Higher Level Practitioner Development: A Way

Forward in the South East

BOPA Symposium 2007

Michael PowellLead Pharmacist

Mount Vernon Cancer Network

Aims

• To outline the function of the Joint Programme Board

• To describe the pharmacy practitioner development strategy as it relates to higher level practice

• To describe current and likely future developments in higher level practice in the South East. How might these be relevant to oncology pharmacy practice?

Why reform post-registration education?

• No systematic provision of post grad education for pharmacy practitioners.

• Level of current provision evolved in somewhat haphazard way from the need for a level of clinical pharmacist skills and knowledge not catered for by undergrad/pre-reg curricula

Why reform post-registration education?

• Foster Report (July 2006):– Re-emphasises the need for competence

linked with performance assessment– Emphasises the need for re-validation:

• Ongoing evaluation of an individual’s fitness to practice

• Must be both formative and summative

Department of Health. The regulation of the non-medical healthcare professions. A review by the Department of Health. July 2006.

The Joint Programme Board (JPB):

Membership and Function

What is the JPB?

Collaboration

Educational Quality

Academia (SOPs) Brighton KCL Medway Portsmouth London UEA

NHSSpecialist ServicesSpecialist groupsSenior Managers

Service Perspective

Key JPB Responsibilities

• Develop uniform & coherent curricula for general and advanced practice

• Develop tutor training courses to support work-based learning

• Design reliable, fair & appropriate assessments• Undertake the accreditation of training centres• Build systems for on-going QA of E&T systems• Assign academic credits to programmes as

appropriate• Issue statements of completion of training at

general & advanced levels.

To Date – Generalist Training Band 6 (3 years)

• PG Diploma in General Pharmacy Practice (MI, Technical, Patient & Clinical Services plus “tasters” of specialist areas)

• Validated by 5 of the JPB HEI’s

• Statement of completion of general training

• Currently 200 practitioners/students across the south-east

JPB as a supportive infrastructure

Training Centres(Gen + Specialist)Directors PharmacyEducation(Trust/Pan-TrustRoles)

Post-RegistrationPharmacy

Joint Programmes Board

The NHSSPMs,

Training Centres,Specialist Pharmacy

Services

HEIs

The NHSPharmacy

SIGs?

Developing the infrastructure – key principles

• Work-based learning

• Resources practice tutors

• Assesses competence and performance

• Systems for dealing with poor performance

• Standardises approaches across specialties

Undergraduate & Pre-registration Phases

Consultant Practitioner

General Level

Framework

Higher Level Framework: Advanced

& Consultant

General Level

Development Phase

Higher Level Development Phase 1

Higher Level Development Phase 2

General Level Practitioner

Advanced Practitioner

PG enabling programmes

General Diploma

Masters Adv Practice

Research Degree

Training infrastructure support Higher Level Practice System

JPB(Regional e.g. South East England)

Training Centres•Single Trusts or collaboratives – across health sectors

•Accredited to deliver training at Generalist, Higher Level or both•Internal QA systems

•Manage tutee experiences

Higher Level Practice

The Career Pathway

Practitioner Development Strategy

• Imperative to recognise formally that there are different levels of practice:– complex & diverse nature of

pharmacist roles– Clinical governance– Impact of AfC

D Webb et al. Hosp Pharm Mar 2004; 11: 104-109

Practitioner Development Strategy

• Different levels of practice must capture:– Clinical pharmacy specialisation (e.g.

oncology)– Expertise in other disciplines (e.g. MI, tech

services)

• Should be sector independent:– Should encompass pharmacy practitioners

within 1°/2° care and community pharmacy

D Webb et al. Hosp Pharm Mar 2004; 11: 104-109

JPB & Higher Level Practice

• Focus now on developing strategy for higher level practitioner development

• Scoping meetings held in London in January and May 2007

• Key themes:– Consistency– Overcoming silo mentality– Identifying barriers– Overcoming barriers– System of representation– Collaborations with HEIs– Time frames– Duality of award– Titles

Practitioner development strategy: Alignment with AfC

Consultant Practitioner

Higher Level Framework: Advanced

& Consultant

Higher Level Development Phase 1

Higher Level Development Phase 2

Undergraduate & Pre-registration Phases

General Level

Framework

General Level

Development Phase

Advanced Practitioner

General Level Practitioner

Band 6 (3yrs)

Band 7 – 8a(3-5yrs)

Band 8 b-d(3 yrs)

Higher Level Practice

Using the ACLF as the backbone

Advanced & Consultant Level Framework (ACLF)

• 34 competencies in 6 clusters:– Expert professional practice (EPP)– Building working relationships (BR)– Leadership (L)– Management (M)– Education, training & development (ETD)– Research & evaluation (RE)

• Each competency has 3 levels of attainment: Foundation, excellence & mastery

• In England, describes the competency profiles expected of applicants for consultant pharmacist posts

Competency Profiles

• Consultant profile– EPP, BR and L at

Mastery– M, ETD and RE at

Excellence• Advanced profile

– 5 clusters at Excellence– RE at Foundation

• PhwSI profile– 4 clusters at Excellence– 2 clusters ETD, RE

optional

JPB – some key facts

• JPB does not influence Specialist Group alliances or relationships

• JPB is a system for discharging the curriculum – which belongs to the specialist group

• JPB is an inclusive system – engages all SGs and all HEIs – promotes local relationships rather than aligning with one HEI.

• Research commitment to final aspect (8b-d) requires local HEI engagement

• Encourages all SGs to collaborate to standardise the output across specialities

• JPBs must maintain a geographical relationship which builds on existing and historical networks.

Accreditation

• Clear recognition that JPB should work with specialist groups such as BOPA to:– Design the curricula for general & advanced

level practice– Design appropriate assessment methods to

meet the learning outcomes associated with general & advanced practice

• Assessment of portfolio of evidence• Viva

Latest Developments with the JPB

Dr Catherine Duggan

Associate Director of Clinical Pharmacy for Evaluation and Development &

Senior Clinical LecturerLondon, Eastern and South East NHS and School of Pharmacy,

University of London

Further reading

• Key literature on practitioner development:– Davies et al. Hosp Pharm Jan 04; 11: 2– Webb et al. Hosp Pharm Mar 04; 11: 104-109– Bates et al. Pharm J Mar 04; 272: 283

• Websites for further info:– JPB: www.postgraduatepharmacy.org– CoDEG: www.codeg.org