The Royal Pharmaceutical Society (RPS) has published an updated competency framework for all prescribers on behalf of, and in collaboration with, all the prescribing professions in the UK.
The framework, which was originally developed by the National Prescribing Centre and published by the National Institute for Health and Care Excellence (NICE) — a health technology assessment body of the Department of Health that provides guidance on which drugs should be used on the NHS — as an England-only resource, expired in 2014. Following discussions between NICE and Health Education England, it was decided that the professional body for pharmacy, the RPS, should manage the update of the framework and publish it on its website for all regulators, professional bodies, prescribing professions and patients across the UK (and internationally) to use.
“Five years in our new guise as the professional body for pharmacy, our work around professional support and guidance has given confidence to external agencies to entrust us as the experts to lead on this,” says Catherine Duggan, director of professional development support and acting director for England at the RPS. “It is very pleasing to have the endorsement of all of these professional bodies,” she adds.
The updated framework has been restructured and now reflects the increasing prevalence of multiple comorbidities and number of non-medical prescribers.
“[The framework is] more intuitive and streamlined than before,” says Catherine Picton, lead author and consultant to the RPS. “[It takes] a more explicit look at inappropriate polypharmacy and deprescribing, which are much bigger issues now for prescribers, reflecting the importance of developing generalist prescribers as well as specialists.”
The framework is designed to be applicable to any prescriber, regardless of their professional background. It comprises ten competencies that are central to effective performance by all prescribers. The competencies are split into two domains: ‘the consultation’ and ‘prescribing governance’. “As a generic framework you have to contextualise it and think how it is relevant to your practice,” says Picton. “There’s work to be done in order to use it. If you’re working in paediatrics, the statements will mean different things to someone who’s caring for the elderly.
“It is unique because it can be used in so many different ways — to develop training, as a governance tool in an organisation, for the development of higher education curricula. … I think one of the biggest uses is going to be in revalidation. It is a great way of demonstrating that you’re up to date with prescribing practice,” she adds.
The framework was updated by a project steering group made up of prescribers and patients. The group received input from a strategic level project board with representatives from England, Scotland, Wales and Northern Ireland. It also engaged with an external reference group of more than 70 organisations and individuals, including professional regulators and higher education institutes, and undertook a six-week consultation, to which 95 organisations and individuals responded.
“This guidance is for all prescribers, anyone can pick it off the shelf. However, pharmacist prescribers also have access to all of our other frameworks, standards and guidance,” says Duggan. The RPS website has a range of resources designed to complement use of the framework, including practice examples from organisations and individuals who have been using the competency framework.
“There’s lots of evidence to show that much needs to be done to improve the way we prescribe,” says Ash Soni, president of the RPS. “This user friendly guide will be invaluable and I’m delighted the RPS has coordinated the update.”
The framework is due to be reviewed every four years but may be updated earlier if any significant changes to prescribing occur during that time.