Good leadership in healthcare is a hot topic as it can improve outcomes. But it’s not just something for managers to develop, writes Charles Gladwin

The concept of leadership in health is becoming increasingly significant as the NHS strives to optimise care. The NHS Leadership Academy argues that “great leadership development improves leadership behaviours and skills. Better leadership leads to better patient care, experience and outcomes.”

The Royal Pharmaceutical Society launched its Leadership Development Framework in January. Its approach is that leadership is something all pharmacists, whatever their geographical location or experience, should develop.

“The concept of a single ‘hero’ leader has been replaced with an engaging leadership approach that cascades throughout a profession,” says the Society. “In an engaging leadership model, leadership is the responsibility of everyone within the team, not just the individual accountable for team performance. Developing leadership behaviour ... is an integral element of pharmacists’ training and learning in order to contribute to the effective running and future direction of the organisation within which they work and, ultimately, to enhance patient care and outcomes.”

The tutoring experience

One approach which combines these various aspirations is to become a pre-registration tutor. As Susan Coffin, Numark’s Pre- Registration Tutor of the Year, explains, tutoring “keeps you on your toes, and does make you think”.

And it is not just the tutor who benefits from the pre-reg experience: “I also have a registered ACT and a pharmacy technician; it makes them think, and the medicines counter assistants think. It’s very beneficial for the whole team.”

Ongoing news about suspensions and investigations surrounding pharmacists’ non-completion of CPD has emphasised the importance of recording this information

Ms Coffin has plenty of experience as pharmacy manager at City Pharmacy in Portsmouth, but only became a tutor in 2013. “We have had a fantastic couple of years,” she says.

Becoming a tutor is relatively straightforward. While there is no formal qualification, Ms Coffin says that she attended tutor training run by the RPS, and also a Numark training evening.

Ms Coffin endorses Numark’s pre- registration programme as it includes training days as well as advice and telephone support A lot of the pre-reg training is on the job, but “buying into a pre-reg training course does take the pressure off. I’m sure then that everything in the course is covered, that the syllabus fills in all parts of the criteria I can’t do.

Opportunities and experience

Ms Coffin ensures her students have a wide range of opportunities and experiences. As well as encouraging the pre-reg to attend local pharmacy meetings, she arranges for trainees to shadow district nurses or practice staff in GP surgeries, and a placement in hospital.

And to demonstrate that the concept of leadership is relevant at all stages of your career, Ms Coffin’s first pre-registration student Omolola (Lola) Adeyemi chose dementia as her pre-registration year project, training to become a dementia friend. “She became a dementia champion and was running training for other pharmacies.”

Clearly, being a tutor can boost continuing professional development, but changes lie ahead in how CPD will contribute to ongoing registration requirements. Under General Pharmaceutical Council proposals to introduce a continuing fitness to practise framework from 2018, two additional evidential assessments will be required alongside ongoing CPD: peer review and performance indicator data. “All three parts of the framework will be flexible enough to be applied across the range of contexts, settings and scopes of practice of pharmacists and pharmacy technicians,” says the GPhC.

In the autumn of 2014, it held a ‘Twitter chat’ to ask how registrants thought existing CPD requirements could be improved. It received a strong message that CPD should focus on outcomes rather than compliance with process.

“We recognise many of our measures are compliance-related currently and are undertaking work to find out how we can play our part in increasing the value of CPD activities and recording,” commented chat host Osama Ammar, GPhC head of Continuing Fitness to Practise. “I also heard a loud message about increasing the opportunity to record CPD using better technology.”

OSCEs or exams?

Another question was whether objective structured clinical examinations (OSCEs) or other exams would be introduced. “We are not proposing OSCEs and exams – one of our principles for development is to focus on a continuous method rather than single point assessments – but an interesting debate emerged,” says Mr Ammar. “Some felt assessments of this type might be the only objective method to determine ongoing competency. Others felt that exams only test knowledge or exam technique and that we needed to think more broadly about professionalism.”

Current arrangements for completing CPD will continue until 2018. However, “ongoing news about suspensions and investigations surrounding pharmacists’ non-completion of CPD has emphasised the importance of recording this information, says Mimi Lau, Numark’s director of pharmacy services.

“CPD in itself is not difficult; we do it every day as part of our job and there are numerous opportunities to undertake structured learning. It’s simply getting into the habit of recording that people still struggle with, but there are some great resources out there to help, so use them.”
Numark has launched a modular CPD resource, Pharmacy Excellence, for pharmacists and technicians. The modules cover treatment of specific diseases and/or drug therapies with the aim of supporting medicines optimisation.

“We have already provided modules on specials, COPD and asthma and the supply of salbutamol inhalers to schools, for instance,” says Ms Lau. “Although the move to continuing fitness to practise is still some way away, all pharmacists need to get into the discipline of recording CPD now. Our advice is: small amounts, regularly!”

Another resource is the CPPE’s interactive theLearningpharmacy.com website. This provides “bite-sized learning on a variety of subjects that you might encounter in your daily practice.”

Recent additions were the learning ‘hotspots’ on the ‘dermatology floor’, with advice ranging from over-the-counter requests to prescription interventions. “To explore the subject, you can work through a variety of these hotspots to address current issues in dermatology treatments – from new products to debunking common dermatology old wives’ tales,” says CPPE.

Support from manufacturers

Manufacturers’ training material can also be useful for certain topics. For example: “Since bladder weakness is a potentially sensitive subject, and because there are a variety of products available to help customers, assisting groups will be selected to participate in the programme with the aim of them cascading their learning to a wider audience,” says Ms Lau.

The programme will consist of four to six modules and the plan is that, on completion, members can use the credits towards achieving a formal qualification with one of the university business schools. “There is a lack of a good business skills programme for independent pharmacies in the market – despite the need. We hope to fill that gap with our programme.”pharmacy staff to engage with customers is a key focus for TENA,” says TENA training and brand manager Donna Wilson.

“Pharmacy is an increasingly important source of products and advice, thus it is increasingly crucial for pharmacy teams to be well-informed so that they can handle customer requests with tact and sensitivity.”

CPD need not just be about clinical matters, though. Numark is launching its Business Skills Programme this year, which again combines learning with leadership. “Superintendents or other senior managers of small pharmacy groups will be selected to participate in the programme with the aim of them cascading their learning to a wider audience,” says Ms Lau.

The programme will consist of four to six modules and the plan is that, on completion, members can use the credits towards achieving a formal qualification with one of the university business schools. “There is a lack of a good business skills programme for independent pharmacies in the market – despite the need. We hope to fill that gap with our programme.”