A flexible approach will make the most of changes to pharmacy education and training

In January 2021, the General Pharmaceutical Council (GPhC) published the revised Standards for the Initial Education and Training of Pharmacists, which announced that from September 2026, newly registered pharmacists educated under the revised standards will enter the workforce qualified to prescribe​[1]​. 

As part of the implementation of these reforms, pharmacy educators are now attempting to navigate major changes that have been introduced to foundation training, which present a series of challenges.

Under NHS England’s new terms of participation for training sites, any organisation can be the employer of foundation trainee pharmacists if it meets all other requirements for providing a learning environment. For example, foundation trainees must complete a minimum of 26 weeks in a ‘patient-facing setting’ and the training plan must include access to a setting with a dispensary that is not located in a GP surgery​[2]​.

Reciprocal training rotations

The new terms present an opportunity for reciprocal training rotations, if two separate training sites (each employing a foundation trainee pharmacist) agree to multi-sector rotations between them, trainees can be exchanged between sites for an agreed time period. For instance, a trainee employed by a community pharmacy could be sent to a GP site to fulfil the requirement for a designated prescribing practitioner (DPP) and access to a prescribing learning environment. Conversely, if the GP site also directly employs a trainee, they can then be sent to the community pharmacy site to fulfil the requirement for access to a dispensary. By exchanging trainees, no additional funding is needed to be paid to the rotational site.

Another significant change involves the harmonisation of funding across all practice sectors and regions in England. In the 2025/2026 training year, each site hosting a foundation trainee pharmacist will receive £26,500 in funding per trainee per year​[3]​. This financial support is a contribution towards training expenses, including salary costs and any supervision associated with hosting a trainee. 

However, if a training site does not have access to a site with another trainee for exchange, they should consider offering a placement fee to the other site to cover expenses for the rotation. NHS England has suggested that £1,000–£1,500 of the funding received by the employer could be used to support supervision during a rotation of up to 13 weeks​[3]​. This is a suggestion only and partner sites will need to negotiate and agree the level of payment individually. 

NHS England also announced at the Clinical Pharmacy Congress conference, held at ExCeL London on 10–11 May 2024, that funding will be available under the additional roles reimbursement scheme (ARRS) for clinical pharmacists undertaking the designated supervisor and DPP roles, as long as this is supported by the primary care network and integrated care board. This should further support system wide rotational training​[4]​.

While multi-sector rotations are not mandatory for the 2025/2026 foundation training year, it will be compulsory from 2026/2027 onwards to include a 13-week multi-sector rotation. Therefore, it is advantageous for pharmacy educators to plan ahead and set the foundations for long-term collaborative training. Doing so will also help bridge the shortfall in DPPs​[5]​.

Designated prescribing practitioners

The changes to the GPhC’s training standards mean that a whole cohort of pharmacist trainees will require access to a DPP, in addition to a suitable prescribing learning environment, to demonstrate the essential skills of a prescriber. The DPP will be expected to assess trainees against the new ‘prescribing assessment activities’, which are part of an assessment strategy compiled by the NHS England workforce, training and education directorate.

The role of the DPP can be undertaken by the trainee’s designated supervisor if they meet the requirements of the role. NHS England has not dictated the number of years of experience a DPP must have. Instead, they stipulate that the DPP must be an active prescriber in a patient-facing role with appropriate knowledge and experience relevant to the trainee’s nominated prescribing area; must actively engage in regular patient consultations; and must practice in line with the Royal Pharmaceutical Society’s ‘Competency framework for all prescribers’​[6]​.

This will undoubtedly present challenges for training sites that either do not have access to a prescribing setting, or sites that may have independent prescribers who are not ‘actively’ using their prescribing skills. 

As such, a rotation for trainee pharmacists into a prescribing setting is an effective way to fulfil this requirement. 

Employers should begin by exploring local prescribing settings, such as GP practices and hospitals, but also keep an open mind about potential locations where a prescriber may be available, such as care homes, NHS acute trusts, mental health trusts and health justice settings. 

There will be a need to advocate for and educate other stakeholders about these changes and the requirements for DPPs, including how they could benefit from training a pharmacist, emphasising the mutual advantages for the workforce and developing prescribers. Employers who were already involved in the existing NHS-funded GP and split-sector placements can leverage these partnerships and continue with a similar offering. 

While these changes present certain challenges, capitalising on this new flexibility affords an opportunity to radically improve and pave the way for truly innovative foundation training placements. Encouraging collaborative partnerships, where expertise from various sectors are pooled to train future pharmacists, provides the foundations to nurture autonomous clinicians who can play a greater role in multidisciplinary clinical teams.

High-quality supervision

NHS England has also introduced flexibility within the designated supervisor role that will enable them to oversee multiple trainees instead of just one and are no longer required to spend a minimum of 28 hours with trainees over four days.

While the changes offer an opportunity for increased flexibility and efficiency in supervision and training, they also raise concerns about potential overburdening of supervisors and variations in training quality. Adherence to quality assurance criteria is essential to mitigate these risks and ensure patient safety and the quality of education for trainee pharmacists. 

In 2025/2026, NHS England will assume the responsibility for quality management of the foundation training programme for all foundation trainee pharmacists in England. This will include assuring the quality of supervision, with all employers required to meet the NHS England workforce training and education quality criteria, including using the assessment strategy and e-portfolio.

As part of the requirements, all trainees must have a supervision plan that complies with quality standards for foundation training. Designated supervisors must adopt a clearly defined job planning process and adhere to a person specification to ensure they can meet the supervision and assessment demands of the trainees for whom they are responsible. This must be described within the training plan, which is required to be submitted to NHS England​[7]​.

Enhancing and expanding the workforce to meet the current and future needs of patients and the public is a priority and ultimately dependent on a sustainable and high-quality educator workforce to support education and training in practice. Aligning with the ambitions set out in its ‘Educator workforce strategy’, which was published in March 2023, NHS England has commissioned two fully funded training programmes designed to equip designated supervisors and DPPs with the essential skills to supervise trainee pharmacists effectively​[8]​. 

The training programmes are essential as they equip supervisors with the necessary skills to effectively supervise trainees, ensuring adherence to high-quality training standards and compliance with quality criteria. This is crucial for maintaining patient safety and the quality and effectiveness of pharmacy trainee supervision under this new flexible model. 

To supplement trainees’ placements, NHS England will also be providing a core training offer. The training offer will focus on supporting delivery of the GPhC’s learning outcomes in practice. The full specification is still subject to further development, but NHS England has announced that this provision will include an induction day, online learning materials and first aid training.

While the NHS England training offer will provide a solid foundation for trainees, employers will need to supplement this core training offer by integrating resources from external training providers, such as clinical assessment skills training, mock exams, revision masterclasses and training days aimed at supporting trainees to prepare for the registration assessment. Given the variability in healthcare demands across different regions, clinical training tailored to specific local needs that addresses local health challenges or focuses on prevalent conditions should also be included.

Collectively, these changes will facilitate the integration of new prescribers into the workforce, signifying a transformative step forward in pharmacy education. This integrative approach sets the stage for ultimately enhancing the quality of healthcare delivery.