Factors that will influence workforce development in the coming years

Factors that will influence workforce development in the coming years

Health service reform

In common with many countries, the National Health Service (NHS) has undertaken major reviews of how it meets society’s health needs. Changing demographics, advances in healthcare and increased patient involvement and expectation mean that the NHS, in common with health systems in other countries, is now entering another phase of major reform.

Economic pressures

The financial pressure on public services caused in large part by international problems in financial sectors has brought renewed urgency to the need to reform the NHS. It has been necessary to identify how to manage reduced budgets and still meet a range of growing and competing demands.

Changes in professional regulation

Following on from the Kennedy report into the problems in Bristol Heart Surgery Services, the Council for Healthcare Regulatory Excellence was established to oversee the roles of the individual professional regulatory bodies.^{5, 6} For pharmacy, this led to a change in the role of the Royal Pharmaceutical Society of Great Britain (RPSGB), with all of its statutory professional regulatory functions being transferred during 2010 to the General Pharmaceutical Council.⁷ Amongst these functions are the profes-sional standards and codes of conduct that govern the education, training and CPD of pharmacists and pharmacy technicians.

Workforce planning

Whilst the NHS has always undertaken workforce planning in an attempt to match the workforce demands of the service with the commissioned numbers of professionals in training, it has recently been severely criticised for not being fit for purpose.⁸ This is a difficult task that needs to make informed assumptions about the factors affecting both the demand and the supply side of this system. The Centre for Workforce Intelligence has been established to improve this process.⁹ One of the key approaches that it is hoped will improve workforce planning is the transition to a focus on care pathways: by deter-mining how key groups of patients will be managed, a workforce model can then be built to estimate more accurately the numbers and types of staff required. One of the challenges with this approach will be to ensure that this planning has sufficient granularity to estimate smaller professional groups such as the pharmacy workforce, and in particular the very specialised roles that may not be obvious when considering a pathway but that make an important contribution to healthcare as a whole.

Advanced and specialist practice

Advanced practice has been defined as when a new role is so significantly different from the original registered qualification that members of the pro-fession and public need to be able to identify the new practitioner and under-stand the education, training and assessment associated with the new role. This is a complex area that has to achieve a balance between providing services that are fit for purpose and affordable, meet collective and individual professional aspirations and protect the public interest.

Currently, apart from pharmacists with extended prescribing responsibil-ities, there is no statutory recognition of advanced and specialist practice; registrants are either pharmacists (with or without prescribing responsibil-ities) or they are pharmacy technicians.

Medical Education England and the Modernising

Pharmacy Careers Project Board

Medical Education England was set up in 2009 to align professional training, education and workforce needs with the needs of the service and patients following on from the Lord Darzi NHS Next Stage Review: A High Quality Workforce. Medical Education England will provide independent expert advice on education and training and workforce planning for doctors, den-tists, healthcare scientists and pharmacists. The pharmacy agenda is being taken forward by the Modernising Pharmacy Careers Project Board. At the time of writing, their work programme covers the following areas that, clearly, will lead to change in the education and training of the hospital pharmacy workforce:

·      the development and implementation of a new approach to pharmacist undergraduate education and preregistration training

·      enabling the registered pharmacy workforce to acquire the additional skills needed to deliver a wider range of clinical services

·      building on current arrangements for advanced pharmacy practice

·      determining and facilitating changes in the training of key pharmacy support staff to improve pharmacy skill mix, making the best use of all those working in pharmacy.