The introduction of a clinically based leadership role in pharmacy is greatly welcomed and supports the establishment of a flexible career pathway for pharmacists, benefiting patients by providing access to experts across localities and ensuring that good practice and expertise are disseminated.
Next steps
The introduction of
a clinically based leadership role in pharmacy is greatly welcomed and supports
the establishment of a flexible career pathway for pharmacists, benefiting
patients by providing access to experts across localities and ensuring that
good practice and expertise are disseminated. However, at present there is no
formal mechanism for career development from the general level/early years of
practice to higher-level practice. While these developments are much needed, it
is crucial that they take account of the need for a flexible workforce and
avoid the overspecialisation seen in the medical model.
The Department of
Health guidance for consultant pharmacists has the key to flexible service
development through use of the ACLF, which describes a majority of practice
areas that are applicable to all pharmacists wishing to develop their practice.
This is particularly relevant as most patients are supported by community-based
pharmacists, whether in retail outlets or primary care, and there is a need for
advanced generalists to fulfil these roles for more complex patients.
While the medical
model of registrar development is well established, it suffers from the ‘silo
effect’, where practitioners are required to undertake a complete registrar
programme again if they wish to change specialities. A more flexible approach
would be to engage the networks of expert phar-macy practitioners, whether
general or specialist, in producing a curriculum of practice for advancing
practitioners, up to consultant level, allowing those practitioners who wish to
progress to complete the curriculum, however they choose to (which may be
self-directed learning and/or through courses). If the practitioners also
submitted evidence of achievement in the five non-expert clusters of the ACLF,
this could then be assessed by the experts and contribute to the establishment
of professional designations as nationally recognised levels of practice,
reflecting these achievements. The Royal Pharmaceutical Society (the
professional leadership body for pharmacy) has adopted this approach and is
working with networks of expert practitioners to achieve this.
This discussion has
focused on the NHS hospital sector. However, it has been shown that this can
apply to primary and community pharmacy practitioners. The concept of
higher-level practice also exists in industry, as the qualified person, and in
academia through postgraduate Masters and Doctorate-level qualification, and it
is not known whether there is benefit to establishing consultant-level practice
outside the NHS.
Already those using
the restricted title ‘consultant pharmacist’ are showing leadership in
non-medical prescribing, where there is an external perception that all
consultant pharmacists are prescribers (which is not the case). Leadership in
risk management initiatives and managing antimicrobials has achieved outcomes
for patient benefit. Consultant pharmacists are engaging in research into
specific drugs such as melatonin, disease states such as delirium, broad
therapeutic areas such as gene therapy and participating in technology
appraisals for national bodies.
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