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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 Hough Pharmacy 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 Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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Page 1: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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)

Page 2: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 3: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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.

Page 4: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 5: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 6: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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”

Page 7: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 8: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 9: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 10: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 11: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 12: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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%)

Page 13: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 14: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 15: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 16: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

?

Page 17: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 18: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

Task Group

If pharmacy technicians undertaking similar medicines

management functions to pharmacists

Could the GLF be used to assess competency and develop pharmacy

technicians?

Page 19: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for 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

Page 20: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 21: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 22: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 23: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 24: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 25: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

Task Group

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

Page 26: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 27: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 28: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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 ?

Page 29: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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?

Page 30: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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%)

Page 31: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 32: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

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

Page 33: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

Competency Development and Evaluation GroupContributors

David Webb Graham DaviesLizzie Mills Denise FarmerDuncan McRobbie Ian BatesNaomi Meadows Sotiris AntoniouJulia Wright Kevin PurserLaura Obiols Jane Hough

Page 34: East & South East England Specialist Pharmacy Services Technician Level Framework –TLF – a professional development framework for pharmacy technicians

East & South East England Specialist Pharmacy Services

My contact details: 01865 221504

[email protected]

CoDEG website:www.codeg.org