Helen Davies, Pharmacist Team Leader: Education, Training and Workforce Development, Primary Care
Cwm Taf Morgannwg University Health Board
Industry partner: AlphaTangoDelta LTD
GP practice pharmacist roles have increased in number and become more clinical over the last six years. However, training for this sector is in relative infancy, with previous pathways mainly focusing on hospital and community pharmacy roles. As such, there is a need for intense training to transition pharmacists to become competent in these GP sector advanced roles.
Including GP practice pharmacy into the ‘grass roots’ of training pathways, to prepare our workforce for these extended roles is a strategy recognised by Health Education and Improvement Wales (HEIW), Welsh Government and Health Boards.
To explore the current GP pharmacy foundation training at CTM UHB, by focussing on the voice of the learners and tutors, and make innovative improvements.
Pharmacists are ideally positioned to tackle the polypharmacy crisis that afflicts many people in primary care, but compared to the community and secondary care counterparts, GP pharmacist roles are often more isolated and autonomous.
GP pharmacists manage patients that endure multimorbidity and complex medication regimes. A competent GP pharmacist can promote behaviour change in the complex patient cohort with their consultation and motivational interviewing skills. Ensuring pharmacists are prepared for this role at an earlier stage may translate into improved healthcare outcomes and patient experience. In turn, they will release other healthcare staff to focus on non-medication issues, and solidify pharmacy as a valued member of the primary care multi-disciplinary team.
Image: issues identified with the primary care training model Following feedback from foundation trainees
The trainers identified the following issues with the training programme:
Difficulty in covering some sessions of training due to tutor shortages and workplace capacity.
Reduced efficiency of tutors; training often at the expense of patient appointments
An idea for a training app was conceived early on, originally intended to be the main intervention. However, funding was not obtained until December 2020 so additional solutions to the training flaws required.
COVID-19 and enforced social distancing has impacted all parts of training and will continue to do so. Innovative ways of training remotely are vital.
This project sought to overcome identified flaws with our training programme.
Recruiting more tutors is an obvious solution, but this would require a minimum of one whole time equivalent advanced pharmacist. This is an expensive solution, and the experienced workforce are not always available to recruit, nor is there workplace capacity for extra staff.
Reorganise the training pathway so that placements complement tutor availability.
Purchase trainee laptops to overcome limited workstations, allowing trainees to work hands-on alongside tutors to ensure supervision.
Collaborate with AlphaTangoDelta LTD to create a training app. This will host consultation role-play scenarios for the trainees to complete together despite being in different GP practices, recorded for tutor assessment. The app is currently in development, funded by a ‘Pharmacy: Delivering a Healthier Wales’ project board grant, supported by HEIW.
Image: proposed App design
“I am delighted to hear about the Bevan project Helen Davies is leading to explore the use of technology to support the pharmacy education and training within GP practices. This innovative project supports the HEIW vision for multi-sector and multi-professional training. I am really looking forward to seeing the outcomes from this exciting project.” Professor Margaret Allan, Pharmacy Dean, HEIW
It is estimated the app will be ready for the proof of concept phase in the first quarter of 2021. If successful, the app may be further developed by HEIW, as it is recognised as an innovative training solution for all of the NHS, not just pharmacy.
The app can incorporate many important themes, such as shared-decision making, and patient opinions will be sought during the review process.
The voice of the trainee has been the main focus when formulating these innovative solutions. The ability to facilitate training remotely is also welcomed given the challenges faced during the COVID-19 pandemic.
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