Future Plans for the Pharmacy Workforce

The Deputy Chief Pharmaceutical Officer for NHS England and NHS Improvement and the Pharmacy Dean (South East and South West) for Health Education England (HEE) reflect on the NHS Interim People Plan and the opportunities it provides within the Primary Care Networks launching next week for pharmacy professionals to play an integral role in the delivery of new models of care, disease prevention and improving patient outcomes:

We know from practical experience, the positive impact of pharmacy professionals on patient care as part of multidisciplinary teams in hospitals, care homes, urgent and emergency care, primary care and in the community.

Now thousands more clinical pharmacy professionals will be employed in multidisciplinary teams in primary care networks (PCNs) over the next five years as part of GP contract arrangements in order to deliver NHS Long Term Plan commitments. This is a significant opportunity for pharmacy and a game-changer which will revolutionise the care offered to people in local communities across England, creating an integrated service for patients.

The NHS Long Term Plan sets out how patients and the public will increasingly rely on clinical care provided by pharmacy professionals:

  • Clinical pharmacist prescribers will be a central part of multi-professional teams across PCNs. It is intended that pharmacy technicians will also support this new part of the primary care workforce.
  • Community pharmacy teams will deliver consistent, high-quality care of patients with minor illnesses and support the public to live healthier lives.
  • Hospital pharmacists will continue to be part of specialist teams but will extend their practice into primary care, including providing consultant pharmacist support.

Medicines safety will be improved, wastage reduced, and medicines optimised through structured medication reviews led by clinical pharmacists.

The challenge now is ensuring sustainability and consistency across the country for services we know have demonstrable impact, whilst ensuring workforce supply and development, so we have pharmacy professionals where they are needed with the right skills and support.

This means we need a model of education and training that delivers the right pharmacy workforce – one that can adapt to the increasingly complex health and care system, and respond to technological and data advances and changing patient needs.

To ensure we have the model right, HEE carried out a review of the current model of education and training for the pharmacy workforce, working with partners to consider:

  • The initial education and training pathway for pharmacists and how this could be delivered differently.
  • Foundation training across primary, community and secondary care for clinical pharmacists and how this could be standardised to build on the initial education and training and to meet the future requirements of service.
  • A review of the training of pharmacy technicians to ensure they are competent and confident to advance their practice across primary, secondary and community settings.

The Advancing Pharmacy Education and Training Report includes a range of recommendations and helps to provide valuable evidence for the development of the Interim People Plan which was published earlier this month.

The Interim People Plan sets out the vision and first steps, including funding and priorities, for 2019-20. A full People Plan will follow, translating the national vision into detailed, costed action plans, alongside a detailed implementation plan for the NHS Long Term Plan as a whole.

The interim plan has been developed by the National Workforce Steering Group, chaired by Baroness Dido Harding, which had five working groups and included a Pharmacy Sub-Group, chaired by Chief Pharmaceutical Officer Keith Ridge, which comprised senior pharmacy and policy leads from the Department of Health and Social Care, NHS England and NHS Improvement, and HEE.

A vital process of national engagement was carried out through a Partners’ Forum, which met three times from February to April 2019, and which included representatives from national organisations including academia, pharmacy professional and trade bodies, NHS provider bodies and pharmacy regulators.

The interim People Plan sets out how NHS England and NHS Improvement will:

  • Introduce new approaches to cross-sector pre-registration and postgraduate clinical training pathways for pharmacy professionals to assure high quality care. These will be underpinned by establishing a common foundation programme for all newly registered pharmacists. It is likely that a professional framework for pharmacy technicians will be developed.
  • NHS England and NHS Improvement will also work with the General Pharmaceutical Council to reform undergraduate and pre-registration training to align with this vision.
  • New training may also be developed to support community pharmacy teams to deliver consistent, high-quality care for patients with minor illnesses.
  • Consistent delivery of these goals throughout the NHS will require clinical and professional leadership across the health and care system. Appointment of senior and experienced NHS pharmacists as clinical directors of pharmacy and medicines in each integrated care system is likely to be an important part of the clinical and professional leadership system and NHS England and NHS Improvement will pilot and evaluate these roles during 2019-20 to develop a sustainable approach.
  • Given the opportunities described in the NHS Long Term Plan, NHS England and NHS Improvement intends to strengthen the image and reputation of pharmacy teams to attract a larger and wider pool of people to the future pharmacy workforce.

NHS England, NHS Improvement and HEE will now develop a system wide board to oversee the delivery of the Plan pharmacy workforce plans, to enable a focus on the key activities, and ensure engagement with stakeholders in order to deliver the broader aspirations within the People Plan.

Richard Cattell

Richard Cattell has been a pharmacist for 28 years with a career mainly in acute hospitals in the South West, Cardiff and the West Midlands.

He most recent roles have included Chief Operating Officer and Chief Pharmacist.

His current role is the Deputy Chief Pharmaceutical Officer for NHS England and NHS Improvement. In this he focuses on supporting trusts with their care quality, driving the improvement in 7-day pharmacy services, developing aspiring chief pharmacists and providing the senior medicines leadership to the Medicines Safety Programme.

He is passionate about supporting patients and the healthcare team in getting the best from medicines, reducing harm and improving care.

Trevor Beswick

Trevor Beswick started his career in hospital posts before joining the South Western Regional Health Authority in education and training and medicines information.

In 1993 he took up the post of South West Regional Pharmaceutical Adviser, followed by a post at Bristol Primary Care Trust as Head of Medicines Management and then as Associate Director of Primary Care Commissioning.

He took a specialist regional pharmacy role in medicines information and education and training at South West Medicines Information and Training and then joined HEE’s South Region in August 2017 and has been working on a range of national and regional projects including:

• Advanced Clinical Practitioner Framework
• The review of pharmacy education and training
• Reforming pre-registration pharmacist support in HEE South
• Education quality
• Medication safety education and training
• Supporting advanced and consultant pharmacy practice
• Apprenticeships for pharmacy technicians
• Pharmacy workforce data and intelligence.

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