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The COVID-19 pandemic has changed the pharmacy profession in many ways, but perhaps the longest-lasting could be the planned changes to the preregistration year.
For a long time now, so called ‘early years’ pharmacists have looked enviously at the extensive two-year programme of foundation training that all medical graduates in the UK complete before they are able to fully register with the General Medical Council.
The closest equivalent in pharmacy is the preregistration year. This bridges the gap between university and working in the real world, but in recent years it has become generally accepted that it is not fit for purpose now that pharmacists are working in more clinical roles and a much greater variety of settings within the health service.
Current support for early years pharmacists is patchy and fragmented. The Royal Pharmaceutical Society (RPS) has been operating a foundation programme since 2014; the Centre for Pharmacy Postgraduate Education provides a foundation pharmacist training pathway; and NHS Education for Scotland runs a two-year programme, accredited by the RPS. Some big high street community pharmacy chains and NHS trusts run their own programmes, and Healthcare Education and Improvement Wales is piloting a foundation programme for pharmacists, mainly in the community pharmacy sector.
A Health Education England report in 2019 found available foundation training programmes varied geographically, and across sectors, and that there was “no clearly defined end point” or consistency in funding.
Hopes had been raised for more consistency in July 2017 when the RPS proposed a UK-wide, mandatory foundation programme after the preregistration year. This was backed by the UK’s four chief pharmaceutical officers, and fitted neatly with proposals from the General Pharmaceutical Council (GPhC) in 2019 to integrate the preregistration year in what amounted to a five-year pharmacy degree programme.
Up until now progress on this has been slow, but COVID-19 has changed all that.
In July 2020, just a week before they started their new jobs, it was announced that all pharmacists who have had to provisionally register in England — due to the COVID-19 pandemic preventing them taking their preregistration exam — will be offered a year-long interim foundation programme from September.
And, even more significantly, it was announced that a UK-wide year-long permanent foundation programme, which could include an independent prescribing qualification, would be introduced from next summer. This would replace the current preregistration year and would mark a genuine step change in the support that pharmacy graduates receive as they enter the profession.
Of course, there remain many questions. The proposal that all newly minted pharmacists should be able to independently prescribe has proved controversial. There is little detail on how the training will take place and what extra funding will be available to ensure that graduates are offered the right support — indeed, The Pharmaceutical Journal has been told that learning time for the interim foundation programme will not be mandated, that it will mainly be done online and there will be only workplace assessments.
The Pharmacy Schools Council has tabled a counterproposal that graduates should receive two years of foundation training post-graduation, with the first year effectively replacing the preregistration year, and independent prescriber training being introduced in the second year once pharmacists are registered with the GPhC.
It’s clear that everyone is reading the same book, but they’re not necessarily yet on the same page. The controversy over A-level and GCSE results shows that changes to education must be brought in carefully and with an eye on consequences that can undermine good intentions.
The pharmacy sector has just a year to get this right, and while it is encouraging to see some momentum behind these changes, everyone must gather around the table and ensure that they put their personal interests aside to introduce the best possible programme. If that happens and new pharmacists are offered support comparable to that received by doctors on entering their working lives, it could prove transformative for both those individuals and the NHS.
