Technician Level Framework TLF a

(1)

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)

(2)

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

(3)

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.

(4)

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

(5)

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?

(6)

(7)

General Level Framework 2nd Edition

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.

New General Level Framework

Personal Problem Solving Delivery 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

(8)

Staff Management

a b a b a b a b

c d c d c d c d

NEVER carries out staff appraisals SOMETIMES

carries out staff appraisals on a regular basis USUALLY carries

out staff appraisals on a regular basis

Performance management (Optional)

ALWAYS carries out staff appraisals on a regular basis Comment d c d c d c d c b a NEVER supports staff in their development b a SOMETIMES supports staff in their development b a USUALLY supports staff in their development b a ALWAYS supports staff in their development Staff development (Optional) Comment d c d c d c d c b a NEVER correctly applies employment issues b a SOMETIMES correctly applies employment issues b a USUALLY correctly applies employment issues b a ALWAYS correctly applies employment issues Employment issues (Optional) Comment

Basic Structure of the Framework

Management and Organisation Cluster

(9)

Management and Organisation Cluster Competency

a b a b a b a b

c d c d c d c d

ALWAYS carries out staff appraisals on a regular basis Comment d c d c d c d c b a NEVER supports staff in their development b a SOMETIMES supports staff in their development b a USUALLY supports staff in their development b a ALWAYS supports staff in their development Staff development (Optional) Comment

Space to write feedback on individuals development

d c d c d c d c b a NEVER correctly applies employment issues b a SOMETIMES correctly applies employment issues b a USUALLY correctly applies employment issues b a ALWAYS correctly applies employment issues Employment issues (Optional) Comment

(10)

a b a b a b a b

c d c d c d c d

Management and Organisation Cluster Competency d c d c d c d c b a NEVER correctly applies employment issues b a SOMETIMES correctly applies employment issues b a USUALLY correctly applies employment issues b a ALWAYS correctly applies employment issues Employment issues (Optional) Comment

(11)

a b a b a b a b

c d c d c d c d

Management and Organisation Cluster Competency d c d c d c d c b a NEVER correctly applies employment issues b a SOMETIMES correctly applies employment issues b a USUALLY correctly applies employment issues b a ALWAYS correctly applies employment issues Employment issues (Optional) Comment

(12)

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%)

(13)

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

(14)

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

(15)

Pharmacist Development Strategy

Pre-registration Pharmacist Registered Pharmacist General Level Pharmacist Advanced Level Pharmacist Consultant Pharmacist Qualified Practitioner Senior or Specialist Practitioner Advanced Practitioner Consultant Practitioner Healthcare Scientists

Making the Change

Consultant Advanced Practitioner Specialist Practitioner Practitioner

Allied Health Professions

Meeting the Challenge PAM(PTA)2/2001

(16)

Pharmacy Support Staff and Technician Development Completion of MPharm ?

Further role developments (e.g. via Foundation Degrees/NVQ4)

Medicines Management Pharmacy

Technician: Near Patient/Clinical Duties

Senior Pharmacy Technician (includes post-qualification training: ACT etc.).

Pharmacy/Dispensing Assistant (NVQ2) Registered Pharmacy Technician (NVQ3)

(17)

Technician Roles

• 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)

(18)

Task Group

If pharmacy technicians

undertaking similar medicines

management functions to

pharmacists

Could the GLF be used to assess

competency and develop pharmacy

(19)

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

(20)

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

(21)

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

(22)

• 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

(23)

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

(24)

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

(25)

Task Group

There is no need to prove:

• It works!

• Is evidence based

• Measures competence • Is reliable

(26)

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

(27)

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

(28)

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 ?

(29)

Your turn to have a go!

A B A B A B A B

C C D C D C D

RARELY

introduces self to explain role and checks patient details with prescription and patient SOMETIMES introduces self to explain role and checks patient details with prescription and patient USUALLY introduces self to explain role and checks patient details with prescription and patient Patient Assessment ALWAYS introduces self to explain role and checks patient details with prescription and patient

Consider aspects of medicines management role

Where should the standard be set ?

(30)

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%)

(31)

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

(32)

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) GLF

Could technician NOS work link to Technician Level Framework

(33)

Competency Development and Evaluation Group Contributors

David Webb Graham Davies

Lizzie Mills Denise Farmer

Duncan McRobbie Ian Bates

Naomi Meadows Sotiris Antoniou

Julia Wright Kevin Purser

(34)

Technician Level Framework TLF a