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

NHS Stakeholder Event

The NHS Stakeholder Event provided the opportunity to glean the views on a five year integrated initial education programme for pharmacists of a wide range of individuals and organisations involved in aspects of leadership, pre-registration training and/or postgraduate pharmacy education. Participants received presentations from the service providers, Schools of Pharmacy and NES on the current situation and were invited to discuss the key issues and options for change.

The presentations highlighted the following key issues:

• Service: needs of the service for a different type of pharmacist practitioner; and support for increased experiential training;
• Schools of Pharmacy: limited experiential training and IPL; SFC arrangements; and the number of graduates produced from the two Schools is much higher than the available training places making Scotland a net exporter of students and not benefitting the Scottish workforce;
• PRPS: well-respected UK scheme with robust recruitment, consistent training and rigorous QM monitoring with a memorandum of understanding (MoU) with GPhC; only 170 training places currently; no workforce planning; an increasing number of non-funded places (30) with limited input and QM; and the modular programme offers experience in all sectors and produces more rounded pharmacists.

The following is a summary of the themes that were identified as a result of the subsequent workshop discussions.

There was consensus from all groups that the status quo was not an option with unanimous disquiet on the 'shame' associated with a situation where a pharmacy graduate from a Scottish School of Pharmacy cannot access a funded pre-registration position in Scotland. A compelling reason to change was to provide all pharmacy students from the two Scottish Schools of Pharmacy with the opportunity of a funded pre-registration place in Scotland .

Currently the two Scottish schools are in the minority in that they make offers based on academic grade predictions alone, unlike most other schools of pharmacy across GB who have more extensive admissions processes. There was consensus on the introduction of a more robust admissions process with a preference towards interviews as a way of ensuring selection of students with the appropriate values and behaviours.

There was broad agreement on the value of increasing experiential learning . The requirement to increase the experiential learning at undergraduate level was common to all discussion groups with a view from some that placements were critical in order to underpin the context of the students learning and that leaving that to the equivalent of a pre-registration year to do so was too late.

Representatives of the service were clear on the need for a different type of practitioner with enhanced clinical decision-making and consultation skills for future pharmacy practice. They also recognised their responsibility to support increased experiential training.

The service had very strong views on the importance of interprofessional learning ( IPL) throughout the pharmacy course and the need for pharmacists to be competent and confident working in the multi-disciplinary team. The focus needed to include all care settings, including health and social care.

The Schools of Pharmacy expressed concern that the introduction of a five-year fully integrated programme would impact significantly on the attraction of the MPharm course to international students who were essential to ensure the financial viability of the courses. The Schools were also adamant on the need to maintain their own unique individual identities .

There was a view that funding was critical to providing the time and capacity as training provider goodwill was at the limit. The current SFC funding model limits access to additional funding. All of the current PRPS funding is used for trainee salaries.

With regard to the options for programme structure , whilst there were views expressing support for a fully integrated five-year programme with coterminus graduation and registration, the general consensus was a preference to aim for an enhanced '4+1' model as an initial step. Advantages and disadvantages of both were recognised with the former being challenging for the service to deliver in terms of capacity especially in hospital but providing a more flexible model with student placements phased across years. Some participants shared concerns about the logistics of distributing elective modules during the course. Countering that was the argument that if this was a vocational course then experiential learning needed to be integrated and embedded throughout. NES had been developing a modular pre-registration programme offering experience in each sector of practice. There was some concern expressed about whether a more modular arrangement reduced the ability for employers to recruit to their sector however on the other hand others felt it allowed a particular sector to raise its profile with future employees and therefore help address recruitment. The GPhC confirmed that as long as the learning outcomes were met and the final six-month period of learning in practice was maintained then there would not be a problem with any of the proposed options from their perspective. The GPhC also indicated their willingness to support any transitional programme structure.

The discussion triggered a number of questions which were collated for further feedback from event participants. These questions were also used to structure the discussion at staff and student meetings held at both Schools of Pharmacy.