Student Technician Questionnaire 2007

South East

Medicines Management Education & Development

Student Pharmacy TechnicianRecruitment & Training Scoping Exercise 2007/8

Background

Current recruitment & training of student pharmacy technicians

Student pharmacy technicians are currently recruited and trained within Acute NHS Trusts paid at £14,182 per annum 1st year and £15,195 per annum 2nd year; students are normally recruited in August commencing their underpinning knowledge (technical certificate) at a local Further Education College in September. The course is 1 day per week and students are in their placements for the remaining 4 days. Some Trusts deliver underpinning knowledge in house using Buttercups distance learning and combine both this delivery alongside the NVQ which has its benefits, however this seems favourable in larger Trusts with larger training capacities. In addition to underpinning knowledge, students are required to complete the NVQ Level 3 in pharmacy services during their two year training period. These qualifications are both fully funded by the SHA’s and vary in costs depending on the education provider and NVQ centre used.Funding from SHA’s also currently covers a contribution to salary at band 1 point 1 equating to £585 inclusive of on costs per month.

NVQ 3 delivery is dependent on Trusts having sufficient infrastructure to support it – this means adequate numbers of assessor and internal verifiers for all NVQ trainees. In 2004 a mandatory NVQ2 was introduced for all pharmacy assistants – this has significantly impacted upon the NVQ infrastructure requirements in most pharmacy departments as the number of overall NVQ trainees has increased.

Over the last few years, SEMMED has noticed an overall fluctuation in the total number of student pharmacy technicians being trained within the region (Table 1). Noticeably, the introduction of NVQ2 caused a reduction in student pharmacy technicians numbers in 2005 whilst additional NVQ assessors and verifiers were trained. However the majority of Trusts now have NVQ structures in place and the number of level 2’s being trained now appears to have plateaued. The numbers have also been affected within South Central by recruitment freezes (anecdotal reports)

Table 1

Student pharmacy technician commissioning requests for 2008/9 have already been collected for all Trusts in the region and these are as follows:

Table 2

In order to gain a better understanding from Trusts as to why the number of student pharmacy technicians being trained is being reduced, SEMMEDconducted a scoping exercise.

Questionnaires were sent to all Acute Trusts who train student pharmacy technician and the results are shown below:

Part 1 – Recruitment & Retention

Question 1. Do you believe you are currently training sufficient student pharmacy technicians to meet future service requirements for:

a) Your own Trust? b) The local health economy

Graphs A & B show the data collected and further comments included below:

Graph A

Graph B

Question 2. SEMMED asked Trusts if they had advertised positions but been unable to fill these posts and whether they had been prevented from recruiting due to recruitment freezes, the responses are collated below:

South Central

Three Trusts within South Central have been unable to advertise due to recruitment freezes but are able to recruit once these had been lifted. One Trust is still currently subject to recruitment freezes. If the barrier to recruitment freezes was lifted Trusts confirmed they would be able to train more students.

South East Coast

The majority of Trusts within South East Coast do not have an issue with recruiting, however the following was noted:

• Ashford & St Peters have been subject to recruitment freezes and would have employed 2 students if this was not the case.

• Princess Royal Hospital (Brighton & Sussex University Hospitals NHS Trust) were unable to recruit a suitable applicant this year, however the Trust is reviewing it’s advertising and recruitment campaign which has been organised separately over both sites in previous years to look at recruiting jointly.

• Worthing & Southlands commented on the poor quality of applicants for their posts this year and therefore the process took longer than usual.

Part 2 – Barriers to training

Question 1. What are the major barriers to training additional student pharmacy technicians?

The following graphs show the major barriers to training additional pharmacy technicians

Graph C

Graph D

Graph E

3 major factors affect barriers to training, these are:

Financial

NVQ Infrastructure

Capacity to train

Question 2. Does your Trust struggle to support NVQ L3 candidates due to a lack of Assessors/Verifiers or challenges in freeing time to assess/verify?

If you have answered yes what support do you think is needed?

South Central - 3 Trusts confirmed that they struggle to support training for the following reasons:

• Winchester

Assessing & verifying work is not included as part of staff’s job role and is seen as an ‘add on’ – more trained staff required so that assessors and verifiers get dedicated time.

• Basingstoke

Lack of qualified assessors & verifiers to cover all candidates (level 2 & 3). Staffing issues prevent time being made available for assessing. Student technician position is relied on heavily as they are recruited in place of vacant qualified post. Chief Pharmacist is only internal verifier so time constraints are an issue. Trusts has identified need to train a further assessor and train/employ internal verifier

• Portsmouth

Currently understaffed to support NVQ, other pressures take priority. Sickness caused by overwork, imminent maternity leave for 3 experienced staff and role changes likely. Trust has identified that if recruitment freeze lifted and suitable staff employed plus support given during induction and training would ease the situation.

• Southampton

The trust has sufficient capacity to train NVQ staff but the Impact of the L2 over the last few years has shown but on target now, however have been subject to recruitment freezes.

South East Coast – 3 Trusts have robust NVQ infrastructure to support L3 candidates, however 1 still confirms they are stretched to the maximum. The following issues are noted for the remaining Trusts:

• Brighton & Sussex Hospitals (including Princess Royal who submitted separate response) a good NVQ infrastructure is in place at Brighton but department is under constant pressure within workforce constraints. All Trusts within the local area support one another to maximise the use if Internal Verifiers, assessing in the workplace is the main constraint and is not a priority or part of the job role.

Princess Royal have less infrastructure with 1 Assessor and trainee IV but have vacant post waiting to fill which should address these issues.

• Maidstone & Tunbridge Wells & Royal West Sussex have issues with lack of trained assessors and verifiers.

• Dartford & East Kent state that other work commitments clash with assessing and if additional funding were available specifically allocated to NVQ assessing this would help. Current problems with recruiting assessors in dispensary and aseptics. – Support by way of accepting NVQ assessing and verifying as a meaningful qualification and recognition under A4C could help.

• Medway states that freeing up time for assessing is an issue and no spare capacity, there is no funding for training as it’s not a target. Funding is required for qualified technician to support L2 & L3

• East Sussex Hospitals has a number of issues ranging from geographical barriers to attend standardisation meetings and costs of students travelling to college (students put off by having to travel to London for underpinning knowledge) NVQ support is always the first to be cancelleddue to poor staffing levels. Trust identifies that overall more staff are required.

Question 3. The current funding available for student pharmacy technicians is based on band 1 point 1 and is a contribution to salary, this equates to £585 inclusive of on costs per month. If extra funding (for example 100%) were available would this encourage you to employ more students and how many could you therefore accommodate?

South Central

All 4 Trusts agreed that if extra funding were available this would support the training of extra students. Two Trusts however confirmed that this funding should not necessarily be used to fund the post but in training qualified staff to support trainees

South East Coast

2 Trusts confirmed that funding would not make any difference to the number of students trained.

All others agreed that if extra funding were available this would support the training of extra students. Medway & East Kent confirmed that funding to support qualified staff would also be beneficial.

In summary with regards to funding, Trusts confirmed that if student pharmacy posts were fully funded the number of students they could train is shown in table 3 – however this does not necessarily mean the NVQ infrastructure is in place to support this number or that funding would be available.

Table 3

Question 4. Are there any other barriers to training which you would like to inform SEMMED of at this time?

South Central

Portsmouth commented that time is given more to facilitating the MM courses than assessing NVQ’s

South East Coast

Brighton & Sussex & East Kent Hospital’s both comment that support from region similar to that for the preregistration pharmacist year would be beneficial, this would raise the profile of technicians and they would be seen as a trainee rather than a full member of the department.

Medway commented on getting underpinning knowledge from another source and encouragement of qualified staff to take on the NVQ assessor qualification.

East Sussex commented that other training from SEMMED for qualified technicians, i.e. ACT or MM takes priority over NVQ resulting in any NVQ training being the first to be cancelled.

Discussion

Having considered the above information collected from Trusts there are some common themes emerging:

Rapidly changing service is resulting in a lack of qualified technicians to take on extended roles within Medicines Management in Acute, PCT & Mental Health sectors. This demand is expected to acutely increase as a result of the NPSA/ NICE guidance on medicines reconciliation1. This acute need is considered as higher priority and insufficient numbers of students are being trained to plan for this in future.

Finance, NVQ infrastructure and capacity to train affect all Trusts. However even if increased funding became available, there are still significant issues surrounding the motivation of staff to become NVQ assessors and verifiers and their capacity to undertake this role as part of their job role.

NVQ is still not seen as a priority in all departments

NVQ Infrastructure

Considerable SHA resource has been invested since the introduction of the Pharmacy NVQ level 2 in training NVQ assessors and verifiers. Lack of recognition of NVQ assessor and verifier qualifications within Agenda for Change and competing training priorities have resulted in a shortage of staff coming forward to take up training roles. In response to this situation, SEMMED has worked with smaller departments and prison pharmacies across the South East to outsource NVQ assessment and verification using Buttercups training provider. Feedback from dispensing doctors surgeries using this model suggests that there is a risk of students becoming isolated with this distance learning approach however part of the feasibility study could explore an alternative use of resources such as NVQ verifiers becoming Student Pharmacy Technician Training Managers who oversee and support training.

There has also been a suggestion that some trusts may be over reliant on NVQ assessors to undertake all assessments rather than using other staff to complete witness statements and testimonials. This should be raised with Pharmacy Education Leads and Managers and built into standardisation meetings facilitated by NVQ Centres.

In the longer term, all vocational qualifications are currently being reviewed and it is possible that NVQs may change in either their delivery or assessment. In the meantime, it is recommended that the lack of recognition of NVQ assessor and verifier awards is raised with HR Directors as an issue affecting workforce planning.

Workforce Planning

There is a need for robust workforce planning information to inform future commissioning of pharmacy technicians. This is being considered by the Workforce Review Team as part of their ongoing pharmacy programme. The recently published NHS Pharmacy Education and Development Committee survey of Pharmacy Vacancies in NHS acute and mental health trusts reports a current vacancy rate of 8.6% nationally for pharmacy technicians (12.4% in South East Coast and South Central). The rate is higher amongst the junior grades at 10% nationally (13.6% in SEC and 15.2% in South Central). It would be helpful to consider this data alongside workforce planning information on pharmacy technician demographics (e.g. age range and working patterns) and changes in future need considering local workforce strategies and resultant implications for the NHS workforce. We are aware that recent policies, consultation and guidance such as NPSA/NICE guidance on medicines reconciliation1, RPSGB consultation on the Responsible Pharmacist2 and the new Pharmacy White Paper expected in April 2008 will increase demand for pharmacy technicians as has the reorganisation of PCTs and consequent review of their pharmacy skill mix. Furthermore there is little information about the pharmacy technician workforce in community pharmacy; this is important to consider in view of the expansion in community pharmacy roles, likely future changes in professional regulation and their impact on the supply and demand of technicians to the NHS.

Finance

Finance has been identified as an issue in 2 ways – firstly student pharmacy technicians are currently included in establishment figures and as a result are subject to recruitment freezes. Secondly in some departments the budget previously used to train student pharmacy technicians is being diverted to invest in Medicines Management technicians to meet immediate need. If student pharmacy technician posts were fully funded, posts would be secured as training postsand could be incorporated into wider education commissioning plans. This model has been adopted in some parts of the UK. However the costs of such a move would be significant and would only be likely to make an impact if the identified problems with NVQ infrastructure were resolved. Such a change would need to be considered by Education Commissioning Teams within the context of a broader workforce strategy.

Recommendations from the South East Medicines Management Education & Development (SEMMED) Joint Advisory Group

The Joint Advisory Group considered the content of this paper at its January 2008 meeting and the following recommendations were agreed:

NVQ Infrastructure

In order to increase capacity to train within Acute Trusts, it was agreed to scope the option of using Buttercups distance learning course for NVQ level 2 (pharmacy assistant) training. This course does not require in-house assessing or verifying thus freeing up current Assessors and Verifiers to concentrate on NVQ level 3s (student pharmacy technicians) only. This approach could increase training capacity by over 30% per annum

Finance

All SHA’s are seeking a consistent approach for Health Care Scientistfunding which includes pharmacy. In South Central a proposal has been accepted to taper the funding of Health Care Scientists over a 4 year period as they are able to contribute more to service. For pharmacy technicians this would result in 100% salary support over the 2 years of the course. The JAG recommends that a similar approach to pharmacy technician training is adopted in South East Coast but recognises that this is only likely to be successful in addressing the technician shortfall if part of a wider strategy which includes changing the NVQ training strategy (as described above) and undertaking more robust and regular workforce planning.

References

1. Technical patient safety solutions for medicines reconciliation on admission of adults to hospital. NICE/NPSA Patient Safety Guidance 001, Dec 2007
2. The Responsible Pharmacist- consultation on the content of the responsible pharmacist regulation. Dept of Health Oct 2007

Wendi Willmer/ Gail Fleming

SEMMED, Feb 2008

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