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Final word: Charting a course for pharmacy

In his latest article, Harry McQuillan, chief executive of Community Pharmacy Scotland considered what the future of community pharmacy services needs to look like. Here he turns his attention to how pharmacy teams can be empowered to feel confident in their own skills and abilities to deliver this vision

Let’s start with what we need. Ensuring the safety and effectiveness of each and every supply of medicine and delivering clinical services to the community will require a whole-team approach. 

Our healthcare assistants will be able to triage patients to both pharmacy technicians (armed with underpinning knowledge and PGDs) and pharmacists (with their IP status and assessment skills) for common conditions, while support staff keep the dispensary running smoothly using IT and SOPs.

The pharmacist’s only intervention in the dispensing process will be to carry out the clinical check, focusing their time on helping people to get the very best from their medicines in partnership with other healthcare professionals under properly remunerated national services.

All of this will require not just new skills but a framework of assurance and support to make sure that we nurture confidence and competence in new areas of practice. So how do we get to this point?

Leading the way

My pharmacy technician colleagues in Scotland are leading the way here, building a complete career framework that describes the various levels of practice and the requirements for each clearly.

Looking at the entry point for pharmacists, I’m pleased to say that the undergraduate courses running in Scotland now are completely unrecognisable compared to how I trained – and even those who qualified just six or seven years ago. 

This continual evolution must keep pace with the profession and be informed not just by the scientific foundations of pharmacy but critically by how service delivery is changing to meet healthcare needs in real time. 

Part of the solution here is an incremental increase in experiential learning time for undergraduates. More time spent in community pharmacy at an early stage in a trainee’s career sets them up for success. In this coming year we will be moving to hosting students from all four years across nine weeks – a dramatic increase from the odd day or two when the Scottish programme started.

Undergraduates need to be exposed to the environment that tests the theory learned at university with the real life experience of community practice and how, at times, the two can clash.

“One tricky issue that we are yet to solve is the problem facing us with respect to designated prescribing practitioners”

Staff release

We are now in our second year of providing employers with funding to release staff from the day job to complete the Post-registration Foundation Programme with NES. The trainees taking up these places are also given a place on an independent prescribing course (again backfilled to release the trainee), which includes clinical skills training to best prepare them to be a practising IP. 

It is early days and the prog-ramme isn’t perfect, but we are working with contractors, the RPS and NES to refine it as we go along.

Tricky issue

One tricky issue that we are yet to solve is the supply and demand problem with respect to designated prescribing practitioners. While we are slowly growing the pool and looking to work across sectors to support trainees, the maths just doesn’t add up for the numbers that will be coming through in the coming years. This is another area in which we need to see change.

As a profession, we have moved on from the idea that the passage of time says anything about your experience or readiness for a given role. So the expectation of a DPP having three years’ active practice needs to be replaced with a more realistic assessment in line with IP course entry requirements.

Wider than this, we need to look at streamlining the DPP role to allow them to comfortably take on more than one trainee, perhaps looking for a more robust role for collaborators. The CPS team is looking into these options with NHS colleagues and will make the case for change soon.

Different needs

Our existing workforce needs support too. As the day job changes, we must recognise that there will be a range of different needs to be met. There are some that are more straightforward, like identifying who still needs (and wants) to undergo their prescribing training and securing funding to make this happen. But each individual will have their own aims and objectives. 

That is why we are now looking at continuing our alignment with the RPS curriculum, assessing whether the Advanced framework perhaps provides a structure for people to use in directing their own development in line with service requirements.

To summarise, every pharmacy professional and owner in Scotland has a journey to go on to build a team that is ready for the future. I believe we have the right structures in place and are thinking about this far enough in advance that Scotland’s pharmacies will be able to support people to live longer, healthier lives as close to home as possible by building on and delivering our transition from accuracy of supply to safety of supply.

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