Has a national recruitment scheme created a positive intervention for Black, Asian or other Minority Ethnic pharmacy trainees?

OBJECTIVES: A National Recruitment Scheme (NRS) for Pharmacy trainees was introduced in England and Wales in 2017, standardising recruitment processes on behalf of employers and with the aim of reducing bias for candidates applying to training posts within the National Health Service (NHS). This research attempted to identify whether the introduction of the NRS had an impact on the recruitment of Black, Asian, or other Minority Ethnic applicants into the most sought-after posts within the Scheme (hospital posts). METHODS: An observational study was undertaken. Anonymised pharmacist trainee recruitment data between the cohort intakes of 2015-16 and 2020-21 was obtained from the pharmacy regulator the General Pharmaceutical Council and a comparison of proportional representations of ethnicities was undertaken, to ascertain whether a greater proportion of applicants from minority backgrounds attained the most sought-after posts in the NHS after the NRS was introduced. A robust generalised linear model was then used to analyse the data using binomial as the variance function and logit as a link function, where the proportion of hospital recruitment was an outcome with a two-way interaction between intervention and ethnicity after adjusting for overall proportion. KEY FINDINGS: The statistical analysis of 18 283 pharmacy trainees in total, of whom 4446 were in hospital, shows a significant overall impact of intervention, with a significant positive change in the proportions of Asian-Pakistani applicants (P-value < 0.001) and Black-African applicants (P-value < 0.001) recruited to hospital posts. CONCLUSIONS: Since the introduction of the NRS there has been a statistically significant impact on the correlation between the overall number of Black, Asian or other Minority Ethnic applicants and their proportion in hospital. That is, not only is the makeup of the hospital cohort increasingly reflecting the diversity of the overall cohort, but also a larger percentage of each ethnic cohort is attaining hospital training places.

Reflections of mentors and mentees on a national mentoring programme for pharmacists: An examination into relationships, personal and professional development.

BACKGROUND: While mentorship programmes for professionals are growing in number, the lived experiences of mentor and mentee participants could be captured so as to better inform best practices and considerations for thriving relationships. OBJECTIVE: This study evaluated the lived experiences of mentors and mentees in a nationwide programme for pharmacists administered by a professional organisation in the United Kingdom, specifically examining the nature of relationships comprising those experiences. METHODS: A phenomenological approach was adopted, with semi-structured interviews conducted remotely between November 2019 and June 2020. Potential participants approached via a gatekeeper, employing purposive and convenience sampling. Transcribed data were examined using a combination of inductive and deductive thematic analysis and codes were assigned independently by two researchers, to increase rigour in analysis. RESULTS: A total of 20 participants described their perceived role in their respective mentoring partnerships, gave their own account of the definition of mentoring and discussed the crucial role of trust and understanding in developing a successful mentoring relationship. Mentors' beliefs on their perceived role in the relationship largely guided their approach to the structure of the interactions. The concepts of personal growth and development of peers were often discussed by the participants, along with the acknowledgment that mentoring is a relationship that ideally lasts potentially a lifetime, should the relationship be successful. Mentors felt a sense of pride in giving back to the profession. An unintentional unbalanced power dynamic was often reported and both mentors and mentees acknowledged frustrations when they perceived their partner was not showing the same level of engagement and commitment. CONCLUSIONS: Pharmacists participating in a nationwide mentoring programme expressed considerable enthusiasm with their contribution, underscoring the programme's flexibility, its emphasis of mentoring versus merely advising, and its responsibility for enhancing or reconnecting with their professional identity as well as fostering more positivity and liveliness in their professional roles. . The programme might consider additional training to mentors to promote their own self-efficacy in mentoring, which among other things could curtail perceived potential power imbalances within mentor-mentee dyads and lead to a more dynamic and contextualised mentoring experience.

National recruitment system for pre-registration pharmacist trainees in England and Wales: context, process and outcomes.

In England and Wales, a new National Recruitment Scheme (NRS) for pre-registration pharmacists was introduced in 2017. The NRS replaced the traditional method of employer-led recruitment or the national recruitment system previously limited to some hospital training programmes. NRS uses assessment methodology involving Multiple-Mini Interviews, Situational Judgement Tests and numeracy skills in ranking and appointing candidates to their preferred training providers through a centralised procedure. This commentary will describe the background, assessment methodology, outcomes of preliminary evaluations and priority research areas for the future in the context of the NRS.

Design fundamentals of mentoring programs for pharmacy professionals (Part 2): Considerations for mentors and mentees.

Developing a mentoring program is multifactorial, and organizations developing such programs must be reflective in considering their own organizational culture to determine the goals and outcomes assessment of a mentoring program that aligns with the organization's mission and values. Part 1 of this series of papers on devising mentoring programs for pharmacy professionals paid mind to their structure, logistical concerns, and basic design consideration. Designing a program, though, cannot be successful without consideration of the people involved, and the very human process that is mentoring and being mentored. This Part 2 paper takes into account the human needs of mentors and mentees, both independently and as pairs or groups involved in a potentially intimate and caring relationship that lasts anywhere from several months, to potentially a lifetime should the relationship be successful. As such, this commentary pays careful attention to the evolving roles each person plays and what this means to administrators overseeing or assessing the results and implications from such a program so as to strive for maximum organizational effectiveness for employing institutions and self-actualization for persons involved in the program.

Design fundamentals of mentoring programs for pharmacy professionals (Part 1): Considerations for organizations.

Mentoring programs have been offered by organizations within and outside of healthcare for years. This commentary examines the literature under the prism of design fundamentals for these programs, drawing particular considerations for schemes aimed at pharmacy professionals. The central argument presented is that mentoring can be used as a vehicle to support pharmacists to learn from others and each other, to reinforce and own their professional identity so that the uniqueness of the pharmacy profession is established within a global health landscape of constant change. In this Part 1 of a series of papers, a wealth of literature, theories, and evidence are presented aiming to inform the general structure and logistical considerations for both in-person and distance mentoring programs.

An investigation into the number and nature of the urgent care consultations managed and referred by community pharmacists in South-East England.

BACKGROUND: Community pharmacies are recognised as an under-utilised, accessible resource that could support the urgent care agenda. This study aimed to provide a snapshot of the number and nature of urgent care requests presented to a sample of community pharmacies in three counties in southern England, to determine how requests are managed, whether management is appropriate, as assessed by a group of experts, and whether customers receiving the care are satisfied with pharmacists' interventions. METHODS: A representative sample of pharmacists across the region was invited to keep a log-book documenting all urgent care requests over a two-week period. Data were analysed to estimate frequency and type of requests and to compare consultations in core and non-core hours. Log-book entries were scrutinised blind by an expert panel to determine appropriateness of pharmacist's responses. Customers receiving pharmacists' interventions were surveyed to assess satisfaction. RESULTS: Seventeen pharmacies kept log-books detailing 432 urgent care consultations, equating to 13 consultations per pharmacy per week. Of these, 70% (n = 302) were dealt with by the pharmacist in-house with 30% (n = 130) resulting in referrals. Locum pharmacists were significantly more likely to refer to other NHS services than regular pharmacists. Over half the requests were for symptom management, skin problems presenting most commonly (38% of all symptoms presented). Forty-seven percent of consultations were considered to have 'averted the need for other NHS services'. Pharmacists' referral (but not assessment of urgency) was deemed appropriate by the expert panel in 90% of consultations. Ninety-five percent of customers surveyed were satisfied with the service and would use the pharmacy again. CONCLUSION: Extrapolating findings across the study population (approximately 4.4 million) suggests that community pharmacists manage over 11 500 urgent care consultations per week, with 8050 managed independently. These prevent approximately 5400 other NHS encounters, while also meeting customer expectations and expert panel endorsement.

How do pharmacy students select their pre-registration training providers? A mixed methods evaluation of the national recruitment scheme in England and Wales.

OBJECTIVES: A national pre-registration pharmacist recruitment scheme, which replaces the local recruitment models, was introduced in England and Wales in 2017. This study aimed to explore pharmacy students' behaviour and associated factors in their selection of pre-registration training programmes. METHODS: A mixed-method study using (a) analysis of data from all applicants (n = 2694) of the national recruitment scheme, (b) an online survey and (c) a virtual focus group was undertaken. Survey and focus group questions were developed based on the Theoretical Domains Framework (TDF). Descriptive and inferential analysis of quantitative data was undertaken using Stata software. Qualitative data from focus groups and responses from the open-ended questions were analysed using framework technique. KEY FINDINGS: A vast majority of applicants (n = 2182, 83.9%) selected a hospital training programme as their first ranked preference, with the rest opting for community pharmacy. Urban areas, particularly London, were most popular geographically. A total of 307 survey responses were returned. Long-term career aspirations, followed by geographical factors, were rated most highly in applicants' decision-making. Qualitative data from survey and focus group demonstrated information about programmes/employers, perceived opportunity for skills development and aspiration towards a career path as key contributory factors in their decision-making. CONCLUSIONS: Secondary care was the most desirable destination for pharmacy students to undertake early career training. The clinical roles and career opportunities in community pharmacy needs to be promoted as there is a risk that community pharmacy training programme places may be seen as a 'left over' opportunity for less competitive candidates to uptake.

National recruitment scheme for pre-registration pharmacist training in England and Wales: a mixed method evaluation of experiences of applicant pharmacy students.

BACKGROUND: A national pre-registration pharmacist training recruitment scheme, which replaces local recruitment models, was introduced in England and Wales in 2017. The national recruitment system allows pharmacy students to apply for the 52 weeks training programmes (mandatory requirement for registration as a pharmacist), through a single application system prior to undertaking a nationally administered assessment. This study aimed to explore experiences of pharmacy students on the national recruitment scheme, particularly their views on the selection methodology, application process, and offer outcomes. METHODS: This mixed method study involved a) an online survey of all (approximate n = 2800) year 4 (final year of MPharm degree) pharmacy students in England and Wales and b) a qualitative focus group with four students. The study population was eligible to participate in the 2017/18 national recruitment scheme. Survey respondents were invited to participate in a focus group. Quantitative data were analysed using descriptive and inferential analysis. Qualitative data were analysed using the framework technique. Participation was voluntary. Ethical approval from University of Birmingham was obtained. RESULTS: A total of 307 completed surveys were returned (approximate response rate 11%). Respondents were generally satisfied with the application process and commended the fairness of the selection methodology and convenience in allowing them to apply to multiple training providers. Most survey respondents (n = 181, 72.9%) were either satisfied or highly satisfied with the training programme they were offered based on their assessment performances. Three themes and eight sub-themes obtained from the analysis of over 200 open comments data from the survey and transcript of a focus group with four participants. Results suggested the need to widen the timeframe available for applicants to shortlist their preferred employers, improve the method of programme listing in the application system, and consideration of prior achievements including academic performances and placement experiences to be included in the selection methodology. CONCLUSIONS: Experiences of pharmacy students on the national recruitment scheme suggest that respondents considered the selection methodology to be fair. Student engagement and satisfaction with the recruitment system can be maximised through improved listing of employers and widening the timescales for students to shortlist their preferred employers during application process. Inclusion of University achievements in the selection methodology will require consideration of evidence based approaches. Low response rate limits generalisation of findings.

Exploring the utility of the Prescribing Safety Assessment in pharmacy education in England: experiences of pre-registration trainees and undergraduate (MPharm) pharmacy students.

OBJECTIVES: (i) To provide a preliminary indication of the performance of pharmacy undergraduate students and pre-registration pharmacy trainees in the Prescribing Safety Assessment (PSA). (ii) To determine the feasibility of administering and delivering the PSA in schools of pharmacy. (iii) To examine the potential relevance of the PSA and associated training materials to pharmacy education. (iv) To assess the attitudes of the cohort towards the PSA and their readiness to prescribe. METHODS: Four schools of pharmacy in England recruited final year undergraduate pharmacy students and pre-registration pharmacy trainees undertaking training with both hospital and community pharmacy employers in their locality to undertake the PSA. Performance data and feedback from candidates were obtained. KEY FINDINGS: Pre-registration pharmacy trainees in community (n = 27) and hospital (n = 209) settings mean average scores were 86.3% and 85.3%, respectively. There was a significant performance differential between undergraduate pharmacy students (n = 397) and those in pre-registration training, with the mean average score for undergraduate students being 73.0% (t test P < 0.05). Candidates felt their current course did prepare them for the PSA, some highlighted that additional curriculum content would be needed should this become a compulsory high-stakes assessment for pharmacy trainees. The majority of candidates felt that this assessment was useful and applicable to their training. CONCLUSIONS: The PSA process and associated learning tools could be introduced to pre-registration pharmacy education to support trainees in their development towards future prescribing roles.

Longitudinal qualitative evaluation of pharmacist integration into the urgent care setting.

PURPOSE: To describe the most effective model for managing, educating, and training pharmacist advanced clinical practitioners (ACPs) in the urgent care center (UCC) setting, role evolution and how to measure their effectiveness. PARTICIPANTS AND METHODS: Ethical approval was obtained to perform a qualitative longitudinal cohort study in three sites, with three pharmacists in each trained as ACPs from 2016 to 2017. ACP role, location, management, mentorship, and supervision were locally determined. ACPs attended focus groups (FGs) at 1 and 3 months (sites 1-3), 6 and 12 months (site 1 only), and the UCC staff were interviewed once with a topic guide regarding training, integration, role, and impact. Verbatim transcriptions were analyzed thematically. RESULTS: Eight ACP FGs and 24 stakeholder interviews produced major themes of communication, management, education and training, role, and outcomes. Effective education, training, and integration required communication of role to address concerns regarding salary differentials, supportive management structure, and multi-professional learning. ACPs reported that the model of workplace training, experiential learning, and university-based education was appropriate. Training was better located in the minor injuries and general practitioner areas. Recommended measures of effectiveness included patient satisfaction and workload transfer. CONCLUSION: The education and training model was appropriate. Communication and management require careful consideration to ensure effective integration and role development. Pharmacists were better located initially in the minor illness rather than major trauma areas. Quality of patient experience resulting from the new role was important in addition to reassurance that the role represented a positive contribution to workload.

Roles of the non-medical prescribing leads within organisations across a Strategic Health Authority: perceived functions and factors supporting the role.

OBJECTIVES: Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. METHODS: Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. KEY FINDINGS: In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. CONCLUSION: The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.