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RPS Faculty: development opportunities and evidence of progression

RPS director of professional development and support Catherine Duggan explains how the RPS Faculty and its updating of the CoDEG frameworks will benefit all sectors of pharmacy

By Catherine Duggan

RPS director of professional development and support Catherine Duggan explains how the RPS Faculty and its updating of the CoDEG frameworks will benefit all sectors of pharmacy

The RPS Faculty will be built on partnerships across the profession and working with colleagues who have built tools that support pharmacists wherever they work to be the best they can be. The Faculty will also develop professional practice for the benefit of patients and the public, and will be a foundation for true professional recognition.

Modernising Pharmacy Careers

The Medical Education England (MEE) board was pleased to consider and endorse proposals for further work to develop post-registration pharmacist and pharmacy technician careers at its meeting on 19 September 2012.

The Modernising Pharmacy Careers (MPC) Programme Board considered the next steps for progressing the priorities at its December 2012 meeting, as part of its transition planning for working with Health Education England (HEE). Proposals were identified in the MEE report in the following areas:

• Foundation years’ development and the adoption of national cross sector foundation years frameworks to support the development of a flexible and adaptable workforce
• Developing the workforce to deliver medicines optimisation and enhancing the skills of the pharmacy team in the delivery of public health messages
• National workforce planning for specialist technical areas
• Developing professional and clinical leadership and supporting innovation
• Building the clinical academic workforce

MPC board members are now progressing this important work with colleagues in the HEE and the wider pharmacy networks. The review and reworking of the professional development frameworks within pharmacy is the top priority, since all other areas of work are reliant on having functional and useful developmental frameworks. This will be integral to the work of the RPS as it develops the infrastructures for the Faculty.

MPC and RPS working in partnership

The MPC programme management team recognises that the RPS is best placed to lead on the review of the professional development frameworks for pharmacy, together with its partners, because of the role of the RPS in supporting high standards of practice within pharmacy and helping pharmacists and pharmacy employers to deliver high quality services.

In developing the RPS Faculty, the key factor is professional development and professional recognition. The RPS is working closely with the profession and those with experience in the field of professional development to ensure that the frameworks are refreshed to fit with the new language of the NHS and align with the recommendations from the MPC. Although the MPC has an advisory function for pharmacy careers in England, the RPS has a GB membership and we are working with all three countries to ensure that support tools and the professional development frameworks are aligned with the needs of pharmacists in all three nations.

Supporting and advancing practice

One of the major drivers behind developing the RPS Faculty has been the request from members and across the wider profession from all sectors, for an easy way to record development opportunities and gather evidence of progression — essentially, how to build a portfolio of individual professional development. We also know that, for many, some frameworks that have been used in practice have proven very useful in this way.

Professional development frameworks

During the late 1990s and following the Kennedy report, the health service developed an increased awareness of the relationships and concepts of competence, competency and performance. In the early part of this century, practitioners, academics and employers from several organisations identified that early years pharmacists often struggled to address and prioritise their post-registration development needs; it was noted that young practitioners often found it difficult to work out a focus for the elements of patient care, especially when faced with the complexities of therapeutic management clinical environments.

At the same time, there was no recognised definition or understanding of advanced practice. Indeed, across the profession, we often describe ourselves by the sector (or sectors) we work in, with each sector having a greater or lesser structure to career progression.

In 2001, a mixed group of pharmacists formed CoDEG — the Competency Development and Evaluation Group. CoDEG set out on a mission to develop and support pharmacy practitioners, from junior to experienced, and develop mechanisms to ensure their fitness to practise at all levels and to evaluate these mechanisms in order to move practice forward. Indeed, as the name suggests, CoDEG is not a membership organisation, but a team-based professional interest grouping that has successfully developed into a wide global network of individuals who have contributed to evidence-based developments and outcomes, with a clear interest in enhancing pharmaceutical patient care. One of the chief accomplishments of the group is the evidence-based development and implementation of the early years General Level Framework (GLF), the Technicians Framework (TLF) and the now ubiquitous Advanced Level Framework (ALF; see ).

The subsequent growth of an evidence base around the use and outcomes of the frameworks has been a positive feature of practice development. Most junior pharmacists in NHS employment will engage with the GLF, and nearly all the advanced and specialist groups (both clinical and non-patient facing) advocate the use of the ACLF as a structure for advanced practice development. The use of the GLF and ACLF tools (and local adaptations) has been documented in many countries outside England (including Wales, Northern Ireland and Scotland).

Development and evidence

In 2002 the GLF was launched for use in supporting the development of early years pharmacists across sectors. The use in secondary care was subsequently aligned to new reforms in workplace education models in NHS postgraduate diploma provision across the south east of England (now commonly referred to as the Joint Programmes Board [JPB] — a partnership educational model between the NHS employers and the academic sector). The evidence base behind the benefit of using frameworks as a supportive tool in practice started to build and gain advocacy — being supported by the Guild of Healthcare Pharmacists, the UK Clinical Pharmacists Association and many other specialist groups as useful tools for the development of pharmacists for the benefit of patients.

Employers found the frameworks useful in supporting individuals to develop their practice and to guide the development of standards of practice across various elements of patient care. This model was subsequently adopted by many across England, Wales, Northern Ireland and further afield. The GLF has been adapted, and tested, for use in Australia, Singapore, Croatia, Serbia and Macedonia. The GLF was the basis for the development of a worldwide support framework developed by the International Pharmaceutical Federation (FIP) — the Global Competency Framework. The European PHARMINE project also used the GLF and ACLF as base documents for a European analysis of developmental practice needs.

The ALF was released in 2004 and was designed to support the development of advanced levels of practice. This is also an evidence-based practitioner support framework developed as a partnership with specialist groups across GB and inclusive of non-clinical specialties. The original work was tested and validated with over 400 advanced and experienced practitioners, and was subsequently used as the basis for Department of Health recommendations for the development of the new NHS consultant pharmacist post guidelines, and was renamed as the more widely known ACLF (see DoH “Guidance for the development of NHS consultant pharmacist posts”). The CoDEG evidence bibliography is at the end of this article and tracks the work over the past 10 years.

In 2008, Gill Hawksworth, a former RPS president, hosted a session at the UKCPA symposium to explore the benefits of the GLF for community practice, alongside evidence that had been recently published showing that the frameworks functioned across sectors and could (and did) indeed support practitioner development wherever a pharmacist worked. Following that meeting, the frameworks were adopted and used in many community-based settings but were never endorsed by an overarching pharmacy body.
The CoDEG also worked on a Framework for Pharmacy Technicians, a professional development framework for technicians in medicines management and this has been endorsed by APTUK.

Further validation

There are varying misconceptions that have emerged around the use and validity of the frameworks: for example, that they are only valid in hospital, whereas they were clearly shown to work across various parts of our community practice.

In reality, the development process drew on best practice from across Britain, including leaders in Wales and Scotland. Indeed, the GLF and supporting tools around development and assessment have been adopted and adapted by NES in Scotland; many higher education institutes work to align their provision with the support of developmental frameworks; and many companies seek to align professional development with the frameworks to support individuals. An independent report was commissioned by the MPC into the current use of these frameworks, and was conducted by a team from University of East Anglia led by David Wright. This report subsequently validated the cumulative evidence base and made recommendations to support the use of these frameworks in the future.

The key message here is that the frameworks are used across many settings and countries and have been recognised as valuable source of support for practitioners. There is also the powerful message that supported practitioners are more autonomous in their development and can manage complexity more easily than some expect. This is good for patient care, which, in turn, is good for the “business” of patient care whether in community or hospital settings.

Where next?

Following this validation by the MPC, work will now start on a review and refreshment of the frameworks, which will include a focus on enhancing support for early years (now referred to as “foundation years”) and a greater focus on supporting early engagement in practitioner research and evaluation, ensuring that the GLF aligns with developmental progression to the ACLF.

The RPS will lead on this review in order to establish a core for practitioner development within the Faculty. The work will be uniquely tied to providing pragmatic evidence for areas of expertise (mapped to professional curricula) that reflect practice across all sectors and scope of practice, including leadership and science.

 

Bibliography

Davies JG., Webb DG., McRobbie D., Bates I.   Fitness for practice: a competency-based approach.  Pharmaceutical Journal, 2002, 268: 104-06.

Bates I., McRobbie D., Davies G. Webb D. Why we need a defined career structure in place of informal progression. Electronicjuice, 2004; 272: 283.

Webb DG., Davies JG., McRobbie D., Bates IP.,  Wright J.  Adopting a strategy for practitioner development.  Hospital Pharmacist, 2004; 11:104 108.

Davies JG., Webb DG., McRobbie D., Bates  IP.  Consultant practice   a strategy for practitioner development.  Hospital Pharmacist, 2004, 11; 2 3.

McRobbie D., Webb DG., Bates I., Wright J. Davies JG.  Assessment of Clinical Competence: Designing a competence grid for junior pharmacists.  Pharmacy Education 2001; 1: 67-76.

Goldsmith GM., Quinn J.,  Bates I., Davies JG., McRobbie D., Webb DG.  A pilot study to evaluate clinical competency in junior grade pharmacy practitioners.  Pharmacy Education 2001; 1: 204.

Meadows N., Webb D., McRobbie D., Antoniou S., Bates I., Davies G.  Developing and validating a competency framework for advanced pharmacy practice.  Pharmaceutical Journal, 2004, 273: 789-92.

Antoniou S., Webb DG.,  McRobbie D., Davies JG. Wright J., Quinn J., Bates IP. A controlled study of the general level framework: Results of the South of England competency study.  Pharmacy Education 2005, 5: 201-7.

McRobbie D., Fleming G., Ortner M., Bates I., Davies JG. Evaluating skills and competencies of pre-registration pharmacists using objective structured clinical examinations (OSCEs).   Pharmacy Education 2006, 6: 133-38.

Fernades R., et al.  A new professional framework for developing future chief pharmacists.  Pharmaceutical J. 2008, 281: 329.

Mills E, Farmer D, Bates I, Davies G, Webb DG. The General Level Framework: use in primary care and community pharmacy to support professional development. Int J Pharm Prac 2008; 16: 325-331.

Bates I., Bruno A.  Competence in the Global Pharmacy Workforce. A discussion paper.  Int.Pharm.J. 2009, 23: 30-33

Laaksonen, R., Duggan C., Bates I.  Overcoming barriers to engagement in continuing professional development in community pharmacy: a longitudinal study. Pharmaceutical J. 2009, 282: 44-48.

Patel J., West D., Bates IP., Eggleton A., Davies G.  Early experiences of the mini-PAT (Peer Assessment Tool) amongst hospital pharmacists in South East London.  Int J Pharm Prac 2009; 17: 123-126.   DOI 10.1211/ijpp/17.02.0008

Patel J., Sharma A., West D., Bates IP., Davies JG. Abdel-Tawab R.  An evaluation of using multi-source back (MSF) amongst junior hospital pharmacists.  Int. J. Pharm Prac. 2011; 19: 276-80. DOI: 10.1111/j.2042-7174.2010.00092.x

Bruno, A., Bates, I., Brock T and Anderson C. Towards a Global Competency Framework.  Am. J. Pharm. Educ. 2010; 74 (3) Article 56.

Bates I., Davies, G., Carter S., Quinn J., McRobbie D., Hall G., Galbraith K.  “Advancing and Improving practice in pharmacy: is “Elitism” a dirty word?” Pharmaceutical Journal, 2009; vol 283, 149.

Hough JE, Van Damme C, Obiols Albiñana L, Bates IP. Framework for pharmacy technicians. Pharmacy Technician Journal, 2010. 2: 22.

Laaksonen R., Duggan, C., Bates I. Performance of community pharmacists in providing clinical medication reviews. Anns Pharmacotherapy 2010; 44: 1181 – 1190.  DOI 10.1345/aph.1M719

Coombes I., Avent M., Cardiff L., Bettenay K., Coombes J., Whitfield K., Stokes J., Davies G., Bates I.  Improvement in Pharmacist’s Performance Facilitated by an Adapted Competency-Based General Level Framework.  J. Pharmacy Practice and Research 2010; 40 (2): 111-118.

McKenzie C., Borthwick M., Thacker M., Shulman R., Offord R., Tomlin M., Bates I., McRobbie D.  Developing a process for credentialing advanced level practice in the pharmacy profession using a multi-source evaluation tool.  Pharmaceutical J. 2011, 286: online.

Meštrovic A, Stanicic Ž, Ortner Hadžiabdic M, Mucalo I, Bates I, Duggan C, Carter S, Bruno A, Kosicek M. Individualized Education and Competency Development of Croatian Community Pharmacists Using the General Level Framework. Am J Pharm Educ 2012; 76 (2): article 25.  doi: 10.5688/ajpe76225

Costa HA., Shulman R., Bates I.  A credentialing process for advanced level pharmacists: participant back.  Pharmaceutical J. 2012, 288: 689.  May online. www.pjonline.com/node/1101077

Rutter V., Wong C., Coombes I., Cardiff L., Duggan C., Yee M-L., Lim KW., Bates I.  Use of a General Level Framework to Facilitate Performance Improvement in Hospital Pharmacists in Singapore.  Am J Pharm Educ 2012; 76 (6): Article 107.

Davies JG., Ciantar J., Jubraj B., Bates IP. Evaluating the use of a multisource back tool to develop pharmacists undertaking a  postgraduate programme.  Am J Pharm Educ 2013; 77: In Press.

Coombes I., Kirsa SW., MacCallum P., Dowling HV., Galbraith K.,Duggan C., Bates I.  Advancing Pharmacy Practice in Australia: the Importance of National and Global Partnerships.  J Pharm Practice & Research  2012, 42 (4): 261-63.

 

Citation: Electronicjuice DOI: 10.1211/PJ.2013.11117443

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