a time many employers claim they face a workforce crisis, must be mitigated against and is another reason to ensure that moves toward a greater prevalence of IP in the profession are fully planned and communicated before being rolled out.

The NHS and wider sector must satisfactorily resolve all the above and the PDA is, as ever, willing and able to contribute to that process in the interest of students, trainees, and current employed and locum pharmacists.

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