How will we generate the new generation of prescribing pharmacists?

A few stories recently published by The Pharmaceutical Journal led me to write this column. These are the ‘important-but-not-obviously-nationally-urgent’ stories to which a trade journal can give due attention, and we should hope that they will get noticed more widely. Because they matter.

The first was from investigations editor Sophie Willis, who reported on 14 August 2024 that nearly 900 students dropped out of MPharm courses, after their first year in 2021/2022. 

This is a fairly jaw-dropping statistic: that General Pharmaceutical Council (GPhC) data suggest that 889 out of 4,505 students did not continue the MPharm degree after their first year. A drop-out rate of nearly 20% ought to be of huge concern to everybody involved.

So what has been going so wrong?

A big clue as to the root of this problem came in a statement from the Pharmacy Schools Council (PhSC) that followed shortly after, which warned that growing pains may be to blame.

Once again, The PJ covered this issue, in an article in which the PhSC suggested that difficulties recruiting to academic staff roles within pharmacy schools (following an increase in the number of students undertaking MPharm programmes) were in play.

The article, published on 13 August 2024, warned that while the PhSC welcomed the growth in pharmacy student numbers, heads of school were worried about being able to recruit enough staff to run the courses.

Provider growth without workforce growth?

As well as the UK’s 29 accredited pharmacy schools in the UK, one other school (Swansea University) is believed to be close to accreditation and two more courses — at the University of Leicester, and at the University of Bath in partnership with University of Plymouth — are accepting their first cohorts in September 2024.

This issue seems to parallel something that was covered in one of my previous columns on designated prescribing practitioners (DPPs), published in May 2024. The laws of supply and demand ought not to be confusing to those trying to plan for growth in the health sector but, even in 2024, they do seem to cause undue bafflement. 

It isn’t complicated — if you want to expand education in order to grow a sector, then you need to expand the supply of educators. Sometimes, that’s about training more trainers, and sometimes it’s about increasing the incentives to attract or retain experienced and qualified people as trainers. Inadequate supply or quality of trainers will surely lead to trainees who don’t see the point of keeping going, which is what seems to be happening here.

Immigration, immigration, immigration

Another option is to turn to our old friend immigration, and look to those from overseas to come and bail us out from our unwillingness to put adequate training in place. 

And once again, The PJ has been tracking this, having covered on 7 August 2024 the GPhC proposals that pharmacists from overseas who want to register in the UK could be able to undertake a one-year programme rather than the current two.

Currently, pharmacists who qualified outside the European Economic Area (EEA), or who hold an EEA pharmacist qualification not recognised in the UK, must complete the one-year ‘Overseas Pharmacists Assessment Programme‘ (OSPAP) and 52 weeks of foundation training before they can apply to register with the GPhC.

How urgent is this need for a shorter route to qualification?

At present, we know that the English retraining system looks unattractive: the The PJ reported that the number of pharmacists who applied to the OSPAP dropped by two-thirds between 2022 and 2023.

These figures came from the GPhC, which revealed there were 302 applications to join the programme during 2023 — down by 67% from 2022, when there were 909 applications. The fall in applicants follows a 101% increase in OSPAP applications between 2021 (when 437 applications were received) and 2022.

Ambition and hallucination

The ambitious plans in NHS England’s ‘Long-term workforce plan’, published in June 2023, to increase pharmacy training places by nearly 50% over the next eight years to 2031/2032, aimed “to meet the demand for pharmacy services”. 

For context, there were 3,339 training places in 2022. The ‘Long-term workforce plan’ commits to “increase training places for pharmacists by nearly 50% to around 5,000 places by 2031/2032 … to support this level of growth, we will expand training places for pharmacists by 29% to around 4,300 by 2028/2029, starting with initial growth in 2026/2027 when places will increase by 15% … [while] consideration is being given to the potential of a pharmacist degree apprenticeship”.

Ambition is a wonderful thing, possibly. But ambition without the practical building blocks of delivery isn’t ambition — it’s hallucination.

It’s probably time for a review of how, in practical delivery terms, we go about generating the next generation of pharmacists.

Andy Cowper is the editor of Health Policy Insight