East & South East England Specialist Pharmacy Services
Technician Level Framework –TLF – a professional development framework for pharmacy technicians in medicines management
• Clinical Pharmacy • Clinical Governance & Technical Services• Community Health• Community Pharmacy• Medicines Management Strategy & Development• Medicines Information• Medicines Procurement • Prescribing Support• Quality Assurance• Workforce Development & Education & Training
Jane HoughPharmacy Clinical Services Manager ORH
Honorary Associate Director Clinical Pharmacy ESEESPS
On behalf of the
Competency Development and Evaluation Group (CoDEG)
East & South East England Specialist Pharmacy Services
Background to GLF/TLF • CoDEG – Competency Development and
Evaluation Group• General Level Framework (GLF) used by
pharmacists in primary and secondary care – same group developed Advanced Level Framework - fed in Department of Health Consultant Pharmacist criteria
• GLF used as postgraduate certificate/diploma assessment tool or to help practitioners develop/rate their competence
East & South East England Specialist Pharmacy Services
Background to GLF/TLF
• Could the GLF be used for pharmacy technicians?
• On the basis that appropriate medicines management functions should be performed competently by any individual who has the capability to undertake those functions.
East & South East England Specialist Pharmacy Services
Why a competency approach?
• National Policy– Agenda for Change and the NHS KSF
• Inconsistency in practice• Evidence shows accelerated improvement• Sustainability
• Also defines and makes explicit development needs
East & South East England Specialist Pharmacy Services
Definitions•A Competency Framework is a collection of competencies central to effective performance
•The competencies describe what you need to know or be able to do so you can do your job properly
Similarity with NVQ approach to learning and skills?
Definitions
East & South East England Specialist Pharmacy Services
The Framework
Figure 1A Typical Competency Framework
Structure (From Whiddett and Hollyforde)
Competency Framework
CC1 CC2 CC3
Competency Clusters e.g. “Delivery of Patient Care”
C1 C2 C3etc. etc. etc. etc. etc. etc.
Behavioural indicatorsOrganised into related groups e.g.
“Ensures prescription is legal”“Ensures prescription is unambiguous”
Closely related competencies e.g.
“Provision of product”
East & South East England Specialist Pharmacy Services
Cluster names
Competency Titles
Each competency further defined by behavioural
statements that describe behaviours that would
be observed when the competency is demonstrated.
The framework contains a rating scale to allow
Rating of performance.
General Level Framework 2nd Edition
New General Level Framework
Personal Problem SolvingDelivery of Patient Care
Management and Organisation
Drug specific issues
Provision of drug product
Selection of the drug
Medicines information
Need for the drug
Monitoring drug therapy
Patient consultation
Evaluation of outcomes
Effective communication skills
Teamwork
Organisation
Professionalism
Analysing information
Providing information
Knowledge
Follow up
Gathering information
Service Provision
Budget setting and reimbursement
Clinical governance
Organisations
Training
Staff management
Procurement
Staff Management
Performance management(Optional)
ALWAYS carries out staff appraisals on a regular basis
a b
USUALLY carries out staff appraisals on a regular basis
a bSOMETIMES carries out staff appraisals on a regular basis
a b
NEVER carries out staff appraisals
a b
c d c d c d c d
Comment
Staff development(Optional)
ALWAYS supports staff in their development
a bUSUALLY supports staff in their development
a bSOMETIMES supports staff in their development
a bNEVER supports staff in their development
a b
c d c d c d c d
Comment
Employment issues(Optional)
ALWAYS correctly applies employment issues
a bUSUALLY correctly applies employment issues
a bSOMETIMES correctly applies employment issues
a bNEVER correctly applies employment issues
a b
c d c d c d c d
Comment
Basic Structure of the Framework
Management and Organisation Cluster
Space to write feedback on individuals development
Staff Management
Performance management(Optional)
ALWAYS carries out staff appraisals on a regular basis
a b
USUALLY carries out staff appraisals on a regular basis
a bSOMETIMES carries out staff appraisals on a regular basis
a b
NEVER carries out staff appraisals
a b
c d c d c d c d
Comment
Staff development(Optional)
ALWAYS supports staff in their development
a bUSUALLY supports staff in their development
a bSOMETIMES supports staff in their development
a bNEVER supports staff in their development
a b
c d c d c d c d
Comment
Employment issues(Optional)
ALWAYS correctly applies employment issues
a bUSUALLY correctly applies employment issues
a bSOMETIMES correctly applies employment issues
a bNEVER correctly applies employment issues
a b
c d c d c d c d
Comment
Basic Structure of the Framework
Management and Organisation ClusterCompetency
Space to write feedback on individuals development
Staff Management
Performance management(Optional)
ALWAYS carries out staff appraisals on a regular basis
a b
USUALLY carries out staff appraisals on a regular basis
a bSOMETIMES carries out staff appraisals on a regular basis
a b
NEVER carries out staff appraisals
a b
c d c d c d c d
Comment
Staff development(Optional)
ALWAYS supports staff in their development
a bUSUALLY supports staff in their development
a bSOMETIMES supports staff in their development
a bNEVER supports staff in their development
a b
c d c d c d c d
Comment
Employment issues(Optional)
ALWAYS correctly applies employment issues
a bUSUALLY correctly applies employment issues
a bSOMETIMES correctly applies employment issues
a bNEVER correctly applies employment issues
a b
c d c d c d c d
Comment
Basic Structure of the Framework
Management and Organisation ClusterCompetency
Behavioural Statement
Space to write feedback on individuals development
Staff Management
Performance management(Optional)
ALWAYS carries out staff appraisals on a regular basis
a b
USUALLY carries out staff appraisals on a regular basis
a bSOMETIMES carries out staff appraisals on a regular basis
a b
NEVER carries out staff appraisals
a b
c d c d c d c d
Comment
Staff development(Optional)
ALWAYS supports staff in their development
a bUSUALLY supports staff in their development
a bSOMETIMES supports staff in their development
a bNEVER supports staff in their development
a b
c d c d c d c d
Comment
Employment issues(Optional)
ALWAYS correctly applies employment issues
a bUSUALLY correctly applies employment issues
a bSOMETIMES correctly applies employment issues
a bNEVER correctly applies employment issues
a b
c d c d c d c d
Comment
Basic Structure of the Framework
Management and Organisation ClusterCompetency
Behavioural Statement Assessment ratings at times a,b,c and d
Space to write feedback on individuals development
East & South East England Specialist Pharmacy Services
The Framework
Assessment
ALWAYS demonstrates the behaviour with very rare lapses (85-100%)
USUALLY implies occasional lapses (51-84%)
SOMETIMES much more haphazard (21-50%)
NEVER very rarely demonstrates the behaviour (0-20%)
East & South East England Specialist Pharmacy Services
The Framework
The handbook
• Handbook helps to interpret the competencies and behaviours
• Describes how competencies and behaviours relate to different sectors
• Promotes thought on how the competencies and behaviours relate to the pharmacist’s/technician’s job
• Includes the grids to provide evidence for formal assessment or as a complete CPD resource
East & South East England Specialist Pharmacy Services
General Level Framework• First Edition –1999 - was implemented in 100+ hospital trusts • Outcomes based on research evidence (accelerated
improvement in performance which is sustained)• Second Edition (nGLF) – 2004 - piloted in Community
Pharmacy to cover primary and secondary care • Used in Joint Programme Board - on CoDEG website• Adapted for use in Australia! • Mapped MI by UKMi and MUR service delivery• Mapped to KSF profile for a Band 6 Pharmacist
Pharmacist Development Strategy
Qualified Practitioner
Senior or SpecialistPractitioner
AdvancedPractitioner
ConsultantPractitioner
Healthcare ScientistsMaking the Change
Consultant
Advanced Practitioner
Specialist Practitioner
Practitioner
Allied Health ProfessionsMeeting the Challenge PAM(PTA)2/2001
Pre-registrationPharmacist
Registered Pharmacist
GeneralLevel
Pharmacist
AdvancedLevel
Pharmacist
ConsultantPharmacist
Pharmacy/Dispensing Assistant (NVQ2)
Registered Pharmacy Technician (NVQ3)
Senior Pharmacy Technician (includes post-qualification training: ACT etc.).
Medicines Management Pharmacy Technician: Near Patient/Clinical Duties
Further role developments (e.g. via Foundation Degrees/NVQ4)
Completion of MPharm Pharmacy Support Staff and Technician Development
?
East & South East England Specialist Pharmacy Services
• Currently roles for technicians vary across different acute, mental health trusts and PCTs
• Boundaries between pharmacist and pharmacy technician duties vary in different trusts
• Often related to ability to recruit and skill mixing• Variations in training requirements within Trusts
eg formal accredited course v in-house training• No specific Competency Frameworks for post-
NVQ3 pharmacy technicians i.e. there is a a degree of inconsistency (as there
was for pharmacists)
Technician Roles
Task Group
If pharmacy technicians undertaking similar medicines
management functions to pharmacists
Could the GLF be used to assess competency and develop pharmacy
technicians?
East & South East England Specialist Pharmacy Services
Task Group
• Identified members – ranging from technician practitioners, those running MMT courses, interested pharmacists
• Looked at work already in existence• What do medicines management technicians do (varies
from place to place)• Identified which competencies/behavioural statements are
appropriate for technicians• Checked what needed modifying • Identified those to be added• And some behavioural statements were deleted
East & South East England Specialist Pharmacy Services
We found
• Most behavioral statements appropriate in two clusters (personal and problem solving)
• Management and Organisation behavioural statements – some less relevant depending on role
• Delivery of Patient Care Competencies – most challenging (and largest section)
• Added more behavioural statements especially around PODs/Discharge
• For all behavioural statements - two levels – core and optional
East & South East England Specialist Pharmacy Services
Work undertaken
• NEVER “rarely demonstrates the behaviour (0-20%)” replaced with RARELY
• Layout wasn’t logical! • Handbook needed reworking • Numbered behavioural statements to make
cross referencing easier• Have suggested level(s) of competence
East & South East England Specialist Pharmacy Services
• Redefined some of the terminology to ensure reflects practices by pharmacy technicians
• Used term pharmacy technician (MMT, Clinical Technician, near patient technician)
• Suggested what evidence can be used to show competence
• Checked applicability to primary care• Discussions around accountability and working within a
governance framework• We have a pilotable version! - almost
East & South East England Specialist Pharmacy Services
Governance Framework • There may be locally agreed situations where appropriately
trained and assessed pharmacy technicians undertake some clearly defined clinical roles – however the accountability for their actions remains with the pharmacist.
• Medicines Management activities are undertaken in accordance with a system of governance that reflects roles, responsibilities and accountabilities of different professional groups.
• Before using the framework it is important to identify locally what is the scope of practice for pharmacy technicians in respect of medicines management
East & South East England Specialist Pharmacy Services
Current work
Gathering support of “sponsoring” organisations
• CoDEG – valuable piece of work “ with the (P)GLF describes a complete medicines management service”
• UKCPA• Guild of Health Care Pharmacists• APTUK• UK Clinical Technicians Network• UK Psychiatric Pharmacy Group• Discussed with the Society
Task Group
There is no need to prove:• It works!• Is evidence based• Measures competence• Is reliable• Shows improvement with time
East & South East England Specialist Pharmacy Services
Pilot• Will run during 2008• Launch meeting in central London on
Wednesday January 16th
• Assessments during February, May and August• Each reviewer two MMTs• Complete a validation tool• Attend feedback meeting autumn• Looking for a range of services and sites
East & South East England Specialist Pharmacy Services
Pilot – behavioural statements
• Delivery of Patient Care 42• Personal 19• Problem solving 15• Management & Organisation 21
Handbook to help reviewers and pharmacy technicians navigate around the framework
East & South East England Specialist Pharmacy Services
Pilot• Does the framework work for medicines
management ?• Does it describe what pharmacy technicians
involved in medicines management activities do? – in all sectors ??
• Is it user friendly ?• Do we need to change anything ?
Patient Assessment
ALWAYS introduces self to explain role and checks patient details with prescription and patient
A BUSUALLY introduces self to explain role and checks patient details with prescription and patient
A BSOMETIMES introduces self to explain role and checks patient details with prescription and patient
A BRARELY introduces self to explain role and checks patient details with prescription and patient
A B
C C D C D C D
Your turn to have a go!
Consider aspects of medicines management role
Where should the standard be set ?
What evidence could be used to demonstrate level of performance?
East & South East England Specialist Pharmacy Services
Your turn to have a go!!
Assessment
ALWAYS demonstrates the behaviour with very rare lapses (85-100%)
USUALLY implies occasional lapses (51-84%)
SOMETIMES much more haphazard (21-50%)
RARELY very rarely demonstrates the behaviour (0-20%)
East & South East England Specialist Pharmacy Services
Core Project Group
• Jane Hough• Diane Blunden• Julie Chatters• Kulpna Daya• Dawn Denison• Vanessa Eggerdon
• Bev Faulkner• Tess Fenn• Elizabeth Fidler• Sarah Gray• Paul Lindars• Tracey Tisley
CoDEG Future Work
• CoDEG developing an electronic version
• As (P) GLF mapped onto Band 6 Pharmacist KSF - could the TLF map to Band 5 or 6?
• Work on NOS using (P) GLFCould technician NOS work link to Technician Level Framework
Competency Development and Evaluation GroupContributors
David Webb Graham DaviesLizzie Mills Denise FarmerDuncan McRobbie Ian BatesNaomi Meadows Sotiris AntoniouJulia Wright Kevin PurserLaura Obiols Jane Hough
East & South East England Specialist Pharmacy Services
My contact details: 01865 221504
CoDEG website:www.codeg.org
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