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Supporting and developing the primary care workforce through pharmacist education

The aim of the project was to develop the potential for pharmacists and pharmacy technicians working in integrated models of general practice/primary care service provision


The project was run by University of Exeter Collaboration for Academic Primary Care, Exeter.  Pharmacists represent an important clinical professional group, many of whom are based in primary care/community settings. Within this professional group, newly qualified pharmacists have particular interests and skills which are of direct relevance to general practice/primary care.

The aim was to design a continuing professional development course, which built on, and extended the knowledge, skills and attitudes of pharmacists for practice-based roles in new models of care.  In order to scope the relevant curriculum content of the CPD course, a training needs analysis was conducted through consultations with stakeholders, pharmacy organisations and pharmacists working, or intending to work in primary care.  The findings from these consultations, literature reviews and professional guidance resources highlighted the need for training to include skills development alongside knowledge acquisition.  This led to the design of a framework of six curriculum domains on which to base training. These included communication and clinical skills training, medicines optimisation, long-term condition care and professional practice skills such as leadership in prescribing quality improvement activities.

The project was completed at the end of October 2016.

An evaluation of the course was undertaken by the Project Team using a mixed methods approach. Participants completed written feedback forms at the end of each study day. Their responses comprised global and session-specific rating scores, along with written replies to open-ended questions to encourage free text comments.

A medical knowledge multiple-choice test based on course content was administered to the participants, pre- and post-course. Analysis of results showed an increase in participant knowledge from a group mean score of 57% to 85%.

Semi-structured interviews were conducted with participants pre- and post-course. Participants were asked to comment on the course, on their perception of pharmacists’ roles in primary care, on the competencies needed for these roles and on their own preparedness for these roles.

Findings

This project highlighted the following points: -

  • There is considerable local and national interest in the development of pharmacists’ further integration into primary care. This was demonstrated by the involvement of the stakeholders, the number of enquiries about this course and the engagement of the participants on the course.
  • A specialist medical educational provider, such as The University of Exeter Medical School, brings unique resources (E.g. clinical tutors, expert speakers, access to patients, access to training environments etc.) to developing and delivering postgraduate healthcare training.
  • Pharmacists have characteristics of adult learners and using these in designing teaching activities, enhanced peer-to-peer learning and professional networking.
  • All participants spoke positively regarding the course. The clinical skills teaching was by far the most highly valued element for all participants.
  • Small group teaching is suitable for delivering communication and clinical skills training so that tailoring to previous experience, receiving feedback on performance and repetition of practice can occur.
  • Training in Primary Care IT systems and administrative processes, including using test patient records and referencing local and national guidance, was facilitated by delivery in a GP practice setting.
  • The CPD course was shown, by way of pre- and post-course testing, to improve the medical knowledge of participating pharmacists in the areas covered in the curriculum.
  • Pharmacists expressed concerns about the lack of clarity of their developing role, and in the training requirements and career pathway of pharmacists in general practice roles.
  • Pharmacists expressed concerns about gaining competence for extended roles in primary care, access to work-place support and having adequate indemnity provision.

Recommendations

  • Further tailored training provision, for the individuals’ roles and needs, is required to support pharmacists to consider undertaking, performing and developing clinical roles in new models of integrated primary care.
  • Formal training qualifications for practice-based roles needs to include acquisition of independent prescribing status to fully utilise pharmacists’ skills and professional quality assurance.
  • Accredited qualification training programmes for practice-based pharmacists need to include supervised work placements and assessments.
  • Further work at a national level is needed to define the required standards and competencies, and on the role definition of pharmacists in general practice. This would bring them in line with guidance provided for other healthcare professionals.
  • Further work at a national level is required to outline pharmacists’ career pathways, progression structures and requirements for revalidation of pharmacists in primary care, in accordance with other NHS structures.
  • Review of pharmacy undergraduate and pre-registration training needs to occur, in view of the developing clinical roles of pharmacists 
  • Opportunities need to be created to develop practice-based pharmacists as teacher-practitioners to contribute to pharmacy educational programmes.
  • Further research is needed to measure the impacts that pharmacists make when contributing to the skill-mix in primary care teams and in particular the effect on workload and patient outcomes.
  • Ensuring provision of indemnity insurance of allied healthcare professionals is essential for the future integration of pharmacists into primary care roles.
  • Promotion of the roles of pharmacists in general practice needs to occur so that primary care teams, patients and commissioners understand the expertise pharmacists bring to clinical care.

Full details of the project can be found in the document at the bottom of this page.

 

For more information, please contact Professor John Campbell, Professor of General Practice and Primary Care, Director of University of Exeter Collaboration for Academic Primary Care, Exeter (APEx).

University of Exeter Medical School, Smeall Building, St. Luke’s Campus, Heavitree Road, Exeter. EX1 2LU.  Tel: 01392 722740.  John.campbell@exeter.ac.uk


This Page was last updated on: 21 July 2017

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