University of Bath independent prescribing course reaccreditation event record - January 2020
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University of Bath independent prescribing course reaccreditation event record – January 2020
Contents Event summary and conclusions ................................................................. 1 Introduction ............................................................................................... 2 Role of the GPhC ............................................................................................................ 2 Background.................................................................................................................... 3 Documentation .............................................................................................................. 3 The event....................................................................................................................... 3 Declarations of interest ................................................................................................. 3 Schedule ..................................................................................................... 4 Attendees ................................................................................................... 4 Accreditation Team ....................................................................................................... 4 Course provider representatives .................................................................................... 5 Documentation ........................................................................................... 5 Part 1 - Learning outcomes.......................................................................... 6 Part 2 - Standards for pharmacist independent prescribing course providers ..................................................................................................................25 Accreditation criteria .................................................................................25 Standard 1 – Selection and entry requirements. .......................................................... 25 Standard 2 – Equality, diversity and inclusion. ............................................................. 29 Standard 3 – Management, resources and capacity. .................................................... 33 Standard 4 – Monitoring, review and evaluation. ........................................................ 41 Standard 5 – Course design and delivery...................................................................... 48 Standard 6 – Learning in practice. ................................................................................ 54 Standard 7 – Assessment ............................................................................................. 58 Standard 8 – Support and the learning experience....................................................... 68 Standard 9 – Designated prescribing practitioners ....................................................... 70 Appendix 1 - Standing conditions ...............................................................74 University of Bath independent prescribing course reaccreditation event record – January 2020
Event summary and conclusions Provider University of Bath Course Independent prescribing course Event type Reaccreditation Event date 8 January 2020 Reaccreditation period April 2020 – April 2023 Relevant standards GPhC education and training standards for pharmacist independent prescribers, January 2019 Outcome Approval with conditions The accreditation team agreed to recommend to the Registrar of the General Pharmaceutical Council (GPhC) that pharmacist independent prescribing course provided by the University of Bath should be reaccredited for a further period of three years, subject to two conditions. Conditions 1. The provider must submit confirmation to the GPhC that the independent prescribing course has been validated by the university prior to enrolling any further students. The course is not permitted to run any further cohorts until this has been received and approved by the GPhC. This is to meet criterion 4.6 2. The provider must develop an appropriate feedback process for all DPPs regarding their overall performance as prescribing supervisors, including the arrangements for extra training, support and development as necessary. Details of this process must be sent to the GPhC before the next intake of students onto the course. This is to meet criterion 9.5. Standing conditions Please refer to Appendix 1 Recommendations No recommendations were made Minor amendments 1. Students are currently asked to declare any investigation into their clinical practice in their application form. The question on the application form should be broadened beyond investigations into clinical practice. (Criterion 1.1) 2. The team encouraged the provider to look for opportunities to involve patients and other stakeholders more formally in the course delivery. (Criterion 5.4) 3. The team encouraged the provider to include written information on fitness to practise policies and processes, University of Bath independent prescribing course reaccreditation event record – January 2020 1
including those relating to health, in the course handbook. (Criterion 5.9) 4. The team was unable to find instructions on how to address causes for concern in the course handbook. The team will check and add this information if it is missing. (Criterion 5.10) 5. Provide a copy of the DPP support pack to the GPhC when it is finalised. (Criterion 9.3) Maximum number of 40 all students per cohort: Number of pharmacist 40 students per cohort: Number of cohorts per 2 academic year: Registrar decision Following the event, the Registrar of the GPhC accepted the accreditation team’s recommendation and approved the reaccreditation of the programme for a further period of 3 years, subject to two conditions. Key contact (provider) Joanne Clarke, Programme Lead – Independent Prescribing Reaccreditation team Professor Chris Langley (event Chair), Professor of Pharmacy Law & Practice and Head of the School of Pharmacy, Aston University; Associate Dean, Taught Programmes, School of Life and Health Sciences Mike Pettit, Retired Senior Lecturer, Pharmacy Practice, University of Sussex Fiona Barber, Independent Member, Leicester City Council GPhC representative Chris McKendrick, Quality Assurance Officer, GPhC Amy Beales (Observer) Quality Assurance Officer, General Pharmaceutical Council Rapporteur Jane Smith, Chief Executive Officer, European Association for Cancer Research Introduction Role of the GPhC The General Pharmaceutical Council (GPhC) is the statutory regulator for pharmacists and pharmacy technicians and is the accrediting body for pharmacy education in Great Britain. The reaccreditation process is based on the GPhC’s standards for the education and training of pharmacist independent prescribers January 2019. 2 University of Bath independent prescribing course reaccreditation event record – January 2020
The GPhC’s right to check the standards of pharmacy qualifications leading to annotation as a pharmacist independent prescriber is the Pharmacy Order 2010. It requires the GPhC to ‘approve’ courses by appointing ‘visitors’ (accreditors) to report to the GPhC’s Council on the ‘nature, content and quality’ of education as well as ‘any other matters’ the Council may require. The powers and obligations of the GPhC in relation to the accreditation of pharmacy education are legislated in the Pharmacy Order 2010. For more information, visit: http://www.legislation.gov.uk/uksi/2010/231/contents/made Background The University of Bath was accredited by the Royal Pharmaceutical Society of Great Britain in 2007 to provide a programme to train pharmacist independent prescribers. The programme was reaccredited by the GPhC in 2010, February 2014 and January 2017. No conditions were set at the previous reaccreditation event. In line with the GPhC’s process for reaccreditation of independent prescribing programmes, an event was scheduled on 8 January 2020 to review the programme’s suitability for further reaccreditation. The provider confirmed that there will be two cohorts per year with a maximum of 40 students in each cohort. The programme is led by a pharmacist and is only offered to pharmacists. Documentation Prior to the event, the provider submitted documentation to the GPhC in line with the agreed timescales. The documentation was reviewed by the reaccreditation team and it was deemed to be satisfactory to provide a basis for discussion. The event The event was held at the GPhC head office on 8 January 2020 and comprised a number of meetings between the GPhC reaccreditation team, representatives of the University of Bath prescribing course and students (via teleconference). Declarations of interest It was noted that one of the provider representatives, Nicholas Haddington, is an external examiner at Aston University. University of Bath independent prescribing course reaccreditation event record – January 2020 3
Schedule The event Meeting Meeting Time number 1. Private meeting of accreditation team and GPhC 09:30 -11:30 representatives 2. Meeting with provider 11:30 -13:10 3. Lunch 13:10 – 13:45 4. Student meeting (teleconference or individual calls) 13:45 – 14:30 5. Private meeting of the accreditation team 14:30 – 14:45 6. Learning outcomes testing session 14:45 – 15:30 7. Panel private meeting 15:30 – 16:15 8. Feedback to provider 16:15 – 16:30 Attendees Accreditation Team The GPhC’s accreditation team (‘the team’) comprised: Name Designation at the time of reaccreditation Meetings event attended Professor Chris Langley Professor of Pharmacy Law & Practice and 1-8 (event Chair) Head of the School of Pharmacy, Aston University; Associate Dean, Taught Programmes, School of Life and Health Sciences Mike Pettit Retired Senior Lecturer, Pharmacy Practice , 1-8 University of Sussex Fiona Barber Independent Member, Leicester City 1-8 (lay member) Council along with: Name Designation at the time of reaccreditation Meetings event attended Chris McKendrick Quality Assurance Officer, GPhC 1-8 Jane Smith Chief Executive Officer, European 1-8 (rapporteur) Association for Cancer Research Amy Beales Quality Assurance Officer, GPhC 1-8 (observer) 4 University of Bath independent prescribing course reaccreditation event record – January 2020
Course provider representatives The team met with the following representatives of the university: Name Designation at the time of reaccreditation Meetings event attended Nicholas Haddington Director of Taught Postgraduate 2, 3, 6, 8 Programmes Emma Taylor Teaching Fellow, Independent Prescribing 2, 3, 6, 8 Course Documentation Documentation provided in advance of the event: • Completed submission template part 1 • Completed submission template part 2 • Evidence documents: o Appendix 1 – The Consultation_references Summary Sept 2019 FINAL o Appendix 2 – Legal and Professional background to Independent Prescribing Sept 2019_FINAL o Appendix 3 – Assessment Guide_Sept19 version o Appendix 4 – Portfolio task guide for students o Appendix 5 – Online_Application_Form o Appendix 6 – Application form and Guidance notes for new programme June 2020 intake o Appendix 7 – Updated Portfolio Markers Guide from June 2020 o Appendix 8 – PA500356_Learning_Agreement_2020 o Appendix 9 – Staff CVs o Appendix 10 – Unit Description CMIS o Appendix 11 – STUDENT FEEDBACK_Workshop 1 o Appendix 12 – PA500356_WtdW_Sept19_FINAL o Appendix 13 – WORKSHOP OVERVIEW provisional timetable o Appendix 14 – Clinical_Review_Group_TOR o Appendix 15 – Trafficlight_Marking_Scheme o Appendix 16 – Flow Chart of Use of traffic light marking scheme o Appendix 17 – Handbook_PT_Specific_Final o Appendix 18 – DPP_Support_Guide_June 2020 o Appendix 19 – DPP_Assessment_Guide_June 20 o Appendix 20 – PA500356 DPP Interim_Feedback_2020 o External examiners reports – submitted separately before the event University of Bath independent prescribing course reaccreditation event record – January 2020 5
In addition, Minutes of the AP3T Board of Management, the provider’s Fitness to Practise procedures and the criteria used to assess prospective DPPs’ applications were made available to the team on the day. Notes on the format of this record: • The record of the event incorporates the provider’s commentary (shown in black text) and the accreditation team’s commentary (shown in blue text). • The provider’s commentary has been taken verbatim from their submission document which was sent to the GPhC in advance of the event. • References to individual appendices and/or specific page numbers have been removed where necessary. • There have been no changes to the content or wording of the provider’s commentary. Part 1 - Learning outcomes During the event the team reviewed all 32 learning outcomes relating to the independent prescribing course. To gain additional assurance the team also tested a sample of six learning outcomes during a separate meeting with the provider and was satisfied that all 32 learning outcomes would be met during the course to the level required by the GPhC standards. The following learning outcomes were tested at the event: 6, 15, 19, 23, 26 and 28 Domain: Person-centred care Upon successful completion of the programme, a pharmacist independent prescriber will be able to: 1 Recognise the psychological and physical impact of prescribing decisions on people Level: Knows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is explored within the online learning resources (Consultation and Prescribing Theme) as part of the hours of directed learning, and is explored within workshop sessions with simulated consultations. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio - Consultation tasks 1-6 (including direct observation) pOSA (online multiple-choice examination) Case Presentation 1 and 2 6 University of Bath independent prescribing course reaccreditation event record – January 2020
DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. 2 Understand and meet their legal responsibilities under equality and human rights legislation and respect diversity and cultural differences Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal and Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – Workshop tasks 1, 3 DPP Assessment Guide pOSA Accreditation team’s commentary This learning outcome is met. 3 Take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary University of Bath independent prescribing course reaccreditation event record – January 2020 7
Portfolio – Workshop task 5 Portfolio – Consultation tasks 1-6 (including direct observation) Case Presentation 2 DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. 4 Demonstrate appropriate history-taking techniques through effective consultation skills Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided through blended learning; starting with online learning resources (The Consultation) included ‘flipped learning’ content, and then within face-to-face workshops – sessions are provided on consultation skills including medication history taking. This is also taught within feedback of ‘fishbowl’ sessions facilitated by the programme team where students complete consultations with medical actors and have peer feedback. Students are also directed to undertake activities exploring this theme within practice-based learning environments. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – Consultation tasks 1-6 (including direct observation), Workshop task 4 OSCE Case presentation 2 Accreditation team’s commentary This learning outcome is met. 5 Demonstrate and understanding of the role of the prescriber in working in partnership with people who may not be able to make fully informed decisions about their health needs Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided through blended learning; starting with online learning resources (Legal/Professional), and then developed within face-to-face workshops. Sessions are provided on consultation skills including looking at complex cases. This is also taught within feedback of ‘fishbowl’ sessions facilitated by the programme team where students complete consultations 8 University of Bath independent prescribing course reaccreditation event record – January 2020
with medical actors and have peer feedback. Students are also directed to undertake activities exploring this theme within practice-based learning environments. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – Consultation tasks 1-6 (including direct observation), Workshop task 1 DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. 6 Support individuals to make informed choices that respect people’s preferences Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided through blended learning; starting with online learning resources (The Consultation), and then developed within face-to-face workshops. Sessions are provided on consultation skills. Students are also directed to undertake activities exploring this theme within practice-based learning environments. How the provider assesses whether the student achieves this outcome DPP Assessment Guide Provider’s commentary Portfolio – Consultation tasks 1-6 (including direct observation) Case Presentation 2 DPP Assessment Guide OSCE Accreditation team’s commentary This learning outcome was tested at the event. The provider stated that the topics of informed consent and shared decision-making are introduced within the learning theme of the consultation. Students are directed to look at some material on the VLE in advance and this is discussed in one of the workshop sessions, where the consultation is linked back to the underpinning legislation. This is explored in increasing complexity in the ‘fishbowl’ sessions. These are sessions in which students undertake simulated consultations with medical actors and receive actor and peer feedback facilitated by the programme team. There is also a workshop peer discussion task on influencing in prescribing. The ethical challenges of patients not consenting to treatment or choosing not to take medicines are discussed in these workshops. University of Bath independent prescribing course reaccreditation event record – January 2020 9
The learning outcome is assessed in the portfolio in which students are required to describe patient consultations that take place during their period of learning in practice and to show that patients are making informed choices with all the necessary information. It is also assessed in the OSCE where shared decision making is a specific requirement in the marking criteria and there is a question on the ethical issues in the online multiple-choice assessment. This learning outcome is met. Domain: Professionalism Upon successful completion of the programme, a pharmacist independent prescriber will be able to: Demonstrate a critical understanding of their own role and the role of others in multi- 7 professional teams Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary Students are directed to undertake activities exploring this theme within practice-based learning environments. It will also be covered within face-to-face workshops. Students are required to develop a ‘Treatment Plan’ that explicitly sets out all components of decision making within their area of clinical practice, including clear identification of referral points and route in order to escalate patient care/achieve holistic care. They are then required to demonstrate the use of the Treatment Plan within a number of consultations, where they will demonstrate interaction with the roles of other healthcare professionals within the teams. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation), Treatment Plan tasks 1-3 DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. 8 Recognise their own role as a responsible and accountable prescriber who understands legal and ethical implications Level: Does 10 University of Bath independent prescribing course reaccreditation event record – January 2020
How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 1, 3 DPP Assessment Guide pOSA Accreditation team’s commentary This learning outcome is met. 9 Apply relevant legislation and ethical frameworks related to prescribing, including remote prescribing and the handling and sharing of confidential information Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop tasks 1 and 3 pOSA Accreditation team’s commentary This learning outcome is met. 10 Recognise and manage factors that may influence prescribing decisions Level: Does University of Bath independent prescribing course reaccreditation event record – January 2020 11
How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided through blended learning; starting with online learning resources (The Consultation) for them to complete self-directed learning, and then some components are developed further within face-to-face workshops in teaching sessions on clinical reasoning, where concepts around decision making models and the role of heuristics and cognitive biases are explored. Within the online learning resources there are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) Portfolio - Workshop task 5 Case Presentations 1 and 2 OSCE DPP Assessment Accreditation team’s commentary This learning outcome is met. 11 Apply local, regional and national guidelines, policies and legislation related to healthcare Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (The Consultation) for them to complete self-directed learning and then further within workshop sessions exploring development of the Treatment Plan. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio - Consultation tasks 1-6 (including direct observation) Portfolio – Treatment plan tasks 1-3 Case Presentation 2 DPP Assessment Guide OSCE 12 University of Bath independent prescribing course reaccreditation event record – January 2020
Accreditation team’s commentary This learning outcome is met. 12 Reflect on and develop their own prescribing practice to ensure it represents current best practice Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by face-to-face workshops on reflection in practice in the induction session. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – reflective pieces x 2 Portfolio – portfolio task 5 DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. 13 Apply an understanding of health economics when making prescribing decisions Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. Students are required to demonstrate this within the construction of their Treatment Plans; within the selection and justification of therapeutic options. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – treatment plan tasks 1-3 DPP Assessment University of Bath independent prescribing course reaccreditation event record – January 2020 13
Accreditation team’s commentary This learning outcome is met. 14 Understand the clinical governance of the prescriber, who may also be in a position to supply medicines to people Level: Knows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 3 and 6 Accreditation team’s commentary This learning outcome is met. 15 Recognise other professionals’ practice and raise concerns related to inappropriate or unsafe prescribing by other prescribers Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 6 Portfolio – portfolio task 6 14 University of Bath independent prescribing course reaccreditation event record – January 2020
Accreditation team’s commentary This learning outcome was tested at the event. This topic is introduced in the governance learning theme via learning resources on the VLE which look at identifying prescribing errors and whistle-blowing. It is then woven through a workshop peer discussion focused on managing risk. This session has recently been broadened to look at the risks of prescribing errors. Issues of influencing on prescribing are also addressed; for example, looking at how students might challenge a more senior colleague if they disagree with their prescribing decision. Facilitators are used in these sessions to make sure that all students engage. Students are required to upload a summary of the workshop discussion into their portfolio, which is assessed. This learning outcome is met. Domain: Professional knowledge and skills Upon successful completion of the programme, a pharmacist independent prescriber will be able to: 16 Apply evidence-based decision-making in all aspects of prescribing Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (The Consultation) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) (supported by treatment plan tasks 1-3) Portfolio – Portfolio tasks 2 and 5 Case presentation 2 OSCE DPP Assessment Guide Accreditation team’s commentary This learning outcome is met. University of Bath independent prescribing course reaccreditation event record – January 2020 15
17 Manage the risks and benefits associated with prescribing decisions Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by face-to-face workshops and within online learning resources (The Consultation) and self-directed learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) Portfolio – workshop task 6 OSCE DPP Assessment Accreditation team’s commentary This learning outcome is met. 18 Demonstrate the application of pharmacology in relation to their own prescribing practice Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (The Consultation) for them to complete self-directed learning in preparation for their presentation, and completion of their treatment plan tasks. How the provider assesses whether the student achieves this outcome Provider’s commentary Case Presentation 1 Portfolio – consultation tasks 1-6 (including direct observation) DPP Assessment Accreditation team’s commentary This learning outcome is met. 16 University of Bath independent prescribing course reaccreditation event record – January 2020
19 Demonstrate clinical and diagnostic skills in clinical setting appropriate to their scope of practice Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided in face to face workshops and students will be directed to complete activities within the practice-based learning setting. How the provider assesses whether the student achieves this outcome Provider’s commentary OSCE DPP assessment Accreditation team’s commentary This learning outcome was tested at the event. The outcome is addressed within the consultation learning theme. Students learn how physical examination findings and other information come together into diagnostic reasoning and decision-making. This encompasses a broad range of consultation skills: preparing the patient, taking a patient history, gaining consent, hygiene, physical examinations techniques, gathering information from a patient’s notes and identifying information gaps and deciding how to address them. A dedicated session looks at clinical reasoning and in simulated sessions this information is used to make a diagnostic decision. These skills are then practised with the DPP; the student is expected to conduct a series of supervised consultations and to write them up in their portfolio, demonstrating their understanding and use of the range of skills. One of these written reports focuses specifically on diagnosis. Portfolio markers assess these reports and cross-reference them with the treatment plan which has been signed off by the DPP. In addition, clinical skills are assessed by the DPP using the DPP assessment guide. Physical examination skills are also assessed in the OSCE. This learning outcome is met. 20 Create and maintain appropriate records which ensure safe and effective care and align with relevant legislation Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught University of Bath independent prescribing course reaccreditation event record – January 2020 17
Provider’s commentary This will be provided in face to face workshops. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 4 DPP Assessment Accreditation team’s commentary This learning outcome is met. 21 Identify relevant investigations and interpret results and data in their prescribing practice Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary Students will be directed to complete activities within the practice-based learning setting, with support from online learning resources (The Consultation). How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) Portfolio – treatment plan tasks 1-3 OSCE DPP Assessment Accreditation team’s commentary This learning outcome is met. 22 Utilise current and emerging systems and technologies in safe prescribing Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary 18 University of Bath independent prescribing course reaccreditation event record – January 2020
Elements relating to this learning outcome (accessing and interpreting results, using electronic notes systems and electronic prescribing systems) are introduced within online learning resources (The Consultation) and further developed within directed activities in the practice- based learning setting. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) Portfolio – treatment plan tasks 1-3 Accreditation team’s commentary This learning outcome is met. 23 Identify and respond to people’s needs when prescribing remotely Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided in face to face workshops and online learning resources (Legal/Professional). How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 6 Accreditation team’s commentary This learning outcome was tested at the event. The topic is introduced in the legal and governance learning theme. Students are pointed to the new GPhC guidance in this area and take part in a workshop discussion on organisational approaches to prescribing. This looks at new prescribing settings and non-traditional prescribing including repeat prescribing, discharge prescribing and remote prescribing. Students already undertaking remote prescribing are encouraged to share their experiences with their peers. The learning outcome is assessed through a risk and safety discussion in workshop task number 6. This learning outcome is met. 24 Apply the principles of effective monitoring and management to improve patient outcomes Level: Does University of Bath independent prescribing course reaccreditation event record – January 2020 19
How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary Students will be directed to complete activities within the practice-based learning setting, with support from online learning resources (The Consultation). How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) OSCE Case Presentation 2 Accreditation team’s commentary This learning outcome is met. 25 Recognise and manage prescribing and medication errors Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This is provided to students within online learning resources (Legal/Professional) for them to complete self-directed learning. There are signposting documents for them to enhance their learning. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – workshop task 6 Portfolio – portfolio task 6 Accreditation team’s commentary This learning outcome is met. 26 Recognise the public health issues in promoting health as part of their prescribing practice Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary 20 University of Bath independent prescribing course reaccreditation event record – January 2020
Students will be directed to complete activities within the practice-based learning setting, with support from online learning resources (The Consultation) and workshop teaching sessions. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) (supported by treatment plan tasks 1-3) OSCE Accreditation team’s commentary This learning outcome was tested at the event. The topic is taught in the consultation learning theme which incorporates a treatment plan. Students must specifically identify and address the public health components of their chosen prescribing area. The Does level is achieved through the use of the treatment plan approved by the DPP in a series of consultations in practice. In the ‘fishbowl’ communication sessions students learn to address difficult issues and discuss signposting to a range of other services such as mental health and bereavement services. This learning outcome is met. Domain: Collaboration Upon successful completion of the programme, a pharmacist independent prescriber will be able to: 27 Work collaboratively with others to optimise individuals’ care, understanding their roles in the prescribing process Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary Students will be directed to complete activities within the practice-based learning setting, with support from online learning resources (The Consultation) and workshop teaching sessions. Students are required to develop a ‘Treatment Plan’ that explicitly sets out all components of decision making within their area of clinical practice, including clear identification of referral points and route in order to escalate patient care/achieve holistic care. They are then required to demonstrate the use of the Treatment Plan within a number of consultations, where they will demonstrate interaction with the roles of other healthcare professionals within the teams. University of Bath independent prescribing course reaccreditation event record – January 2020 21
How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) DPP Assessment Accreditation team’s commentary This learning outcome is met. 28 Recognise their own role and responsibilities, and those of others, in safeguarding children and vulnerable adults Level: Knows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by self-directed learning/signposting to other learning resources from within the online learning resources (Legal/Professional). How the provider assesses whether the student achieves this outcome Provider’s commentary pOSA (online multiple choice examination) Accreditation team’s commentary This learning outcome was tested at the event. All students have some understanding of safeguarding through the mandatory training they do in their workplaces. It is addressed in the legal and ethical resources on the VLE and is assessed in the online multiple-choice examination (pOSA). This learning outcome is met. 29 Recognise when and where to refer people appropriately Level: Shows how How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by face to face workshops on consultation skills and red flag identification. Students are required to build detailed assessment of the patient in relation to diagnosis/differential diagnosis/red flag identification and set out the associated referral 22 University of Bath independent prescribing course reaccreditation event record – January 2020
processes. Students receive feedback on the initial drafts of their treatment plans from their DPP, and then receive formative feedback from their portfolio marker, in order to provide further student support/development. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation), treatment plan tasks 1-3 DPP assessment OSCE Accreditation team’s commentary This learning outcome is met. 30 Collaborate with people to encourage them to take responsibility for managing care Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by face to face workshops on consultation skills. Students are also directed to undertake practice-based activities (the consultation tasks) to further develop and then demonstrate this. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) OSCE Case Presentation 2 Accreditation team’s commentary This learning outcome is met. 31 Demonstrate appropriate consultation skills to get information from individuals who are either unaware of or guarded about their health needs, to inform safe prescribing Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary University of Bath independent prescribing course reaccreditation event record – January 2020 23
This will be provided by face to face workshops on consultation skills, with support from online learning resources (The Consultation). How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) OSCE DPP Assessment Accreditation team’s commentary This learning outcome is met. 32 Recognise when to seek guidance from another member of the healthcare team or an appropriate authority Level: Does How the provider supports the student to achieve this outcome and where the learning outcome is taught Provider’s commentary This will be provided by face to face workshops on consultation skills, red flag identification and boundaries of competence/professional practice. Students are required to build detailed assessment of the patient in relation to diagnosis/differential diagnosis/red flag identification and set out the associated referral processes. This process is designed to allow the student to explore and define the boundaries of their professional competence – when to act autonomously and when to refer. Students receive feedback on the initial drafts of their treatment plans from their DPP, and then receive formative feedback from their portfolio marker, in order to provide further student support/development. How the provider assesses whether the student achieves this outcome Provider’s commentary Portfolio – consultation tasks 1-6 (including direct observation) OSCE DPP Assessment Accreditation team’s commentary This learning outcome is met. 24 University of Bath independent prescribing course reaccreditation event record – January 2020
Part 2 - Standards for pharmacist independent prescribing course providers Accreditation criteria Standard 1 – Selection and entry requirements. Selection processes must be open, clear and unbiased, comply with relevant legislation and ensure that applicants meet course entry requirements. 1.1 Selection criteria must be clear and must include meeting all the entry requirements in these standards. Provider’s commentary There is a clearly set out admissions process for the Independent Prescribing unit at Bath. There are a number of requirements that must be met prior to an admission decision being made. Application data is collected on the unit application forms. Information is corroborated by register searches, discussion with applicants, employers, DPPs and referees where appropriate. Applicants are required to complete an electronic Online Application Form (a standard requirement of the University) and additionally a separate unit specific Application Form. Together these ensure that all relevant information required to determine whether the GPhC pre-requisites for entry are met is available for the Applications Panel to consider. It is a requirement of the University that students applying for the Independent Prescribing unit are fully qualified pharmacists that are registered with the GPhC or the Pharmaceutical Society of Northern Ireland (PSNI). A question on the application form asks for the applicant’s registration number. A check is then made of the relevant professional register (GPhC or PSNI) to assure that the pharmacist is registered and to identify if they have any restrictions on their practice which may affect their appropriateness to undertake the course. If applicants are not registered, they do not progress through the assessment process. If there are any restrictions on their practice this will be discussed with the applicant and a decision made as to whether it is appropriate to undertake the course. Students are also asked to declare any current or pending formal investigations into their clinical practice on the Prescribing Context form. The standard application forms capture the following information: • Online Application Form: collects relevant professional and biographical information including details (and dates) of previous academic awards and professional registration; University of Bath independent prescribing course reaccreditation event record – January 2020 25
• Application Form contains the following sections: o Prescribing Context Form: which includes a statement of practice area and prescribing need, confirmation of up to date CPD and establishment of ongoing networks for support; evidence of up to date clinical, pharmaceutical and pharmacological knowledge relevant to their planned area of prescribing; o Declaration of support in practice: this is included so that we have adequate information about where the support is coming from o DPP Form: This form will provide supporting evidence that the DPP fulfils the requirements of the GPhC. The DPP will provide a CV and supporting documentation which the Programme Lead will use to assess whether they meet the requirements within the forthcoming Royal Pharmaceutical Society (RPS) guidance for DPPs. They will also provide a supporting statement on the suitability of the applicant as well as agreeing to support the 90hours of clinical practice. o Academic Reference Form: to confirm suitability to study at this level. The Programme Lead checks that all entrants have at least two years appropriate patient- orientated experience in a hospital, community or primary care setting following their preregistration year, by undertaking a review of the Professional Experience section of the Online Application form, and the Application Form. Once all of the elements of an application have been checked as present, the Admissions Panel meet to consider all applications and make an admissions decision. The Panel members are the Director of Taught Postgraduate Programmes and the Programme Lead, supported by the Postgraduate Officer. An Admissions Panel Decision Form is used as a checklist by the admissions panel to confirm that all of the admissions criteria (for both the GPhC and the University) are met; that there is an appropriate clinical need for the role and that there is funding in place to support the student in their learning. Once all elements are confirmed and a decision is reached by the Admissions Panel the application is progressed and either an offer or rejection letter is generated by the University. If rejected, the reasons behind this will be communicated to the applicant. Accreditation team’s commentary The team noted that applicants are asked to declare any ongoing investigations into their clinical practice in their application and asked why this question was limited to clinical practice investigations. The provider agreed that this question should be broadened to cover any investigations and will update the application form accordingly. This criterion is met. Selectors must apply the selection criteria consistently, in an unbiased way and in a 1.2 way that meets the requirement of relevant legislation. Provider’s commentary See 1.1 The use of a Panel to review and decide upon applications, having a clear and comprehensive 26 University of Bath independent prescribing course reaccreditation event record – January 2020
application form, and use of the Admissions Panel Decision Form is designed to provide an unbiased way of selecting applicants. Staff members at the University have to complete Equality and Diversity Training. Records are kept of individual applications in line with University guidelines and are only accessible to staff members involved in the course. Accreditation team’s commentary The team asked how the provider assesses the appropriateness of an applicant’s two years of clinical experience and was told that there are no set criteria. The provider looks for evidence of patient-facing experience and the baseline skills to transfer into their role as a prescriber. The team asked how the provider ensures the consistency of admissions decisions and was told that the programme team is a small, close knit team of only three people. If there are concerns or questions about an application, these are discussed as a team and the applicant may be invited to take part in a telephone or Skype interview. The interviews follow a set of blueprinted questions and reports of the interview are saved and referred back to if a student is admitted to the course and subsequently struggles. This helps to ensure that admissions policies are adjusted if necessary. This criterion is met. 1.3 Course providers must provide clear guidance on the type of experience a pharmacist should have before applying to the course. This guidance must be available to applicants before they make an application. Provider’s commentary This information is provided in on the website and there is a question in the Prescribing Context form that applicants need to complete – the following wording is used: “A requirement of the programme is to have at least two years’ appropriate patient-orientated experience post-registration, in a relevant UK practice setting. Please provide information below as to how you fulfil this requirement. This experience could be in a hospital, community or practice- based setting but must include situations whereby the applicant has had to consult with patients on a regular basis in the clinical area in which they are going to be prescribing.” Accreditation team’s commentary The team asked how the provider deals with the requirements for an employer declaration in the case of self-employed or self-funded students. The provider explained that they expect applicants to provide a declaration from someone in the planned practice setting in which they will be based. This might be covered by the DPPs declaration, but if there are any queries the applicants will be invited to a telephone interview. This criterion is met. University of Bath independent prescribing course reaccreditation event record – January 2020 27
1.4 Course providers, when considering applications, must evaluate the suitability and relevance of the applicant’s clinical and therapeutic experience (which the pharmacist must demonstrate in their application) against the requirements of the course. Provider’s commentary The Prescribing Context section of the Application Form requires candidates to set out a clear written case describing the identified area of clinical practice in which to develop their prescribing skills, and have up-to-date clinical, pharmacological and pharmaceutical knowledge relevant to their intended area of prescribing practice. This case is reviewed and compared with academic reference, declaration of support, and the supporting statement from the DPP. If there is any lack of clarity on the form, the Programme Lead will interview the candidate prior to the offer of a place on the unit. If necessary, the Programme Lead may additionally contact the Non-Medical Prescribing Lead and/or employer to seek further confirmation. This is all recorded on the Admissions Panel Decision form for the applicant. All self-employed / self-funded candidates are required to be interviewed as part of the admissions process in order to ensure that there is an identified area of practice and that the candidate has up-to-date clinical, pharmacological and pharmaceutical knowledge relevant to their intended area of prescribing practice. Accreditation team’s commentary This criterion is met. 1.5 A course provider must fully evaluate each application and decide if the applicant has sufficient and relevant experience to begin a course to train as an independent prescriber. If the course provider decides that there is insufficient relevant experience, they must reject the application, clearly setting out the reasons behind this decision. Provider’s commentary See 1.1, 1.3 and 1.4 above – the Admissions Panel will make a recommendation to reject the application and the reasons behind the decision will be communicated to the applicant. Accreditation team’s commentary This criterion is met. 1.6 Course providers must ensure that all the entry requirements have been met before 28 University of Bath independent prescribing course reaccreditation event record – January 2020
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