Gail Fleming: ‘We want to develop and invest in postgraduate pharmacy training’

Gail Fleming joined the Royal Pharmaceutical Society (RPS) in September 2018 as director of the newly created directorate of education. Here, she talks to The Pharmaceutical Journal about the directorate’s remit and objectives and, in particular, its plans for UK-wide postgraduate pharmacy training.

What is your background?

I started my career working in a hospital pharmacy, mainly in care of older people. I then went on to specialise in paediatrics. Later, I moved into education and training, and found that was something I really enjoyed. I’ve stayed in that area ever since, moving from working in a hospital to a regional role and ultimately to Health Education England (HEE).

I was with HEE from the day it opened its doors in June 2012. I was the pharmacy dean for London and the South East of England, and was responsible for managing the development of the pharmacy workforce across that area. I also led the development and implementation of the national preregistration pharmacist recruitment scheme for England and Wales through a platform called Oriel. That’s in its second year now.

What is the Royal Pharmaceutical Society’s directorate of education?

The Royal Pharmaceutical Society (RPS) is going through a period of change. Part of that is setting out its new mission and vision, and linked to how we deliver that there’s been an internal restructure. The directorate of education is a new one, and the message that its establishment gives is that the Society sees education as one of its core functions and priorities.

The RPS directorate of education has been established so that career development is a clear focus and doesn’t get diluted

I was attracted to the role because I thought it was an opportunity for the RPS to really make a difference in terms of how it supports its members throughout their careers, particularly around the educational offer.

Why did the RPS decide it needed a separate directorate for education?

It’s about being clear about what the RPS’s priorities are and what our members value, which has been divided into three different areas: the publications the Society has, the recognition it gets for pharmacists; and career development. Education, and how we develop professionals throughout their careers, is an essential component of those three pillars.

The directorate has been established so that career development is a clear focus and doesn’t get diluted.

How broad is the directorate’s remit?

It’s very broad. It covers members from the day they start their careers, from pre-foundation — before pharmacy students have registered — right through the whole of their career to wherever it may lead, the pinnacle being potentially a role as a consultant pharmacist or senior leader.

There is an RPS roadmap that sets out different stages of a pharmacy career. We want to look at what the Society offers and how it can support pharmacists through different parts of their career journey. We aim to articulate that clearly, so people can see what the offer is. We plan to prioritise what we do at each of those different stages and to look at how we support pharmacists to move across sectors during their career. There are all sorts of different settings people may work in now: general practice has expanded, there are more clinical roles in care homes — what can the directorate do to help people transition from one area of practice to another more easily?

We’re also thinking more broadly about how the RPS works with the wider pharmacy team. But, at the moment this is very much in the thinking stage. We’re working together and listening to what people’s thoughts are on what the RPS does now and how things might look in the future, to help us form a strategy.

Can you tell us about the proposed UK-wide postgraduate pharmacy training board?

We have established the Education Governance Oversight Board (EGOB), which will be a predecessor to the Postgraduate Pharmacy Training Board (PPTB). We want to really develop and invest in postgraduate pharmacy training, but no one organisation can do that alone. It requires a partnership — all organisations working together to make it happen. The EGOB is the first forum through which this can be done at the RPS, and has enabled the Society to think strategically about how to make these ideas a reality.

It’s fantastic that the General Pharmaceutical Council (GPhC), chief pharmaceutical officers, employers and universities are involved with the EGOB. Part of the group’s work will be to pave the way for a formal PPTB. 

There has been one meeting so far and we talked about two things: “What would success look like?” and “what should be the contributions of the various organisations around the table?”

The RPS has an advocacy role to get the message out across and beyond the profession. Other major roles for us will be around the curriculum: the RPS has done a lot of work to support curriculum development and that is an area that we wish to continue to focus on. In addition to that, we will work on the assessment that supports the curriculum, to ensure national consistency.

Would that be the same core curriculum that RPS chief executive Paul Bennett announced at the 2018 International Pharmaceutical Federation Congress?

The curriculum was announced at this year’s International Pharmaceutical Federation Congress, but that was before the EGOB was brought in. So although we have RPS products, what we need to do now is work with this new group and ask if everybody is happy with the direction of travel and whether there is anything we might need to revisit. There may be some work that comes out of our talks with pharmacists working in advanced roles and consultant pharmacists, and we need to think about how that all aligns.

So the principles are there, but we have a new group with everyone around the table to take it further.

We are working in partnership with Health Education England to look at the roles of foundation pharmacists

Regarding the RPS’s role in curriculum, one of the things that we are doing now is working in partnership with HEE to look at the roles of foundation pharmacists. That’s a UK-wide piece of work. We will be taking stock of the roles that newly registered pharmacists are doing right now and are likely to be doing in five years’ time. People are working across many different settings now and delivering more complex care than they would have done in the past.

We need to understand how roles may have changed and will be changing. That, in turn, will help us to ensure that we have a framework that is fit for the future, along with an associated curriculum that supports it. This will feed into the postgraduate training pathway.

So the EGOB will focus on the whole career pathway, not just foundation training?

It’s postgraduate — so for pharmacists, that’s anything beyond registration. Initially, the thinking was whether we should focus on foundation, but actually, it’s much broader than that. There was recently a consultation regarding consultant pharmacists asking: what should be done in terms of recognising posts and also people — for example, should they be credentialed? This has now closed and, depending on the outcome of that, we want to implement some of those recommendations. There’s a great opportunity to do that with the PPTB.

Likewise, the RPS Faculty particularly supports advanced practice. But there’s parallel work going on with advanced clinical practice and there’s work we can do there, through the board, to be clear that we’re all talking the same language across professions.

Will the preregistration system be retained in its current form under the new proposal?

Preregistration will not be part of the remit of the PPTB. We are focused on post-registration training.

Obviously there is a lot going on with preregistration training and we look forward to the forthcoming consultation and review of the initial education and training standards that the GPhC is leading on. We have contributed to some of the pre-consultation work on that. From the education directorate’s perspective, we are always keen to think about how we support them.

I am talking to lots of people outside the RPS to hear other perspectives on where we are and where we should be going

One of the areas of our work is on pre-foundation and we are reviewing and working closely with the British Pharmaceutical Students’ Association on how we can best support pharmacy students and those who are undertaking their preregistration training.

What stage is the proposal at: when will this postgraduate training be implemented?

I’m only a month into this post and the focus for me in these early days is very much on working with my current team, which has been doing some excellent work, and for us to work together to be clear on identifying our strengths and the areas where we might need to develop. I am also talking to lots of people outside the RPS to hear other perspectives on where we are and where we should be going.

In November 2018, we’re going to start reviewing and developing our education strategy, which will inform our plans for 2019. I’m hopeful that by the end of 2018, we will have a clear view on what our priorities are for the next year.

Will your directorate work with the schools of pharmacy and the deaneries?

To help us get to where we want our profession to be, we need to work closely with others. I’m very keen on collaboration. I do see both the Pharmacy Schools Council and the deanery-type equivalents — HEE, NHS Education for Scotland and the newly formed Health Education and Improvement Wales — as major partners that I want to work very closely with.

From a RPS governance perspective, our work reports into the Faculty and Education Board, which is chaired by Peter Kopelman. It’s superb to have him in that role and the RPS is fortunate that he is also chairing the EGOB.

What are the directorate’s priorities in 2019 and beyond?

If we think about the different aspects of people’s careers that we want to support, there’s work to do around pre-foundation and what our priorities are there. The other main areas are foundation, moving into advanced practice and consultants. That will all be impacted by what comes out of the EGOB and future PPTB.

In addition, there is other work we need to do. The RPS has been very active around revalidation and how it can support our members with that, and we are continuing to look at what that might look like moving forward: what things we can develop. We’re particularly thinking about the revalidation requirements for next year; for example, peer discussion. There may be other educational offers to support revalidation. That lifelong learning element is really important.