Certificate of Professional Development in Independent Prescribing for Pharmacists
Designated Prescribing Practitioner Guide
Liverpool John Moores University’s (LJMU) Masters Level Certificate in Independent Prescribing for Pharmacists has been developed in response to Government initiatives to extend prescribing rights and the role of pharmacists within the NHS. The programme aims are to provide pharmacists with the skills to practise as independent prescribers and meet the standards for independent prescribers set by the General Pharmaceutical Council (GPhC).
Practitioners on the programme are required to complete at least 12 days (7.5 hours per day; 90 hours total) of supervised practice, known as the Period of Learning in Practice. A Designated Prescribing Practitioner (DPP) is a practitioner who agrees to oversee, support and assess the competence of non-medical prescribing trainees, in collaboration with academic and workplace partners.
The specific learning outcomes that must be met by students undertaking the programme are shown in Appendix 1 below. The learning outcomes are fully mapped to the learning outcomes specified by the GPhC for providers of independent prescribing programmes for pharmacists, and the relationship between the programme learning outcomes and those set by the GPhC can be seen in Appendix 2 below.
Who can take on the role of the Designated Medical Practitioner?
Professional regulatory changes in 2018/19 has allowed for a wider variety of prescribing healthcare professionals to take on a supervisory designated practitioner role during the Period of Learning in Practice. The Royal Pharmaceutical Society (RPS) has led on the production of a competency framework for taking on this role. This stipulates that a DPP is a registered independent prescribing practitioner (medical/non-medical) that:
- be registered by their professional regulator, with the necessary annotation to act as a non-medical prescriber
- has no annotations of their professional register indicating unsuitability to supervise trainees
- is an experienced prescriber, in a patient facing role - normally this would entail having at least three years recent clinical experience for a group of patient/clients in the relevant field of practice. For medical prescribing practitioners, works within a GP practice and is either vocationally trained or is in possession of a certificate of equivalent experience from the Joint Committee for Post-graduate Training in General Practice Certificate or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other NHS employer
- is an active prescriber in a patient-facing role with appropriate knowledge, experience and competence in clinical and diagnostic assessment relating to the trainee’s area of clinical practice
- agrees to provide supervision, support and opportunities to develop the student’s competence in prescribing practice and has the support of the employing organisation or GP practice to provide this
- has some experience or training in teaching and/or supervising healthcare professionals in practice
- normally works with the student - If this is not the case, then a placement has been organised through which the student and DPP can work together during the prescribing practice
- must be sufficiently impartial to the outcome for the student and, wherever possible, should not be the same person sponsoring the student to undertake the programme
- has the support of the employing organisation or GP practice to act as the DPP who will provide supervision, support and opportunities to develop competence in prescribing practice
When does the Period of Supervised Practice take place?
The programme runs over six months, during which time, twelve 7.5 hours days (90 hours) of supervised practice should be agreed between the practitioner and the DPP.
What is a DPP expected to do?
The DPP has a crucial role in educating and assessing non-medical prescribers. This involves:
- working with the university and the student to establishing their baseline skills and knowledge and jointly create a learning contract with the student, using a template provided by LJMU
- planning a learning programme that will provide the opportunity for the student to meet their learning objectives and develop and demonstrate their competence in prescribing
- facilitating learning by encouraging critical thinking and reflection
- providing dedicated time and opportunities for the student to observe how the DPP conducts a consultation/interview with patients and/or carers and the development of a management plan - A minimum of 60 hours must be directly supervised by the DPP
- allowing opportunities for the student to carry out consultations and suggest clinical management and prescribing options, which are then discussed with the DPP
- helping the student integrate theory with practice
- providing opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient care and prescribing behaviour can be examined further
- assessing and verifying that, by the end of the course, the student is competent to assume the prescribing role
Throughout this period, the DPP will be supported by a named liaison at LJMU, who will normally be the student’s personal tutor.
Prior to undertaking to role, the DPP must ensure that they:
- fulfill the criteria required to undertake the role
- have time to supervise the student effectively and are able to provide appropriate opportunities as set out above
- are willing/able to view an induction session provided by the university, via a webinar
How will this impact on clinical time?
Training new prescribers will undoubtedly take up some time. As the approach to teaching and learning should be developed on an individual basis, it is difficult to predict how much time this will involve. It is unlikely that the trainee will need to spend all of the Period of Learning in Practice with the DPP, as other clinicians who work alongside the DPP and student may be better placed to provide some of the learning opportunities. Where the DPP is not medically qualified, it is recommended that the student is encouraged to spend time with a medically qualified practitioner who is able to offer expertise in diagnostic and clinical skills training relating to the area of specialist practice. However, the DPP remains responsible for assessing whether the learning outcomes have been met.
What constitutes supervision during the supervised practice period?
The following are some suggestions of supervision that the DPP can provide:
- Dedicated time and opportunities for the pharmacist to observe how the medical practitioner conducts a consultation/interview with patients and/or their carers, and how the subsequent management plan is developed.
- Opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient care and prescribing behaviour can be examined further.
- Facilitation of practitioner learning by encouraging critical thinking and reflection using the practitioner’s professional practice portfolio.
- Opportunities for the practitioner to be assessed in carrying out consultations, or clinical assessment, and to receive formative feedback on their performance.
- Opportunities for the practitioner to carry out consultations and suggest clinical management and prescribing options, which are then discussed with the supervisor.
- Observation of the practitioner's abilities to consult and communicate, physically examine (as relevant) and monitor, and prescribe in accordance with a clinical management plan.
What are the benefits to the DPP in undertaking the role?
The DPP and patients benefit from prescribing by pharmacists in the following ways:
- Through supporting others to learn you may reflect on and develop your practice.
- Through supporting pharmacists to train as independent prescribers:
- Patient can be provided with quicker, more efficient access to medicines.
- Doctors’ workloads can be reduced and refocused.
- Multidisciplinary team working is increased, providing more connected care.
Is there any paperwork involved for the DPP? What needs to be submitted to the University and when?
Key points where paperwork is required
When a student applies to join the course – DPPs are required to complete a form as part of the practitioner’s application process, indicating that the practitioner meet the criteria required to act as a DPP, and that they are able to provide appropriate support to the student during the period of learning in practice.
At the start of the Period of Supervised Practice – the DPP is required to review the student’s competency mapping checklist and agree a learning contract with the student.
During the Period of Supervised Practice – the DPP is required to complete, or facilitate the completion, of formative work-based assessment that will form a part of the student’s portfolio of professional practice.
At the end of the Period of Supervised Practice – the DPP will be asked to make an assessment of the practitioner which will then go to the University and become part of the overall practitioner assessment. DPPs are required to ensure that they have observed sufficient activities so as to satisfy themselves that the student is competent in all of the relevant learning outcomes listed in this checklist. In order for the student to become accredited as a prescriber, the DPP must verify that all of the relevant criteria in this assessment have been met. Students must also pass all other assessments in the programme in order to become accredited.
What support is available for the DPP?
It is essential that the DPP and the LJMU programme team running the prescribing programme work closely together. The programme team (see Programme Guide) will provide a range of support to facilitate this, which will include:
- an induction/orientation session (via webinar) and this introductory guide
- additional briefing handbook, including information on the course content, learning outcomes, timetable and assessment strategy
- on-going support with any queries or difficulties experience by the DPP/Student through a named liaison (usually the student’s personal tutor)
What if I have difficulties in supervising a student?
As a part of the induction training for DPPs, training will be provided to support practitioners in dealing with difficulties in supervision in the Period of Learning in Practice. This will include:
- dealing with an under-performing student
- how to stretch and under-challenged student
- how to deal with concerns about a student’s competence
During the Period of Learning in Practice, any queries or concerns around the supervision of students can be directed to your named LJMU liaison, or alternatively the programme leader.
More information on the role of the DPP, the learning outcomes for prescribing courses that are undertaken by pharmacists, and supervision of pharmacy professionals in the workplace can be found in the following documents.
- Royal Pharmaceutical Society (2019), A Competency Framework for Designated Prescribing Practitioners.
- General Pharmaceutical Council (2019), Standards for the Education and Training of Pharmacist Independent Prescribers.
- General Pharmaceutical Council (2018), Guidance on Tutoring and Supervising Pharmacy Professionals in Training.
- Royal Pharmaceutical Society (2016), A Competency Framework for all Prescribers.
Any further questions from DPPs can be directed to your named liaison – you will be provided with contact details for this individual at the time of your induction webinar. Alternatively, you can contact the programme administrator, Dani Bentley, by email: PBSfirstname.lastname@example.org or telephone: 0151 231 2248.