Outline Portfolio to Support Phwsi Accreditation

Version 1 Outline portfolio to support PhwSI accreditation December 07

Outline portfolio to support PhwSI accreditation

Contents

1. Introduction

1. Checklist for evidence in support of application for PhwSI accreditation

1. PCT Application form

1. Summary of evidence to demonstrate relevant competencies, based on generic PhwSI competency framework

1. Evidence of competence in core role

1. Evidence of formal learning

1. Evidence of supervised practice

7.1Reflection from learning through supervised practice

7.2Examples of assessment tools

1. Reference from independent clinician to confirms the applicant’s competence in the new role

1. Additional information

1. Feedback from service visit

This resource and supporting information (assessment tools and sample application forms) is available to download at It is intended that practitioners can use this as a basis for the construction of their own individual portfolio as required.

Section 1: Introduction

This outline portfolio aims to enable individual PhwSI applicants to collate the range of evidence that will be required by local accreditation panels. It draws extensively on experience of portfolio development by universities providing prescribing courses for pharmacists and nurses, amended for PhwSI purposes.

This outline portfolio is intended for use as follows:

• To guide and prompt applicants and service managers as to the types of evidence that may be needed, and how this can be collated for assessment
• To be adapted for local use by practitioners (and PCTs) who intend to submit an application for accreditation as a PhwSI
• To encourage applicants to incorporate reflective elements, and to be used flexibly so that it is possible to incorporate relevant activity such as CPD records
• To be used alongside an application form eg the model form included in the national accreditation guidance ‘Implementing care closer to home – convenient quality care for patients; Part 3: The accreditation of GPs and pharmacists with special interests’

Please note that completion of a portfolio of evidence in itself cannot guarantee the success of any application for PhwSI accreditation; that is a decision for local accreditation panels.

The following resources are already available and are referenced within this portfolio:

• A National Framework for Pharmacists with Special Interests

• Generic competency framework for PhwSIs

• Practitioners with special interests webpage:

This includes links to published national guidance on commissioning and accreditation of PhwSIs and GPwSIs, and also to specialty-specific guidance.

This guidance summarises the information that applicants should include as follows:

Evidence of current registration

A portfolio of evidence to demonstrate appropriate education, motivation, training and development.

All relevant certificates to be submitted with the application

How appraisal and personal development planning will be realigned to take account of their new role

How core role will be protected as they take on the new role

Audits of core role and outcomes for practice development

Summary of the supervised clinical work that they have completed, and participation in appropriate local clinical networks, where this exists

Where they exist, guidance for individual clinical specialties provide more detailed information to guide accreditors towards the kind of evidence that they may expect to see and test during the accreditation process. Full details of the guidance currently available or in progress are available at

For any specialist services where clinical guidance has not yet been developed, accreditors may need to take independent advice from appropriate national or local specialists to support their task.

We would like to gratefully acknowledge assistance of, and permission to draw from resources developed by the following:

Jane PortlockPrincipal Lecturer in Pharmacy Practice, University of Portsmouth

Cate WhittleseaDirector of Postgraduate studies (Primary Care and Community Pharmacy), Kings College London

Dr Patricia BlackDirector of Postgraduate Studies, School of Pharmacy, Keele University

Dr Delyth Higman JamesDirector of Postgraduate studies, Primary Care/ Community Pharmacy, Cardiff University

Dr Graham DaviesProfessor of Clinical Pharmacy and Therapeutics (Kings College London) and Head of Programmes, Joint Programme Board

Section 2: Checklist for evidence in support of application for PhwSI accreditation

Section / Item of evidence
Add lines as required / Date included / Comments
PCT application form
Evidence of competence in core role
Evidence to support specified PhwSI competencies
Evidence of formal learning
Evidence of supervised practice
Reflection
Reference from independent clinician
Additional information or evidence
Feedback from service visit

Section 3: Application to PCT for PwSI accreditation

Applicants will be required to complete an application form as specified by their PCT. Template applications for accreditation and re-accreditation were included in Appendix 3A of Implementing care closer to home: convenient quality care for patients Part 3: The Accreditation of GPs and Pharmacists with Special Interests.

Individual PCTs may use these as a starting point in developing their own documentation.

Word versions of these forms can be downloaded at

Applicants may cross-refer to the evidence in this portfolio when completing the application form.

Applicants will be asked to give full details of the service within which they propose to work as a pharmacist with a special interest. This information could be included in this portfolio for ease of reference.

The RPSGB clinical governance framework for pharmacist prescribers includes some useful guidance, which may also be relevant for PhwSI services.

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Version 1 Outline portfolio to support PhwSI accreditation December 07

Section 4: Summary of evidence to demonstrate relevant competencies

This must be read in conjunction with the generic competency framework for PhwSIs and also any specialty-specific frameworks relevant to the area of practice which is to be accredited

(check for availability).

Competency area 1:
Expert professional practice / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level
(either practitioner level or PhwSI level as described in PhwSI generic competency framework) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
1A / Expert Skills and Knowledge / Enter summary of evidence and reference to full details
1B / Patient Care Responsibilities
1C / Reasoning and Judgement
Including analytical, judgemental, Interpretational and option appraisal skills
1D / Professional autonomy

Competency area 2:

Building working relationships / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level (either practitioner level or PhwSI level) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
2A / Communication
Including ability to persuade, motivate, negotiate empathise, provide reassurance listen Influence and networking and presentation skills
2B / Teamwork and Consultation
Competency area 3:
Leadership / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level (either practitioner level or PhwSI level) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
3A / Strategic Context
3B / Clinical Governance
3C / Vision
3D / Innovation
3E / Service Development
3F / Motivational
Competency area 4:
Management / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level (either practitioner level or PhwSI level) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
4A / Implementing National Priorities
4B / Resource Utilisation
4C / Standards of practice
4D / Managing Risk
4E / Project Management
4F / Managing Change
4G / Strategic Planning
4H / Working Across Boundaries
Competency area 5:
Education, training and development / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level (either practitioner level or PhwSI level) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
5A / Role Model
5B / Mentorship
5C / Conducting education and training
5D / Continuing professional development
5E / Educational policy
Competency area 6:
Research and evaluation / Evidence to support achievement of competency
For all evidence, indicate relevance to this role and level (either practitioner level or PhwSI level) / Date (s) evidence gathered / Further gaps in CPD needs and brief action plan to fulfil
6A / Critical evaluation
6B / Identifies gaps in the
evidence base
6C / Research evidence into practice

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Section 5: Evidence of competence in core role

CPD records should provide the majority of evidence in support of this.

The following can also be included as evidence: testimonials/references from line manager; recent appraisal records

A current job or role description, or possibly a CV should be attached. This allows the accreditors to understand the applicant’s core role that may be linked to the proposed specialist role.

Section 6: Evidence of formal learning

Give full details of formal learning undertaken that is relevant to the proposed PhwSI role. This may include for instance courses leading to qualification as a supplementary or independent pharmacist prescriber.

Include:

• Photocopy of certificate or other award
• Outline of course syllabus
• Number of study hours and credits obtained
• Learning in practice (work-based learning) associated with formal courses. This might include:

significant events

writing guidelines

teaching and presentations

publications or book chapters

case studies

contributing to working parties

audits

Short non-award bearing courses eg CPPE

other appropriate activities, e.g. peer support networks

Note: learning in practice may also be undertaken by practitioners as freestanding activity not linked to formal learning, and can be evidenced elsewhere in this portfolio if preferred

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Summary of relevant formal learning

Type of evidence / Full description / Date evidence obtained
Accreditors will need to take into account the currency of evidence provided
Reflective comment and relevance to achievement of agreed learning outcomes/competencies:
Type of evidence / Full description / Date evidence obtained
Accreditors will need to take into account the currency of evidence provided
Reflective comment and relevance to achievement of agreed learning outcomes/competencies:

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Section 7:Supervised practice

This is an essential element of the evidence required for PhwSI accreditation, and the rationale for this position is outlined in national publications on accreditation of PhwSIs and GPwSIs. There are now a number of tools that can be used to assess an individual’s clinical practice, most of which have been adapted from those used in medicine. These have the added advantage that they may already be familiar to assessors.

Precise details of the nature and minimum duration of any periods of supervised practice will be decided locally, taking into account any recommendations in national specialty-specific guidelines. Their decision will take into account the range, level and complexity of the specialist activity being undertaken.

Periods of supervised practice may be undertaken in a variety of settings, for example:

within an outpatient-based specialist service

(eg diabetes, dermatology, pain management)

within a secondary care pharmacy service

(eg where a pharmacist-led specialist service is moving into a primary care setting)

an inpatient facility in a community hospital or hospice

(eg care of older people, palliative care)

within a community-based specialist team

(eg substance misuse, sexual health)

within a GPwSI –led service, possibly alongside other professionals

(eg long term conditions requiring more complex medicines management)

Two proformas are provided that you can use to provide evidence of supervised practice:

1. a table for you to summarise the periods of supervised practice that you have undertaken

1. suggested format for reflection on each period of supervised practice to link to the required competencies

You will also find links to examples of methods of assessment and assessment tools that your supervising clinician can use to assess you.

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Record of periods of supervised practice

Date / Location / Activity / Duration / Assessment tool completed

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7.1Reflection: learning through supervised practice

Please copy the next two pages and insert as required

Details of Supervised Activity:

Date……………………………………………………………….

Reflective comment:

Relevance to required specialist competency(ies) (state which and reflect on why)

7.2 Methods of assessment and assessment tools

The assessment of individual competences may be undertaken by a combination of some of the following:

• Observed practice using modified mini clinical examination (e.g. mini-CEX; examination of video)
• Case based Discussion (CbD);
• Use of 360-degree appraisal tools such as Mini PAT;
• Demonstration of skills under direct observation by a specialist clinician (DOPS)
• Medication-related consultation framework (MRCF)
• Simulated role play objective structured clinical examination (OSCE);
• Applied Health Assessment
• Reflective practice;
• Observed communication skills, attitudes and professional conduct

Examples of these tools, which have been adapted for use in primary care settings, can be downloaded at . These tools have been amended as appropriate by the original authors for use in this context and the website also gives pointers towards appropriate choice of assessment tool. We are grateful to the Joint Programme Board and Universities of Portsmouth, Cardiff, Kings College and Keele for their help.

Include the completed tools that your supervising clinician has used to assess you in this section of your portfolio.

Which assessment tool will be appropriate?

The following description of the purpose for each tool may be helpful.

Mini-Clinical Evaluation Exercise (Mini-CEX) involves observation and assessment of a practitioner in their day to day work. It may be used to assess practitioner / patient interactions, and specifically to assess the clinical skills, attitudes and behaviors of the practitioner in question. This tool may be used to assess the trainees performance in relation to expert professional practice.

Mini Peer Assessment Tool (Mini-PAT) provides anonymous feedback from a range of nominated co-workers. Feedback received is entirely developmental, with the trainee and the practice tutor agreeing strengths and key areas for improvement, from the collated feedback.

Case based Discussion (CbD)Case based discussions are designed to assess clinical decision-making and the application or use of pharmaceutical knowledge in the care of the training pharmacists own patients. In essence, it involves an experienced practitioner questioning the trainee about the care they have provided for a patient, allowing the assessor to explore the trainees understanding of specific issues (from pharmacology and pathophysiology to monitoring and counselling). It also enables the discussion of the ethical and legal framework of practice (when appropriate), and in all instances, it allows the practitioner student to discuss why they acted as they did.

Medication-Related Consultation Framework

This tool helps the practitioner student to evaluate their ability to undertake effective patient consultations. It can be used either as a self-assessment tool to help identify specific learning needs or for performance based assessment. The framework was developed following a review of a number of medical models of consulting and is specifically tailored towards medication-related consultations. It takes the practitioner through each stage of the consultation from setting the scene, data collection & problem identification, action/ solutions to closing the consultation. The framework also includes specific behaviours and communication skills to demonstrate during the patient consultation.

Section 8:Reference from independent clinicianto confirm the applicant’s competence in the new role

All PhwSI applicants must provide a structured reference from an objective, relevant and independent clinician that confirms that the applicant is competent to take on the new role.

This clinican might for instance be:

• A consultant or senior doctor in the relevant specialty
• A consultant pharmacist in the relevant specialty
• A clinical pharmacy lead
• An experienced GPwSI in the relevant specialty

As an objective and independent reference is required, they cannot be a relative, close friend or business partner.

This reference should include the following information:

• A formal declaration of the relevance of the competencies acquired
• An assessment of the relevance of the applicant’s qualifications, periods of supervised practice and wider education and training for the new role
• The nature of the ongoing relationship which the referee will have with the PwSI after they are accredited

Appendix A of the Department of Health publication The accreditation of GPs and Pharmacists with special interests titled ‘Clinical support document’ gives an example of the format for this reference.

Section 9: Additional information

You may if you wish insert here any evidence that does not seem to fit into other sections, such as ongoing or further CPD needs and other tools for reflection/ assessment, audits, shadowing experience.

Section 10: Feedback from service visit

Members of the accreditation panel may make an optional service visit, within six months of initial accreditation.

The purpose of this visit will be to:

• Assess whether the service that has been established meets the specification that the commissioner submitted at the outset
• Assess the way in which the PhwSI is working, through observation, access to audit data, and data which summarises patient’s experience of the new service
• Meet with the service team as a whole, to review their plans for the way in which the quality of the service will be strengthened and developed in future

This section of the portfolio may be used to summarise information required in preparation for a visit, and also feedback obtained afterwards, and any actions taken.

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