Accessing post-registration training: a regional survey

In 2022, the General Pharmaceutical Council (GPhC) highlighted a lack of consistency and quality assurance in post-registration education and training for pharmacists and pharmacy technicians​[1]​. At a time when the NHS is under significant pressure and there is a shortage of pharmacy staff, understanding the opportunities and barriers to post-registration development is essential if we are to continue to upskill the profession, improve staff retention and deliver better patient care.

In line with its role in planning, educating and training the healthcare workforce, Health Education England (HEE), which is now part of the new NHS England, commissioned NHS Arden & GEM Commissioning Support Unit to undertake a pilot study to explore potential inconsistencies in training across different sectors and regions​[2]​.

Pharmacists and pharmacy technicians working in hospitals, primary care, community pharmacy and multiple settings across the east of England and the Midlands were invited to respond. Surveys were also sent to pharmacy employers, line managers and training providers to gain a rounded picture of post-registration education and training.

These surveys were supplemented with a series of virtual roundtables to enrich understanding and clarify survey results, involving survey respondents as well as professional bodies, including HEE, NHS England, the General Pharmaceutical Council and the Royal Pharmaceutical Society. The Association of Pharmacy Technicians UK was unable to attend.

The results indicate a need to increase awareness of, and access to, current training opportunities and improve consistency in their use across settings.

The 423 pharmacy professionals who responded to the survey expressed an appetite for post-registration qualifications. The most sought-after post-registration qualifications among survey respondents were postgraduate diplomas and independent prescribing for pharmacists, with 74% and 67% of pharmacists saying that they are accessing or planning to access these qualifications respectively. The ‘Accuracy checking pharmacy technician programme’ was most popular for pharmacy technicians, with 72% saying that they are accessing or are planning to access this programme.

Despite this willingness to upskill, only 22% of pharmacists stated that they follow a defined framework to support development, rising to 31% of pharmacy technicians, with training needs typically identified through personal development reviews and appraisals.

On average, 63% of pharmacists and 59% of pharmacy technicians were aware of each of the different education and training frameworks designed to enable career progression across the profession. But 45% of the pharmacy professionals surveyed indicated that they either ‘disagreed’ or ‘strongly disagreed’ with the statement that ‘there are clear pathways for development across the profession’.

At a roundtable held with representatives from pharmacy bodies, pharmacy line managers commented that there are too many choices for training, leading to organisations picking what they believe will be most useful and creating their own internal pathways. While this may support immediate organisational requirements, it potentially restricts broader career development opportunities within the profession, particularly across sectors. Employers and line managers also indicated that a ‘one size fits all’ solution could be equally problematic.

Across all settings, the survey found that there are barriers to education and training, including lack of protected learning time and mentor support for all professionals, as well as access to courses for rural professionals.

Employers also acknowledged that the way pharmacy professionals progress through their career is changing, with more frequent moves between roles and a move towards portfolio careers. This may be partly owing to differences in career and pay progression highlighted in the research.

Some 77% of pharmacists working in hospitals and 76% of pharmacists working in multiple sectors said they were likely to gain a promotion. This was reduced to 53% of pharmacists working within community pharmacy, who also indicated that they are likely to move to other sectors to access broader career opportunities and promotions. But the survey also indicated that a minority of pharmacy professionals and their employers believe that multi-sector working is hampered by a lack of clarity about the post-registration education and training requirements for different roles.

In looking at future training pathways, establishing clearly identifiable, transferable clinical skills would help to address this anomaly.

This short piece of research has indicated that there is a need and desire for an upskilled workforce. While local or national training pathways may be developed to meet this desire, both individual and organisational needs must be considered. In the short- to medium-term, portfolio working and upskilling among individuals may help to fill local health economy workforce needs, but consideration must be given to employers’ needs for overall workforce stability.

A robust framework that encourages workforce collaboration between organisations could reduce the number of pharmacy professionals leaving organisations to progress their career, for example.

Further research is needed to develop a deeper understanding of some of the issues raised in this survey, to expand the sectors covered and secure more comprehensive input from underrepresented groups, including those working in community pharmacy and those with protected characteristics. However, this initial research supports the view of the GPhC that clarity is needed to improve awareness of training pathways, and that consistent use across employers is necessary to support cross-sector working.

Mahesh Mistry, deputy director for clinical service, NHS Arden & GEM CSU; Jo Loague, head of service, medicines optimisation and individual funding requests, NHS Arden & GEM CSU; David Gallier-Harris, lead pharmacist: medicines optimisation, NHS Arden & GEM CSU; Emma Holdsworth, medicines optimisation pharmacist, NHS Arden & GEM CSU; Heena Patel, medicines optimisation pharmacist, NHS Arden & GEM CSU; Jenny Thompson, head of health intelligence: solutions for public health, NHS Arden & GEM CSU; Michel Griffin, researcher: solutions for public health, NHS Arden & GEM CSU