Transcript PowerPoint template

Competency Frameworks
for
Pharmaceutical Services
Dr Catherine Duggan
Associate Director of
Chair of United Kingdom
Clinical Pharmacy
Clinical Pharmacy
Association
London, South East and
Eastern and
Senior Clinical Lecturer,
School of Pharmacy,
University of London
Content
Policy drivers
The competency agenda
Practitioner Development – a strategic view
Practitioner Development- where we are
Policy trends…
Dislocation between education and practice
Non-competency based approaches
Inequitable delivery
No clear practitioner development
Recruitment and retention
Not a partnership
Patient safety agenda
Fitness for purpose
Policy trends…
Self-care
Disease management
Patient safety
Access to medicines
Educational implications?
Preparation graduates
Scope of curriculum sciences
Graduate performance
….and more
Policy trends…
•Competence and fitness for practise/purpose
•Patient safety
•Health Service Reform (pay & training)
Modernising Medical Careers (MMC)
“White Paper” – validation/accreditation
of practitioners
What are we dealing with?
–Workforce capacity
–Skills, knowledge and abilities
–Workforce capability
–Using staff effectively
–Productive time
“time spent on activities that are integral to the
delivery of improved frontline services”
–Workforce sustainability
–Adaptability
–Succession strategies
Key performance indicators F1(medical)
Low Activity
High Activity
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N = 52
hospitals
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R-Square = 0.16
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R-Square = 0.76
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See also Bond,
Texas USA,
regression data
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Mortality rate Index
Borja-Lopetegi, Bates, Webb 2007
The Words
Competency
Single item of knowledge, skill or
professional value
Competence
Full repertoire of competencies
Performance
Reference to observable behaviour
What an individual actually does, as
opposed to what they can do
Effectiveness Effect of performance on a recipient
The real issue…outcome
Competency →
Competence →
Performance →
Fit to practise?
= safe, health improvement
Miller’s pyramid
From UG to post-registration
development
Does
performance assessment in vivo
Shows how
performance assessment in vitro
Knows how
clinical context assessment
Knows
factual assessment
Competency…a complex construct
Values
Behaviours
Values
Behaviours
attitudes
Values
attitudes
Behaviours
Values
attitudes
Behaviours
Competency
attitudes
Competency
Competency
Skills
Competency
Knowledge
Knowledge
Knowledge
Knowledge
Skills
Skills
Skills
Why competency-based approach?
–Global (European) health policies
– Governance; Patient safety; service quality
–Evidence
– Accelerated and sustained performance
– Operationalise “science into practice”
–Sustainability
– defines and makes explicit development needs
Competency Matrix
DELIVERY
OF
PATIENT
CARE
PERSONAL
Organisation,
Team working,
Communication,
Professionalism
Punctuality
Initiative
Confidentiality
Drug
use
process
Drug history taking
Interaction identification
Patient counselling
Whiddett and Hollyforde 1999
PROBLEM
MANAGEMENT
Gathers information
Knowledge
Analyses Information
Provides information
Follows up and reflects
Assesses information
Accurate provides
Relevant, Timely
McRobbie, Webb, Bates, Davies, Wright 2001
Reasons to be optimistic…
–It is straightforward
–Practitioners understand it
–It will performance manage
–Sector independent
–It makes “CPD” a realistic and useful activity !
–It is being used by employers because it works
Controlled trial GLF
in junior pharmacists
.7
.6
Probability
.5
Intervention = GLF
n = 30 hospitals
Intervention
.4
Logrank
P = 0.0048
.3
.2
.1
Non-intervention
0.0
-.1
-2
0
2
4
6
8
Time - months
10
12
14
Skills for ADVANCED LEVEL Pharmacists
Expert professional practice
Expert skills and knowledge
Patient care responsibilities
Reasoning and judgement
Professional autonomy
Building working relationships
Communication
Teamwork and consultation
Leadership
Management
Education, training, development
Research and evaluation
Vision, motivation, governance
Strategy, innovation
Service development
Planning, performance, change
Priorities, resources, standards, risk
Mentorship role model
delivery
CPD
Practice linkage, policy
Critical evaluation, protocol review
Evidence creation, development
Supervision, partnerships
Advanced level practitioners
HOMALS Quantification
Expert PP
6
Leadership
Management
E&T
4
F
R&E
n = 390
Practice level
F
2
F
Specialist in training
F
0
Experienced practitioner
MM
M
Leading-edge
practitioner
M
F
E EE E M
E
-2
-2
-1
0
1
2
Learning modality with time/career pathway
Predominantly FDL
and e-modes
Higher
Post-reg
FDL, e-modes
off-site, experiential
Independent
Career driven
Interns
UG
Predominantly
face-to-face modes
Cohort learners
Lone learner
On-site (HEI)
learning
Off-site (work)
learning
JOINT
PROGRAMME
BOARD (London, East and South East England)
NHS
Specialist Services
Specialist groups
Senior Managers
Educational Quality
Collaborative
programmes
Service Perspective
Statement of Completion
General Training
HE Universities
London
Kings
Portsmouth
Reading
Brighton
Medway
UEA
Kingston
PG Diploma in General
Pharmacy Practice
Early implementation – Joint Programme Board
Generalist Training (3 years)
– Government funding – national model ?
– PG Diploma in General Pharmacy Practice
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Core - MI, Technical, Patient & Clinical Services
Common Validation by HEIs in collaborative
Currently 350 junior practitioner-students
School Pharmacy
Univ Brighton
Univ East Anglia
Univ Portsmouth
Medway School
King’s London
Univ Reading
Kingston Univ
NHS
Competence…summary
– Words and semantics
– Reasons why
– Evidence to support
– A way forward ?
Key performance indicators F1(medical)
Low Activity
High Activity
W
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200
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Saving lives
W
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100
R-Square = 0.16
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R-Square = 0.76
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70
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110
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120
Mortality rate Index
Borja-Lopetegi, Bates, Webb 2007
Competency Frameworks
for
Pharmaceutical Services
Dr Catherine Duggan
Associate Director of
Chair of United Kingdom
Clinical Pharmacy
Clinical Pharmacy
Association
London, South East and
Eastern and
Senior Clinical Lecturer,
School of Pharmacy,
University of London