Pharmacists in Scotland - five-year integrated education programme: scoping report

Recommendations

The Advisory Group members acknowledged the overwhelming impression that people wanted to see positive change. It wasn't that there was anything wrong with existing 4+1 model however there was a need to keep evolving and improving.

The model

The consensus view from the advisory group was to recommend progressing to a five-year integrated initial education programme for pharmacists in Scotland. It was the view of the group that this provided opportunities to better prepare new pharmacists for practice in Scotland and permitted better management of pharmacy trainee numbers to meet workforce demands both in terms of initial recruitment and on-going progression. This, in turn, supported Ministerial priorities to strengthen the workforce, especially in primary care. It also supported the aim that every GP practice will have access to a pharmacist with advanced clinical skills as detailed in the recently published Health and Social Care Delivery Plan, by ensuring the new generation of pharmacists are able to practice in the evolving NHS health and social care landscape.

However this decision was not unanimous and the two Heads of School from both universities asked for their concerns with regards the possible risks of implementing a five-year programme, with coterminous graduation and registration, including potential logistical problems such as resource availability and international student provision which were felt to outweigh any benefits, to be noted. That said, they both acknowledged that an evolution towards a five-year integrated MPharm over a ten year time frame was possible assuming there was due recognition of work to address the potential problem areas including a wholesale change of culture by the training providers. They did not, however, support a shortened journey stating a preference for good pilot studies, robust evidence for progression and apposite resourcing.

The Group did not recommend how a five-year integrated model would be delivered (a 12 month block in year five; two six month blocks, the later in the final six months of year five; or a dispersed set of blocks across the first four years and a final six month block at the end of the fifth year). They agreed that this detail was better worked through as part of the implementation work programme.

Advisory Group members also agreed that a Scotland-wide approach to introducing a new model was preferable in common with the Once for Scotland approach promoted by Scottish Government and the service. It could also support a regional accreditation approach going forward and this would help facilitate that from a Scotland perspective.

In forming this decision, the following key issues and priorities were considered and will form the basis of transitional and implementation arrangements:

• Funding: deliver within the existing funding envelope and utilise the current funding arrangements more effectively.
• Numbers: agree and align student/trainee intake numbers including any flexibility in trainee numbers based on workforce needs to ensure NHS Scotland is self-sufficient and to provide for a progression based on merit.
• Attributes: ensure suitable attribute and qualities to meet workforce demands.
• Admissions: develop a standardised admissions process which is based on values-based recruitment and includes multiple mini-interviews.
• Experiential learning: increase experiential learning in the undergraduate programmes to support preparation for practice. Embed clinical decision-making and clinical assessment skills in the undergraduate MPharm. Increase interprofessional learning.
• Training providers: increase the range of training providers utilised for both MPharm experiential learning placements and pre-registration training, and provide a quality management framework to ensure effective support. Ensure the service supports experiential learning across hospital, community pharmacy and primary care.
• Quality management: develop the existing quality management processes to support the new arrangements as they are implemented.
• International students: ensure the model supports the two Schools of Pharmacy to maintain and manage international students.