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

2. 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

3. Overview of Career Paths
Medics
Nursing
Pharmacy

4. 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

5. 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

6. 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

7. Pharmacy Career Pathways
Different across the sectors

8. 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 £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

9. 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 years experience £35-60k
Several shops / area manger £50-60K
39 hours a week plus evening and weekend rota.
25 days holiday

10. 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

11. 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

12. 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.

13. 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”

14. 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.

15. 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

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

17. 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.

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

19. 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.

20. 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

21. 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.

22. 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)

23. 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

24. 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.

25. 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

26. 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.

27. 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

28. 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

29. 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.

30. 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?

31. Scottish Hospital Pharmacy Vocational Training Scheme
Fiona McMillan
NES

32. Q&A

33. 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?

34. Lunch 1-2pm

35. 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?

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

37. 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.

38. 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.

39. Thank you
Feedback forms