Scottish Developing Practice Stakeholder Event 1st July 2010 Dr Carol Evans

Agenda 10.00 John Cromarty (Scottish Board) – Open Event 10.10 Vision for Developing Practice and Overview of current structures – Carol Evans 10.30 Scottish Hospital Pharmacy Vocational Training Scheme - Fiona McMillan 10.55 Issues and Opportunities for a common pharmacy career path & consistent credentialing – John Cromarty 11.10Community perspective, current career paths and the issue and opportunities from both an employer and employee perspective – George Romanes 11.30 Primary Care Scotland - opportunities for a common GB career path – Alpana Mair 11.45 Q&A 12.00 Discussion: Career path for pharmacy 13.00 Lunch 14.00 Discussion: Credentialing 15.10 Group feedback 15.40 Actions and next steps and agree priorities 15.50 Summary and Close

Overview of Career Paths Medics Nursing Pharmacy

Medic Career Path – Clearly Defined Pre-registration house officer (1 year) Senior house officer (2 to 3 years) Train in a number of specialties Consider career path e.g. GP or speciality consultant Specialist registrar (4 to 5 years) or GP registrar (1 to 2 years) Specialist training Royal college exams for chosen specialty Consultant or GP Principal Postgraduate training in chosen specialty Pre-registration house officer (1 year) All Doctors Senior house officer (2 to 3 years) Train in a number of specialties Consider eventual career path e.g. GP or consultant in a specific specialty. Specialist registrar (4 to 5 years) Specialist training By end of this stage completed relevant medical royal college exams for chosen specialty. Consultant Final stage in the recognised career path

Medical Credentialing & Support Strong Support via Royal Colleges Credentialing in the various specialism's via clearly defined curriculum Well defined assessment process Tendency toward over specialisation Can be hard to change track

Nursing Career Path Modernising Nursing Careers Level 5 – Registered Practitioner Level 6 – Senior Practitioner Level 7 – Advanced Practitioner Level 8 – Consultant Practitioner Level 9 – Senior Leader Capability, skills and knowledge development and assessment Supported by RCN

Pharmacy Career Pathways Different across the sectors

Hospital Pharmacy - Typical Career Path (Approx 15% of pharmacists) Band 5 – pre-reg Band 6 Band 7 Band 8a Band 8b - Specialist Band 8c - Consultant or team manager Band 9 - Consultant (England) or Chief Pharmacist Opportunity for flexible working, often good support staff, good carer structure, NHS benefits. Salaries may be lower, especially in lower grades Pre-reg Band 5 £20-26K Band 6 £24-33k Years 1-3 Band 7 £29-39k Years 2-7 Band 8a £38-45k Band 8b £44-54k Specialist Band 8c £53-65k Band 8d £64-79k Over 10 years Consultant or team manager Band 9 £75-95k Consultant / Chief Pharmacist 37 hours a week, 27 – 33+ days holiday

Community Pharmacy - Typical Career Path 60-65% Pharmacists Around 14% (7000) own their pharmacies Years 1-30 Responsible Pharmacist Locum Pharmacy owner Years 4-30 – Managerial Path Superintendent Pharmacist Pharmacy Manager Several shops or area manager Opportunities to be own boss, salaries start higher Less defined career structure, pharmacist must be on premises at all times, may work in isolation Years 1-3 £22-35k Years 4-20 £35-45k Responsible Pharmacist Superintendent Pharmacist Shop Manager Average salary in community practise self employed £27-39k Average generally for community is £37k Locum average £20-25 per hour Senior level 10-15 years experience £35-60k Several shops / area manger £50-60K 39 hours a week plus evening and weekend rota. 25 days holiday

Academic Pharmacy - Typical Career Path. (Approx 3000 pharmacists) Lecturer / Senior Lecturer in Pharmacy Chair / Reader in Pharmacy Head of Pharmacy School Career expanded to include clinical practitioners who pursue careers in academic pharmacy. Some teacher practitioner posts. Most split with NHS or funded by multiples e.g. Boots The academic pharmacy disciplines include: pharmacy practice, biological sciences, clinical science, continuing education, experiential education, drug discovery, pharmacology etc Work is varied, possibilities to peruse research, opportunities for self development, currently good employment opportunities Teaching post often full time

Industrial Pharmacist - Typical Career Path (Approx 2800 pharmacists) 3-7 Years – Qualified Person 7years+ – Band Director Typical roles include: Quality assurance, development, production, registration, marketing research, sales, drug information, clinical trials. Career path usually management or leadership related and determined by the organisation. Travel often possible, perks of a large organisation May need to move to forward your career, post may be limited

Other Many other areas where pharmacist are employed e.g. Primary Care Prison Government Consultant Director of pharmacy Pharmacist have potential for broad and varied careers with many moving between the different sectors. The majority work in community.

Credentialing Many definitions, most recognised in NHS is: “The formal accreditation of capabilities at defined points within a career pathway that takes into account knowledge, capabilities, behaviours, attitudes and experience”

Credentialing DH Literature Review Relating to Credentialing in Medical Training Feb 2010 suggests the following benefits for credentialing: Supports professional development trough training Could support revalidation A means of demonstrating achievement in competence areas not currently or consistently recognised Providing employer confidence in workforce Providing better patient care and outcomes (evidence in US) Evidence in US (small) that credentialed doctors deliver improved quality of care, clinical outcomes and better patient safety as compared with non-credentialed practitioners.

Specialist Career Path and Credentialing There are large number of specialist groups Mostly hospital sector based Many have curriculum, assessment processes and credentialing. Specialist Curriculum Group (SCG) support development, assessment and credentialing for various specials groups. Critical care group assessment process Collage of Mental Health pharmacists Selection based on group consensus from group and current models of assessment 1.Initial application process 2.Portfolio submission –Assess knowledge and benchmark ACLF 3.Viva voce 4.Peer review -CEX and CBD -application of knowledge 5.360°appraisal –helicopter view of the candidate 6.Credentialing panel to grade each candidate

Credentialing in other Sectors Community PhwSI (England only) Pharmacy prescribers (numbers still low 1000 , approx 100 practising) Industry Qualified Person Academia Professor

What is the problem for Pharmacy? Lack of clear career pathways (unlike medicine) Where career pathways do exist (NHS) they have been established by the employer for their needs. Career progression not based on professional competence as no recognised framework for post registration development and assessment No recognised way to “carry” knowledge and capabilities from between sector or country. Few nationally recognised development frameworks available that cover all sectors. No clear career structure for community pharmacy Currently no recognised way to “carry” knowledge, skills and capabilities from one sector / country to another. Opportunity for new RPS to pull it together and get national recognition for Developing Practice.

Developing Practice Project What’s the Solution? Developing Practice Project

Developing Practice Vision To lead and support development of a flexible and sustainable workforce in order to deliver high quality services to patients and public across the entire profession.

Developing Practice Mission Providing consistent, portable acknowledgement of practice through credentialing of individual achievement, recognized through professional designations applicable to all sectors. Success is members working towards and achieving professional designations. Employers seek to employ those with RPS (Royal Pharmaceutical Society) designations. Pre-registration house officer (1 year) All Doctors Senior house officer (2 to 3 years) Train in a number of specialties Consider eventual career path e.g. GP or consultant in a specific specialty. Specialist registrar (4 to 5 years) Specialist training By end of this stage completed relevant medical royal college exams for chosen specialty. Consultant Final stage in the recognised career path

Ambition Aim to establish clear, common levels of practice across profession. Develop an inspirational career ladder (especially in community), building on what has worked. Encourage and enable pharmacists to pursue professional development post registration through clear advancement mechanisms in addition to CPD Develop an inspirational career ladder (especially in community), building on what has worked in secondary care, academia and industry.

Why? Critical to up skilling workforce and achieving the flexibility needed in economically challenging times. Coordinate /harmonise process across different sectors, interests and specialism's in pharmacy Seek external views from all countries and sectors around: where this “fits” in workforce planning- advancement rather than the focus on specialization the benefits to patients and public rather than a focus on self interest (badge collecting)

Work to date TransCom report on Improved, Advanced and Specialist practice. Work on-going within and across specialist groups PLB project started July 2009 5 Project meetings and a stakeholder event

Output from ASP meetings: July 30th, 1st & 29th October 09 Proposed ASP Governance structure Reviewed existing framework approaches plus open consultation with reference group Created professional designations paper for wider consultation and engagement. Reviewed existing models for specialist curriculum development. Reviewed various curriculum assessment process Proposed ASP Governance structure role, remit, membership, etc for Professional Assessment Board (PAB) & Professional Curriculum committee (PCC). Reviewed existing framework approaches plus open consultation with reference group led to: proposal to use GLF & ACLF (adapted as needed) Created professional designations paper for wider consultation and engagement. Proposal to use SCG model to adapt ACLF for specialist curriculum development. Reviewed various curriculum assessment process to propose process PAB could adopt. Explored how specialist interest groups could be supported.

Developing Practice Project Progress Continued 26th November & 13th January 2010 Created engagement plan Definition of faculty approach and possible structure. Agreed personal specifications and experience needed for roles on the governance bodies. Reviewed current processes for recognition of prior experience for professional designations Proposed model for individual assessments at the lower levels Renamed the project Developing Practice

Stakeholder Event 23rd February 2010 Over 100 attendees Discussions flowed and positive feedback Key points Keep it simple and relevant Sense check across the sectors and public We can learn from QP, skills and competency that is key rather than how you achieved it. PLB have a key role in moving this forward No conclusion on levels or designations.

Next Steps Build on the hard work to date Engage widely with the profession via stakeholder events and engagement listen and get views all sectors, 3 countries, employers, profession In-depth internal project reviews Build further evidence base Evaluate available methods of assessment and credentialing Seek agreement around levels and labels simple is best

Issues Pharmacy career paths are less defined than medical or nursing pathways. Hospital has most definition Current paths are employer driven No recognised professional driven paths across all sectors No consistent, recognised, post graduate, credentialing. Most credentialing in hospital sector

Opportunities Create a clear, recognised professional career path for all pharmacists in all sectors. Path way to facilitate more easy movement between sectors recognition of professional advancement from job to job Facilitate a more flexible work force Opportunity for consistent, nationally recognised credentialing via RPS professional designations Improved patient care Raise the profile of pharmacy through raised profile of pharmacists.

What are your thoughts? What do you want from your future career? What would be use full for you to support this? What do you want your future workforce to be able to do? How could a common professional career path with consistent credentialing help? Professional Designations How can we work together on this?

Scottish Hospital Pharmacy Vocational Training Scheme Fiona McMillan NES

Q&A

Discussion Groups – Career Paths Strengths, weaknesses, issues and opportunities for a common, national career path for Pharmacy across all sectors. Considerations for Scotland? How to move forward the opportunities? How to get employers on board? Future pharmacy workforce? How to engage community & other sectors? Your future career aspirations? Role of new Society?

Lunch 1-2pm

Group Discussion - Credentialing What are the specific considerations for consistent, credentialing of post graduate advancement via professional designations for: Scotland? Community pharmacy and other sectors? The chronic disease agenda? Pharmacy future workforce? How could consistent credentialing help? How many levels of credentialing? What credentialing for your career? What support would be useful?

Flipcharts 5min per group Feedback from groups Flipcharts 5min per group

Actions and Next Steps Summary of today pulled together Article in enews Slides to all participants Similar events in Wales and England Report from all events key findings Further sector, employer, commissioner engagement plus wider profession.

Objectives of Meeting Overview career paths the various sectors. The issues and opportunities for a common career path with consistent credentialing in each sector. Discussion on ways we can move forward to support advancing pharmacists’ practice.   Discussion on ways to consistently recognize practitioners who have advanced. How this could support specific needs such as community pharmacists and the chronic disease agenda etc.

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