1. Utility of appraisals in revalidation Evidence from pharmacy with relevance across professions Ellen Schafheutle Karen Hassell, Peter Noyce Windsor – 28 March 2014 Manchester Pharmacy School

2. Presentation overview Pharmacy profession DH funded/ GPhC commissioned study Possible sources of evidence for revalidation –Focus on appraisals Considerations for implementation

3. Background: Pharmacy 3rd largest healthcare profession > 47,000 pharmacists (Phs) > 22,000 pharmacy technicians (PTs) Working in different sectors

4. Aims & methods Aim: to evaluate the use of appraisals & alternative sources of evidence for the purpose of revalidation in pharmacy – Objectives –Existing structures, processes, items covered in appraisals & –How appraisals could feed into revalidation in future –Other possible sources and structures which already exist Methods Surveys/ semi-structured interviews –Registrants: pharmacists & pharmacy technicians –Employers –Community; NHS (Hospitals & PCOs); Pharmaceutical industry; Academia – GB: England, Scotland, Wales

5. Revalidation in pharmacy: Possible sources of evidence Continuing professional development (CPD) Appraisals Other sources of evidence: –GPhC (RPSGB) inspections –Community pharmacy contract monitoring But what to actually assess against?

6. Revalidation ‘assessment’ in pharmacy – against what? Professional standards to remain on register Doctors: Good Medical Practice –Core ethical guidance for doctors Pharmacy? –GPhC Standards of Conduct, Ethics and Performance –Ontario Canada: patient facing –UK: broad definition of pharmacy professional

7. Appraisals in pharmacy What is ‘performance’? Depends on organisational focus/ targets  Hospital, NHS  CPD, KSF Community pharmacy & Pharma. Industry  business focus, commercial targets Academia  research & teaching focussed  Professional/ clinical performance  seen as individual’s responsibility NB. Not all are patient facing

8. Where are appraisals in use?  In all managed sectors  BUT Lacking: –‘Top of management structure,’ incl. owners –Locums (self-employed) –Working in >1 sector Who conducts appraisals?  Line manager  Not necessarily pharmacy professional

9. Other sources of evidence GPhC position on ‘continuing fitness to practise’ –Framework with 3 main components Structures specific to pharmacy –GPhC (RPSGB) inspections –Community pharmacy contract monitoring In use in other professions, e.g. medicine –360° Feedback, MSF Colleagues Patients

10. Considerations for implementation All sectors? All pharmacy professionals: Phs & PTs? Appraisals – fit for purpose? Poor performance –Appraisals etc. best? – Remediation? Balance (conflict?) –formative (supportive) vs. summative (assessment) Who ‘judges’? –Peer – employer? – Sufficient role understanding? What is employer role & responsibility? Quality assurance, governance arrangements? –Training & accreditation Infrastructure? – Role of regulator?

11. Publications Schafheutle EI, Hassell K, Noyce PR. Ensuring continuing fitness to practise in the pharmacy workforce: Understanding the challenges of revalidation. Research in Social & Administrative Pharmacy 2013; 9: 199-214 Report: Exec summary, full report (2 volumes): –http://pharmacyregulation.org/resources/researchhttp://pharmacyregulation.org/resources/research –Schafheutle EI, Jacobs S, Jee SD, Elvey R, Hassell K, Noyce PR. Revalidation in Pharmacy: Evaluation of appraisal and alternative sources of evidence. General Pharmaceutical Council. December 2010

12. Further papers Research in Social & Administrative Pharmacy – Special issue 2013, Vol 9 Potter H, Hassell K, Noyce PR. Pharmacists’ and pharmacy technicians’ views on a process of revalidation of pharmacy professionals in Great Britain. 142–154 Jee S, Jacobs S, Schafheutle EI, Elvey R, Hassell K, Noyce, PR. An exploration of the utility of appraisals for the revalidation of pharmacy professionals in community pharmacy in Great Britain. 155-165 Jacobs S, Schafheutle EI, Jee S, Elvey R, Hassell K, Noyce, PR. Existing arrangements for monitoring community pharmacies in England: can they have a role in the revalidation of pharmacists? 166-177 Elvey R, Schafheutle EI, Jacobs S, Jee S, Hassell K, Noyce, PR. Revalidation arrangements for pharmacy professionals in industry and academia in Great Britain: a qualitative study. 178-187 Schafheutle EI, Jee S, Hassell K, Noyce PR What could the NHS appraisal system contribute to revalidation in pharmacy? Pharmaceutical Journal 2011; 286: 82