Technician Level Framework –TLF – a professional development framework for pharmacy technicians in medicines managemen

1. 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 Hough Pharmacy Clinical Services Manager ORH Honorary Associate Director Clinical Pharmacy ESEESPS On behalf of the Competency Development and Evaluation Group (CoDEG)

2. 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

3. 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.

4. 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

5. Definitions Definitions • A Competency Framework is a collection of competencies central to effective performance • The competenciesdescribe 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?

6. The Framework

7. New General Level Framework Delivery of Patient Problem Solving Management and Personal Care Organisation Gathering Patient consultation Organisation Clinical governance information Need for the drug Effective Knowledge Service Provision communication skills Selection of the drug Analysing Budget setting and information reimbursement Teamwork Drug specific issues Organisations Providing Professionalism information Provision of drug product Training Follow up Medicines information Staff management Monitoring drug therapy Procurement Evaluation of outcomes General Level Framework 2nd Edition 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.

8. Basic Structure of the Framework Management and Organisation Cluster Staff Management Comment Space to write feedback on individuals development Comment Comment

9. Basic Structure of the Framework Competency Management and Organisation Cluster Staff Management Comment Space to write feedback on individuals development Comment Comment

10. Basic Structure of the Framework Competency Management and Organisation Cluster Staff Management Comment Space to write feedback on individuals development Comment Comment Behavioural Statement

11. Basic Structure of the Framework Competency Management and Organisation Cluster Staff Management Comment Space to write feedback on individuals development Comment Comment Assessment ratings at times a,b,c and d Behavioural Statement

12. 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%)

13. 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

14. 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

15. Consultant Pharmacist Consultant Practitioner Consultant Advanced Level Pharmacist Advanced Practitioner Advanced Practitioner General Level Pharmacist Senior or Specialist Practitioner Specialist Practitioner Registered Pharmacist Qualified Practitioner Practitioner Pre-registration Pharmacist Healthcare Scientists Making the Change Allied Health Professions Meeting the Challenge PAM(PTA)2/2001 Pharmacist Development Strategy

16. Pharmacy Support Staff and Technician Development Completion of MPharm ? Further role developments (e.g. via Foundation Degrees/NVQ4) Medicines Management Pharmacy Technician: Near Patient/Clinical Duties Senior Pharmacy Technician (includes post-qualification training: ACT etc.). Registered Pharmacy Technician (NVQ3) Pharmacy/Dispensing Assistant (NVQ2)

17. Technician Roles • 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)

18. Task Group If pharmacy technicians undertaking similar medicines management functions to pharmacists Could the GLF be used to assess competency and develop pharmacy technicians?

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. There is no need to prove: It works! Is evidence based Measures competence Is reliable Shows improvement with time Task Group

26. 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

27. 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

28. 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 ?

29. 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?

30. 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%)

31. Jane Hough Diane Blunden Julie Chatters Kulpna Daya Dawn Denison Vanessa Eggerdon Bev Faulkner Tess Fenn Elizabeth Fidler Sarah Gray Paul Lindars Tracey Tisley Core Project Group

32. 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) GLF Could technician NOS work link to Technician Level Framework

33. Competency Development and Evaluation GroupContributors David Webb Graham Davies Lizzie Mills Denise Farmer Duncan McRobbie Ian Bates Naomi Meadows Sotiris Antoniou Julia Wright Kevin Purser Laura Obiols Jane Hough

34. My contact details: 01865 221504Jane.Hough@orh.nhs.ukCoDEG website:www.codeg.org