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Pharmacist independent prescribers will be able to supervise trainees

The GPhC scrapped its proposal to remove the need for trainees to have patient-facing experience
The GPhC scrapped its proposal to remove the need for trainees to have patient-facing experience

Pharmacist independent prescribers will be able to supervise pharmacists in training for the role, after the GPhC changed the requirements in order to encourage more applicants.

At present, only doctors can supervise pharmacist independent prescribers during their training. But the General Pharmaceutical Council (GPhC) announced last Tuesday (December 11) it had agreed to allow “experienced, non-medical independent prescribers” to supervise those in training from as early as next year.

When the GPhC proposed the move in March, it said it would “remove a potential barrier to the expansion of the number of pharmacist independent prescribers”.

The GPhC’s most recent published figures show the number of independent prescribers was 6,019 at the end of August, up from 1,545 in 2010.

Two years’ experience requirement retained

The GPhC agreed to scrap its proposal to remove the requirement for applicants to the independent prescriber course to have worked in a patient-facing role for two years, following “mixed” consultation responses, it said.

In the consultation document, the GPhC had said there was “no evidence to suggest that time alone spent in a particular area produces applicants of the right quality to train”, and suggested that greater emphasis should be placed on the nature of applicants’ experience.

Explaining its decision to scrap the proposal to remove the need for patient-facing experience, the GPhC said that “the case for removing the time requirement had not been made with sufficient force”. Moving forward, “course providers should evaluate both the quality and quantity of an applicant’s experience”, it added.

Formal mentoring proposal scrapped

The regulator has also decided to scrap its proposal for independent prescriber trainees to have “formal mentoring”, it said.

The GPhC received a “high number of ‘disagree’ responses” to the proposal, mainly from the education and training sector. Some course providers saw the proposal as “increasing their obligations in respect of the quality [of] management and support” for trainees, including in mentoring, the GPhC said.

The changes will be implemented when the GPhC accredits training courses from next year, and “will be done on a phased basis…over the next few years”, it added. The final revised standards will be published next year.

RPS welcomes change

In a statement last week (December 14) the Royal Pharmaceutical Society welcomed the move, as it had “long championed the use of pharmacists as prescribing supervisors”.

“This will improve prescribing opportunities for the wider workforce, and also support [GPs] by distributing the supervision workload,” the RPS said.

The society is developing a set of performance guidelines for pharmacist independent prescribers who will be supervising trainees, it added.

View the draft standards in full.

12 Comments
Question: 
Will these changes make you more likely to train as an independent prescriber?

How High?, Community pharmacist

It says a lot about our profession when every pharmacist I know is clamouring to become a prescriber.

 

Aldosterone antagonist, Locum pharmacist

Spot on, nearly all of the newly qualified pharmacists, especially my friends want to go down the prescribing route.

Muhammad Siddiqur Rahman, Primary care pharmacist

Do we have enough #Pharmacist Prescribers that have enough experience and competence right now compared to a GP who themselves takes ten years of training to become one? Prescribing is more than just being medicine experts. It's also about diagnosing correctly and the Pharmacy degree does not prepare pharmacists for this at all compared to doctors and nurses. We all can't even do basic obs competently upon graduation with minimal patient facing exposure, if any. 

The new Advanced Clinical Practice (ACP) MSc course does it correctly first, learn the basic physical body examinations in the first year and then do the prescribing element in the second year.

Prescribing is not an administrative task, whenever you sign a presccription, you are essentially reconfirming that patient's condition and all of the liability and responsibility will fall on the prescriber. 

Reeyah H, Community pharmacist

The MSc is a three year course, so aren’t you looking at a very long time before prescribing? Or are you suggesting do the IP course whilst still on the ACP course?

Muhammad Siddiqur Rahman, Primary care pharmacist

As part of the ACP course, you do the IP modules in the second year after doing the physical examination modules in the first year so by end of the second year, you will become a prescriber and do the research module in the third year to obtain the MSc qualification plus the portfolio during those three years to become an accredited ACP pharmacist.

Really? Wow, Superintendent Pharmacist

A common sense response to what is a reckless decision. 

I cannot help feeling that the Gov are trying to use pharmacy as some kind of stick against the GP's with disregard for the outcomes. 

 

NewLocum Pharmacist, Community pharmacist

Pharmacists are more than capable to be prescribers. No one is saying that pharmacists should be IP's right out of university (not as the course currently stands anyway). Although some universities were thinking of incorporating the IP within their Mpharm course. 

Many pharmacists that are prescribers are also advanced practitioners (AP) or studying to become one. AP's are great diagnosticians and there is ZERO evidence that a doctor is anymore competent than APs when it comes to diagnostics. Yes, It takes 7 years to train a doctor, but have you actually worked with a junior doctor? These lot only become good at diagnostics in the later years of learning IN practise. I even worked with junior GP's when I worked in a surgery and I honestly was not impressed.  

Even today, most of these conditions we are referring to the GP for we have a very good idea how to test and treat for. Yes the medical course provides better diagnostics training, but if the pharmacy course changes to incorporate training such as AP within in and given them more exposure to the diagnosing scene then we can be much more confident in the ability of pharmacists to diagnose. 

My advice to my fellow pharmacists thinking of becoming an IP is this: Get your AP training!

Ronald Trump, Pharmaceutical Adviser

GAME CHANGER! This will make it much easier to gain IP status as it removes the biggest barrier which is to find a DMP (medical doctor) that is willing to supervise you. This is great news for the profession and the NHS as it allows pharmacists to gain more autonomy and expand their scope of practice through prescribing- thus relieving some prescribing pressure on doctors. Pharmacists are already leaving community pharmacy im their droves to take up new positions in GP practices, primary care, care homes etc This is bad news for multiples and contractors as it means they will have to pay more and offer better working conditions to attract pharmacists to work for them. But what goes around comes around. Multiples have been driving down pharmacist wages and increasing workload on pharmacists for years now so its about time that the power shifted back to the individual practitioner.

 

Also, I think that is another step towards the goverments strategy to integrate prescribing into the undergrad training (as pharms will able to train pharms). I predict in 15 years time  Pharmacy will be a 5 year degree with integrated prescribing and pre-reg type training. Then there will also be a much more structured postgrad training pathway for all sectors, not just hospital. The role of the pharmacist continues to evolve...

 

Leroy Jackson, Community pharmacist

Like R-Plate drivers teaching learners. 

Having a GP with 7 years diagnostic training substitued by some "clinical pharmacist" who will do anything to add to their sense of self importance is a disaster waiting to happen. 

All these pharmacists scrammbling for scraps to show what they could do without thinking if they should. 

 

NewLocum Pharmacist, Community pharmacist

Pharmacists are more than capable to be prescribers. No one is saying that should be the case right out of university. Many pharmacists that are prescribers are also advanced practitioners (AP). AP's are great diagnosticians and there is ZERO evidence than a doctor is anymore competent than AP's when it comes to diagnostics. It takes 7 years to train a doctor, but have you actually worked with a junior doctor? These lot only become good at diagnoastics in the later years of learning in practise.

Ronald Trump, Pharmaceutical Adviser

This comment just shows how out of touch you are with modern day pharmacist learning and training. This is not about substituting 7 years diagnostic training of medical doctors or about pharmacists pretending or wanting to be doctors. Like all healthcare professionals, pharmacist prescribers should only prescribe within their competencies. If they are trained to diagnose in a specialist therapeutic area and are competent to do so then whats the problem? Pharmacist prescribing in primary care will mainly be focused around the ongoing management of multiple long-term conditions that have already been diagnosed by a medical doctor.  Pharmacists do not have the advanced diagnostic and physical examination training that doctors have and thats why pharmacists are not doctors. I think the key point you are missing is that you do not necessarily need advanced diagnostic skills to prescribe and manage most patients, if a diagnosis has already been made. Pharmacists prescribers will be most use complimenting doctors and nurses in multidisciplinary teams where they can use there advanced medicines knowledge to treat and manage patients. Pharmacists are not subsitutes for doctors and are not acute diagnosticians (although with specialist training could be in certain areas). Pharmacists bring there own skill set. Regards, Ronald

Barry Pharmacist, Community pharmacist

Best news in ages - for the profession but not perhaps for employers.

This opens the door to a massive number of the 30,000+ on the register who are not prescribers and who have felt that the hurdles were too high. It actually gives hope to younger members of the profession who would otherwise be facing the prospect of hundreds of pharmacies closing. 

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