In January 2021, the General Pharmaceutical Council (GPhC) published revised Standards for the initial education and training (IETP) of pharmacists. This created 55 new learning outcomes for MPharm programmes to meet. It also saw a move away from the pre-registration year towards a foundation training year (FTY) for trainee pharmacists.
The new standards brought with them a requirement for prescribing training for trainee pharmacists, allowing them to become independent non-medical prescribers upon qualification. The standards are now nearly three years old, and it is worth looking back to see where we have come from, and what is still to come.
Pharmacists qualifying from 2026 onwards will be independent prescribers. This means that student and trainee pharmacists will need to meet intended learning outcomes aligned to prescribing. In November 2023, a panel of experts at the UKCPA Conference sought to reassure the audience that this doesn’t mean ‘doing an independent prescribing course’ during the foundation training year. IEPT looks at the process of becoming a pharmacist (which now includes being a prescriber) as a five-year continuum; started during the MPharm with theory and practice of skills, to the FTY where trainee pharmacists will work with prescribers to further develop their skills.
Gone are the days of students shadowing a pharmacist around a ward; under the new placement arrangements students will be permitted to dispense medicines, provide immunisation and other appropriate activities.
FTY has changed from the previous process of a pre-registration year. Tutors have been replaced by designated supervisors and the GPhC has asked NHS England to quality assure foundation training. NHS England has also developed an assessment strategy with resources to support trainees and their supervisors such as an e-portfolio, and assessment activities amongst others.
From 2025, trainee pharmacists will need to additionally have a designated prescribing practitioner (DPP) and time in a prescribing learning setting (90 hours). The designated supervisor and the DPP can be the same person, but this is not compulsory. The DPP does not have to be based in the main training site and the DPP can supervise multiple trainees. In addition, the DPP is not required to have the three years’ experience element of the RPS DPP competency framework.A DPP can be any independent prescriber including pharmacists, doctors, nurse independent prescribers etc. NHS England will be providing further information and resources.
Supporting new prescribers
To support the existing healthcare workforce to understand how the Foundation Pharmacist learning outcomes enable early career pharmacists to implement prescribing in practice, NHS England has worked with experts across the pharmacy landscape to develop an interactive resource. This provides examples of how early careers pharmacists may be used as prescribers.
The introduction of prescribing learning outcomes has required a shift in the education of students to facilitate these learning outcomes. One change is the introduction of an increase in experiential learning or placements for undergraduate students. To support this move, pharmacy was added to the list of professions that are eligible for clinical tariff payments. In preparation for this, Health Education England (now part of NHS England) worked with pharmacy service providers and higher education institutions in 2021/22 to pilot working models.
In addition to the number of and tariff availability for placements, the NHS England team have been working on how to bring consistency into the placements. One activity is the use of entrustable professional activities (EPAs). EPAs are “units of professional practice that can be described as responsibilities or discrete tasks that supervisors entrust trainees with, once they achieve adequate competencies.” Gone are the days of students shadowing a pharmacist around a ward; under the new placement arrangements students will be permitted to dispense medicines, provide immunisation and other appropriate activities.
The University of Bath was commissioned to develop the list of EPAs and 47 different activities are described in the list. Whilst HEIs and placement providers are not required to undertake the EPAs, they do provide a framework in which students can develop and demonstrate their skills. Individual HEIs will be working with their provider stakeholders to develop working models that fit local needs. A toolkit for the implementation of EPAs is in development and will be published on the NHS England website in the coming months.
Recruitment process for placements
To further facilitate the implementation of the IETP standards, all FTY places starting in 2025 will be recruited through the National Foundation Trainee Pharmacist Recruitment program, also known as Oriel. Whilst HEE-funded FTY places (such as those in secondary care or programmes that include time in GP practice or in the health and justice sector) have always used the Oriel system, those in community pharmacy have had the opportunity to recruit outside. This change will allow NHS England to quality assure recruitment and the FTY.
In addition, from 2025 there will be a harmonisation of funding of FTY places across all sectors and from 2026, it will be mandatory for all programmes to have a multi-sector rotation (a minimum of 13 weeks). NHS England will also provide a funded training course, which will be accessible by all foundation trainee pharmacists regardless of sector or region.
Where to from here?
To support the implementation of the IEPT standards, NHS England and the Pharmacy Schools Council identified priority subjects to facilitate the continuum of learning across the five years and have developed indicative criteria for these. The criteria are:
- Public Health and Health Inequalities
- Antimicrobial Resistance and Antimicrobial Stewardship
- Clinical Reasoning
Whilst it is not compulsory for HEIs and Foundation training providers to use these criteria, they are a guide for all educators. More information on the criteria can be found on the NHS England website.
There is additional work to be done to clarify some of the information described above. Pharmacists can sign up for IETP updates by going to the NHS England website.
Further information and support can be found at:
- NHS England Initial education and training of pharmacists – reform programme
- NHS England Workforce, Training and Education You Tube Channel
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.