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Pharmacist apprenticeship proposals: the big debate

Some pharmacy professionals say students will welcome the reduced loan burden
Some pharmacy professionals say students will welcome the reduced loan burden

Could a five-year pharmacist apprenticeship reduce student loans or erode the profession? C+D gathered views across the sector to find out

The revelation that a proposal for a five-year pharmacist apprenticeship scheme was under consultation was met by responses ranging from support to alarm across community pharmacy.

The 10-day consultation, launched by the Institute for Apprenticeships and Technical Education – an employer-led public body not affiliated with a government department – closed on April 14.

Now the first stage of the consultation has finished, more than 6,000 responses will be reviewed by a “health and science route panel”, along with the proposals themselves.

The proposal is for a level 7 apprenticeship, equivalent to a master’s degree, where pharmacists would train as apprentices on placements hosted by pharmacy companies.

The General Pharmaceutical Council (GPhC) says the apprenticeship would still need to meet its learning outcomes and standards in order to be fully accredited, and trainee pharmacists would still be required to pass the pre-registration exam to join the register.

C+D spoke to high profile pharmacy figures to understand why the proposals have sparked such controversy.

“Eroding the profession”

Hampshire contractor Sultan ‘Sid’ Dajani condemns the proposals, claiming they are part of “a continuing governmental policy to further dumb down and erode the profession”.

“There is nothing wrong with the system, this is regressive change for change’s sake. I’m all for change but this is yet [more] illogical thinking that [should go] onto the compost heap of ideas.”

Mr Dajani – who is also a Royal Pharmaceutical Society (RPS) English board member – believes that an apprenticeship would not prepare pharmacists for the problem-solving required to deliver optimal patient care.

“There are problems you don’t find in a book or on the internet that you have to find yourself. That’s where a university and apprenticeship differ. An apprenticeship won’t teach you how to help patients,” he claims.

“At university you get to learn the basics and strong foundations. If you go straight to practice you’ll never understand theory.” Mr Dajani acknowledges that the apprenticeship would have to be GPhC accredited, but believes the pre-reg exam “would have to change”.

He also believes it’s a “commercial decision, rather than a professional one”. He claims the “multiples would love it”, because it would make pharmacist employees more dependent on their managers, like “robotic beings”.

While there is no evidence the multiples intend to create “robotic” apprentices, Boots, Well, Lloydspharmacy and Superdrug have all confirmed to C+D they are part of the “employer trailblazer group” – a group of at least 10 employers that according to the institute’s website “come together as the creators and early adopters of new apprenticeship standards”.

“Students may welcome the reduced loan burden”

As managing director of 12-branch chain Daleacre Healthcare and chair of the group behind apprenticeships for pharmacy support staff, David Evans is more optimistic about the proposals.

“The pharmacist apprenticeship proposals appear to be all about funding – how employers can tap into the government’s apprenticeship levy to train staff and plug some of the recruitment gaps across the sector, especially in more rural areas of the country,” Mr Evans says. Organisations with a wage bill of over £3 million annually can claim back the cost of apprentice training from this tax, while smaller employers would only pay for 10% of the education costs.

The proposals may be equally attractive for students, Mr Evans says. “I think prospective students might welcome the proposal to be funded and have a reduced student loan burden.”

Mr Evans stresses that pharmacist apprentices would still have to pass the GPhC exam. “If a degree-level pharmacist apprenticeship is the same academic qualification, to the same standards, with a broadly similar structure as the current set up, but the student is employed full-time and is paid during the process, I don’t see the problem.”

He says the use of the term ‘apprentice’ has “clearly created a poor impression” in pharmacy. The aim is to use the government’s levy fund to train staff, which is “common” in other professions, he points out.

“There are already successful healthcare degree apprenticeship schemes, including for physiotherapists, radiographers, occupational therapists, midwives, nurses, paramedics and podiatrists, which result in graduation with a bachelor’s degree.

“There is also the advanced clinical practitioner apprentice qualification, with which an apprentice qualifies with the equivalent of a master’s degree.”

The 10-day length of the initial consultation on the proposals “caused some concern” in the sector due to its brevity, “but unfortunately that’s just how the initial approval process works”.

“Much more detail will become available in the next stages of consultation,” he insists.

“There will be two more consultation stages”

Steve Mosley, chief officer of Lincolnshire local pharmaceutical committee, also stresses that the consultation is only at its first of three stages.

“There will be two further, much more detailed and rigorous, stages of consultation”, he says. He interprets the consultation as asking two primary questions: whether the sector “needs more pharmacists?” and “is pharmacy hard?”.

The consultation response document asked seven questions, including “do you support the development of the apprenticeship standard set out in the proposal?” and “do you recognise this occupation?”.

Criticism of the proposals “weren’t relevant at this stage”, Mr Mosley claims, though they will be at the next two stages.

“Our voices shouted too loud, too early. Calm down, look at what the process is,” he tells concerned pharmacists.

Mr Mosley draws attention to the time required in the proposals for on-the-job training (445 days), which he says equates to around two days a week over five years. “It’s for the trailblazer group to demonstrate how this meets the [GPhC standards] at stage two and three of the consultation. At the end of the day it would be the GPhC who will determine whether it has legs.”

However, he does question whether the government would want to fund the apprenticeship scheme through the tax levy, as it “sounds a lot more expensive than five years of private loans”.

“Creating a one-dimensional pharmacist?”

Professor Reem Kayyali, head of pharmacy at Kingston University in London, says the proposals need to be reconsidered to include the varied role of pharmacists.

“Pharmacists are now recognised as part of the multi-disciplinary team, with careers in community, hospitals, GP surgeries, care homes, NHS 111 and urgent care,” she says. “Many of these roles have been established recently, due to the recognition that pharmacists are healthcare professionals who can meet the increased pressure on the NHS, especially with Brexit looming.

“Their training makes them unique in that they are the only scientist as part of the healthcare team with a syllabus that includes: physiology, pharmacology, therapeutics, chemistry, microbiology and pharmaceutical formulation.

“Their versatility makes them able to have careers in public health, industry and academia, and many now are prescribers and run their own specialist clinics.

“So how would the apprenticeship ensure this versatility and ensure the growth of this workforce to fill the pressure in the NHS?” she asks. “Is the apprenticeship trying to generate a pharmacist who is one dimensional and thus indirectly challenge the sustainability of this profession? Is it planning to grow one sector or one approach?”

“Apprentices would be prepared for the role”

Team PreReg directors left to right: Jay Modhvadia, Fawzia Lokat, Harvinder Mann and Mital Thakrar

Mital Thakrar, co-founder of pre-reg support provider Team PreReg, also has concerns about the quality of the training apprentices would receive.

University courses offer experiences such as “group learning, presenting, lateral thinking and the time to think”. As pharmacy moves away from dispensing towards a more services-oriented approach, pharmacists need to have “an embedded foundation of knowledge” from university, he says.

He acknowledges that this is just the first stage of the process of creating apprenticeships. “There’s a lot of steps involved to get it where it needs to get to. Once we can see the clear framework, the competencies and the plan, then employers can look at it.”

There are benefits to training in a pharmacy, Mr Thakrar says. “Having a long-term position where you’re working every day can develop you. You’d be prepared for the role.”

His Team PreReg co-founder Harvinder Mann says there is potentially a “wide opportunity” for the sector for students who can’t afford university fees.

However, hearing about the scheme was “a bit of a surprise” and the “industry is quite unsure” about it, he admits. He raises a concern about apprenticeships creating an inconsistency in the kinds of pharmacists produced, by offering an alternative route. In addition, he worries it could reduce pharmacists’ wages and damage their workplace rights.

“Change the narrative”

Ade Williams (pictured above, centre), superintendent pharmacist at the C+D Award-winning Bedminster Pharmacy in Bristol, says the apprenticeship proposal provides an opportunity for the profession to do some soul-searching. Community pharmacy needs to understand why it has materialised and ensure that it does not damage the sector, he says.

“If you haven’t identified the right problem, you will most likely come up with the wrong solution. We need to come together – what are the challenges?”

The “outrage” the proposals triggered means the sector needs to “build some consensus” to “change the narrative”, Mr Williams says.

Whether the proposals could present an attractive opportunity for students who can't afford university loans or threaten to erode the profession is still up for debate. How the Institute for Apprenticeships and Technical Education reacts to the 6,000 responses it has already received to its consultation will determine whether it progresses to the next stage, coming one step closer to making pharmacist apprenticeships a reality.

Read everything C+D knows about the pharmacist apprenticeship proposals

19 Comments
Question: 
What do you make of proposals for a pharmacist apprenticeship scheme?

Alf An interested pharmacist, Community pharmacist

Another reason the other professions are laughing at us. Never heard of a proposal for GP apprenticeships and even the nurses now require a university decree! I hold my head in shame at the ploys of these multiples. Can you imagine trying to understand organic chemistry and so on with the pressurs of working in a short staffed pharmacy?!

David Evans, Superintendent Pharmacist

why do you say that, it’s ok throwing wild accusations out, so come back it up, why on earth would I want that?

David Evans, Superintendent Pharmacist

the pharmacist apprenticeship proposal involves them taking the same degree as they do now? Why do you think it doesn’t? If other professions are using the proposed funding route why should it not be suitable for pharmacy? I only used the ACP scheme to illustrate that is is used for healthcare training, in the light of the thread the previous week that claimed it devalued the profession. It’s a route to secure training funding that’s all. No doubt you were all aware of the proposals to used exactly the same funding to consider a similar route for clinical pharmacy diplomas and the like last year? 

 

 

 

 

N O, Pharmaceutical Adviser

""" Mr Evans says. Organisations with a wage bill of over £3 million annually can claim back the cost of apprentice training from this tax, """

Mr. Evans, if this is the case, then spend that money on hiring more support staff so that the Uni trained Pharmacist can focus on upskilling their knowledge and practice to provide more efficient and SAFE patient care. 

No point (other than cheap labour) of having more pharmacists, when one store hires only one Pharmacist. Lets rather spend the money in supporting the existing infrastructure to provide more robust and safe place of work. Spend more on getting apprentices in other supporting roles and see the difference.

David Evans, Superintendent Pharmacist

You can’t spend it on hiring and wages, only on training costs

Greg Lawton, Community pharmacist

The first stage of the consultation is about whether the development of the apprenticeship goes ahead. This is exactly the right time to be shouting about it, before the steam train leaves the station.

Michael Mustoe, Community pharmacist

It seems clear that the future of Pharmacy is in the clinical arena, as part of the multidisciplinary healthcare team. And therefore, the need for high quality university courses is paramount.
Apprenticeships are totally unsuitable as they would not deliver this goal, and would potentially be biased towards the commercial needs of the employers

David Evans, Superintendent Pharmacist

they will be taking the same university degree?

 

Benie I, Locum pharmacist

You have a conflict of interest. I suspect you would hire monkeys in place of pharmacists and support staff if it saved a penny or two and then tell us that it is for the benefit of patients.

David Evans, Superintendent Pharmacist

Explain?

Thomas Wilde, Community pharmacist

Not quite, the scheme gives them a level 7 which they say is equivalent to a Masters degree. They need to clarify what course content they would cover, who would be teaching them and how they can justify that the learning will be as good as the university course. 

David Evans, Superintendent Pharmacist

They take the same masters degree, it’s just funded thru the apprenticeship levy.

Dominic Smith, Locum pharmacist

I thought typically degree apprenticeships were part time study mode rather than full time no?

I am aware of full time business sponsered degrees but that would be funded out of pocket and not via apprenticeships.

Also as a superintendant why would you have a person taking a full time degree on payroll?

Obviously i'm not savvy about finance and semantics but having an employee on the books for 4-5 years without them actually at work would seem odd? (is it for that £3m tax break?)

It just seems too good to be true.

Students dont have to pay much for the degree, they get the same degree and you're on the books for a company for almost gaurenteed work after. I just can't see what a company would get out of this if that is the case. And in my experience if there isnt a benefit for the company (it can be mutual) then there is no go ahead.

David Evans, Superintendent Pharmacist

Dominic - to answer your points in this and the other thread, this was my original view to the C&D which was not published in full which explains my view succinctly.

As I understand it, Under the current proposals, any pharmacist apprentice will still have to obtain an MPharm degree, complete 52 weeks of training in practice and pass the registration exam. So, if a degree-level pharmacist apprenticeship is the same academic qualification, to the same standards, with a broadly similar structure as the current set up, but the student is employed full-time and is paid during the process, I don’t see the problem, in fact I think prospective students might welcome the proposal to be funded and have a reduced student loan burden.

Clearly, the training needs to be in block placements rather than day release, Akin to the current university terms, and if that isn’t the case then a pharmacist apprenticeship will not be supported by the profession, nor me.

There are already successful healthcare degree apprenticeship schemes, including for physiotherapists, radiographers, occupational therapists, midwifes, nurses, paramedics and podiatrists, which result in graduation with a Bachelor’s degree. There is also the advanced clinical practitioner apprentice qualification would qualify with the equivalent  of a Master’s degree. 

As regards to employment for the 4-5 years, clearly it is a non starter for non levy paying employers, but it might work for those who do, including hospital trusts, who were looking at the proposal last year.

Keith Howell, Primary care pharmacist

This article seems to paint the picture of a 50:50 split amongst pharmacists on this issue...Note the 2 thumbs up and 2 down. Yet a recent C+D survey showed that 80% of pharmacists were against the apprenticeship proposal. Surely C+D should have highlighted this to show the strong feeling against this ridiculous idea?

Also, David Evans draws parallels with the Advanced Clinical Practitioner masters. I have never read such prattle. This programme is aimed at trained nurses, pharmacists, physios and paramedics. Without such a background or at least a relevant degree you will not get onto this competitive course. To use this to draw comparisons with the pharmacist apprenticeship proposal demonstrates ignorance on a colossal scale.

David Evans, Superintendent Pharmacist

who is saying they wouldn’t actually do the MPharm to actually get to do this? 

Dominic Smith, Locum pharmacist

The proposal we have been given stated level 7 apprenticeship equivalent to the masters. The MPHARM is only able to be taken FULL TIME. if it is sandwhich or part time you would fall foul of the start of degree to enrollment on the register rules as per GPHC.

There is not a single mention of the MPHARM bieng put on there but instead a level 7 apprenticeship. which would usually be expressed as akin to BTEC or NVQ level 7. My mother has a NVQ 3 in hairdressing. Equivalent to an A - Level. But it is an NVQ not an A - Level.

And in the article it seems the GPHC suggested you won't do an MPharm. See the section where they mention

"The General Pharmaceutical Council (GPhC) says the apprenticeship would still need to meet its learning outcomes and standards in order to be fully accredited"

As in they will accredit the apprenticeship? This is surely a sign that they will NOT do the MPharm as otherwise they would have said "They will have to attend a accredited university and pass the pre-reg exam still" instead of that.

I mean your main response is answered in the first two paragraphs from an article in which you are a key player in! 

David Evans, Superintendent Pharmacist

Look at the IET the GPhC have just consulted on. It says that students must complete an accredtited L7 MPharm degree, if the apprenticeship scheme does not faciitate that then it wont happen. The GPhC just refer to an accretided course, but if you drill down into what they require its implicit its one of the current MPharm courses, or the studunt will not meet their requirements.

Benie I, Locum pharmacist

His motives are clear as day. Asking him his views on this would be akin to asking if Turkeys would be happy to abolish Xmas.

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