2.8  Funding for pre-registration training

We do:

• provide a training record as proof of your training arrangement, for you to give to your employer. If you are a community pharmacy trainee, your employer will send this to the CCG (for trainees in England), Local Health Board (for trainees in Wales) or NES (for trainees in Scotland)
• send you a new training record:
  • if your training site changes
  • if your training needs to be extended

We do not:

• give funding for pre-registration training
• influence whether or not you are eligible for funding within any particular training arrangement or at any stage of training. Therefore we are not able to give advice on whether you will be able to get funding for your training
• tell anyone else about your change of training arrangements, so any responsibility for telling funding providers about this lies with you or your employer (or both)
• show on your training record whether your training is full or part–time, so any responsibility for telling funding providers about this lies with you or your employer (or both)
• issue a training record to anyone other than the trainee named on the training record.

2.9  Restrictions on the training site and tutor

To make sure there is an objective relationship between trainees and tutors, you must not train anywhere that you:

• have a significant financial interest in, or
• have a significant relationship with a director, owner or employee

‘Significant’ relationships include:

• any family relationships, such as father, mother, aunt, uncle, cousin and so on
• family relationships through marriage or civil partnership
• girlfriend-boyfriend-partner relationships
• people you depend on financially or to whom you have a financial commitment
• people who depend on you financially or who have a financial commitment to you

In a public sector placement (for example an NHS hospital trust) where there is clearly no commercial interest, we will consider applications from trainees wanting to train at a site where a family member or partner works. However, the training provider is responsible for making sure that training and assessment is managed by someone else, to avoid any conflict of interest. Any operational issues that may arise through this must be managed by the training provider.

Important: The tutor is responsible for approving the competence of their trainee. Any abuse of this responsibility resulting from any family relationship will be a fitness to practise issue for the pharmacist and we may terminate the trainee's training placement.

2.10  Deciding where and how to train

Most trainees will train in one sector for the full 52 weeks. But there is also the option to train in more than one sector. There are patient-facing sectors, such as community and hospital pharmacy, and non-patient-facing sectors such as the pharmaceutical industry and academia.

If you decide to train in more than one sector, there are two main options:

• joint training: you train for up to 26 weeks in a non-patient-facing sector and for at least 26 weeks in a patient-facing hospital or community pharmacy
• split training: you train in both hospital and community pharmacy

Examples of training plans can include:

• the full 52 weeks in a single patient-facing sector
• split training plans with, for example, six (or perhaps nine) months spent in community pharmacy and six (or perhaps three) months in hospital pharmacy
• joint training plans with six (or perhaps nine) months spent in a patient-facing sector and six (or perhaps three) months in a non-patient-facing sector
• integral training plans, where at least half the week is in a patient-facing sector and the rest of the time covers other aspects of pharmacy practice such as internet pharmacy services (as this would be classed as non patient-facing)

One university in Great Britain – Bradford – offers a five-year degree including two 26-week periods of training in different academic years. This is known as ‘sandwich’ training – if you are on a sandwich course, you will have made this choice when you applied to Bradford as an undergraduate.

The University of Nottingham and University of East Anglia run 5-year pharmacy courses that include pre-registration training. Although our pre-registration scheme requirements still apply to Nottingham and UEA students, any pre-registration training you do as part of either course must comply with university regulations also.

2.11  Full- and part-time training

Usually training is full time, which means working between 35 and 45 hours a week.

You must agree any arrangements to work part time with the GPhC in advance. ‘Part time’ means working at least 17.5 hours a week, over at least three days a week. This might be agreed before you start training or as the result of a change in circumstances during the year.

Things to consider when deciding if a part-time training arrangement is right for you:

• Will you still be eligible to sit your chosen assessment? To enter the registration assessment, you will need to complete at least the equivalent of 39 weeks’ full-time training by the assessment entry date for any particular sitting.
• Can you meet the GPhC Criteria for initial education and training? You should complete your part-time training within the time limits given, and there is no extra time allowed if you choose to train part time.
• Will you have enough contact time with your tutor? You should make sure that the hours you usually work each week overlap with your tutor for at least 80 per cent of the time you are working.
• Will your part-time arrangement affect any other trainees? Usually your tutor will only be allowed to supervise one trainee at a time. If changing to a part-time arrangement means your training will overlap with that of another trainee, you should discuss with us whether the arrangement meets our requirements.

Your employer must also agree that their standard training plan can be changed to fit in with this arrangement and still give you the opportunity to meet all the performance standards.

2.12  Training outside Great Britain

You may carry out up to 13 of the 52 weeks of your training in a pharmacy in another member state of the European Union. This must be one continuous placement and must be completed between weeks 13 and 26 of training. The training outcomes for those 13 weeks must form part of your training plan, and you must agree them with your tutor and the GPhC before you start your training year.

2.13  Training at another site in Great Britain

Unless you get our agreement first, you may only train outside your main training organisation in one of two ways:

• five days in ‘unlisted’ training sites (that is, a site that is not approved for pre-registration training)
• four weeks in a listed training site

You can only do each of these things once in a training year without specifically agreeing it in advance as part of your training plan, or as part of your application to enter training.

2.14  Attendance requirements

If you are absent for more than 40 days during your pre-registration year – for whatever reason – you must tell the GPhC as this may affect your eligibility to sit the registration assessment or to register on a particular date. The 40-day limit includes public holidays, sickness and annual leave. For part-time training arrangements, the 40 days applies to the whole training period. If you are training part-time, you must have been in training for the equivalent of 39 weeks of full-time training. For example, if your training will take 104 calendar weeks to complete, you will need to have been in training for at least 78 weeks by the assessment entry deadline.

If you are absent for more than 40 days, you will need to complete additional training to be eligible to sit the registration assessment. You must have completed at least 39 weeks of training by the application entry deadline for the sitting. 

If you are absent for more than 40 days before your 39-week progress review, you should delay the review until you have worked the additional days that have been missed to have completed the equivalent of 39 weeks training.

If the revised date of your 39 week progress review is before the assessment entry deadline for that sitting and you are assessed as satisfactory, you could still meet the eligibility criteria for that sitting. Any additional absence after you have met the entry criteria will not affect your assessment eligibility, but you should refer to section 5.6.

In all cases, to meet the criteria for registration as a pharmacist, you must complete 52 weeks pre-registration training (during which you can be absent for up to 40 days). If you are absent for more than 40 days during the 52 weeks, you should complete an extra training day for each extra day of absence. This will affect the earliest date that you can register as a pharmacist, if your revised training end date passes the 1st or the 15th of the month (the days on which you can join the register). 

You must tell us of your new finish date by submitting a change of training details form, so that we can update your records.

2.15  Starting dates

There are two fixed dates in the training year:

• the summer registration assessment, which is usually around the last week in June in the year after you began training
• the autumn registration assessment, which is usually around the last week in September in the year after you began training

Because you must have been signed off as satisfactory at 39 weeks to be eligible to enter the assessment, you must start your training before a set date – which is set out on the key dates page.

If you have chosen to train part time, your latest starting dates will depend on your training arrangement. Contact us for confirmation of the dates that will apply to you.

2.16  Breaks in pre-registration training

If you have had a break in your training, contact us for confirmation of your starting deadline for any particular assessment sitting.

2.17  Your tutor

You must have a designated tutor – your pre-registration tutor – who must be approved by the GPhC. The tutor has the overall responsibility for you during your training and for signing you off as satisfactory or unsatisfactory. Usually the tutor will only be responsible for one trainee at a time.

If your tutor’s previous trainee has not finished their training by the time you are due start yours, your tutor will be permitted to train two trainees for a maximum of 13 weeks – so you won’t need to wait until the previous trainee has finished before starting you placement.

Your tutor must have worked as a registered pharmacist for at least three years in the UK, in the sector of practice in which they plan to tutor you. If they are under investigation by the GPhC, they will be assessed for suitability under our pre-registration training tutor suitability policy. If you are aware of any conditions or restrictions on your tutor’s registration at any point before or during your training, contact us.

Your tutor is expected to meet with you at least once a fortnight to make sure you get regular feedback, and must carry out a formal review of your progress at 13, 26 and 39 weeks, and at the end of your training (by completing a 'final declaration', if applicable). See section 2.4 for more information about final declarations.

If your tutor cannot work full time with you (at least 28 hours over four days each week), we will consider approving more than one tutor to work with you. (This is called a ‘joint-tutoring arrangement’.) This must be approved in advance and will apply to all areas of practice.

If you are following an integrated, split or joint training programme, we expect there to be more than one GPhC approved tutor involved in your training. This could be either as part of a joint tutoring arrangement throughout the year, or as individual tutors for specified dates. It is important that this responsibility is shared in the case of joint tutors or handed over appropriately between tutors when they change over.

During the training year, you may be supervised for agreed periods by another healthcare professional, such as a pharmacist other than the designated tutor, a pharmacy technician or a nurse. These supervisors are called ‘practice supervisors’.

Your designated tutor is still responsible for you at all times, even when you are being supervised by a practice supervisor. Your designated tutor must know who is supervising you.

Our guidance on tutoring will help you understand what you can expect from your tutor. If you have any concerns about your tutor or their behaviour, contact us.

2.18 Changing tutors

Trainees may need to change tutors for a number of reasons. A tutor could leave a pharmacy, or personal or professional differences could develop between a trainee and tutor, for example.

If you change your tutor, please tell us using a change of training details form, and include your new learning contract. The new tutor must also meet GPhC requirements.

2.19  Your training site

Your training site must have been approved for the full period of your pre-registration training by the GPhC before you will be allowed to start your training. You can search the list of approved pre-registration training sites here.

If you are training at a site in Scotland, it is also covered by the quality-assurance processes of the NES Pre-registration pharmacist scheme (PRPS). Your application to train at one of these sites must be approved by NES before you submit it to the GPhC. NES will only approve your application for  that training year, so if your training was extended for any reason you would need to apply to them again.

 

2.20 Resources and support

We expect training sites to have up-to-date core reference sources, including those online, for use by employees, including trainees.

We realise you may want to look for support when you are preparing for the assessment. But we do not endorse any reference sources, books or websites that claim to offer support or sample questions. Only the questions we link to in the registration assessment section of this manual are guaranteed as genuine.

2.21  Non-patient-facing sites

Training can be undertaken in non-patient-facing sites as part of a joint placement for a maximum of 26 weeks and must form part of the 52-week training plan. Read more about deciding where and how to train

Non-patient-facing training sites could include:

• the pharmaceutical industry
• primary care organisations or their equivalent
• internet pharmacies
• schools of pharmacy
• veterinary pharmacies

The list is not limited to these sectors of practice. Before you agree your training plan for training in any other type of non-patient-facing site, you will need to apply to the GPhC.

Training can be undertaken in a variety of blocks of time across various sectors.

Sites must be suitable to support a trainee and their training.  Find out more about becoming a training site

2.22  Changing your training site

If you do change sites, ask your current tutor to fill in the relevant section of the final declaration form.

Sometimes trainees need to change their training arrangements. If you do, there are two main options:

Changing to a site within the same organisation

If circumstances at your named training site change, you may need to relocate within the organisation. As long as you are following the same training programme at the original site, you can move to another approved training site once the arrangement has been agreed by the GPhC. You must tell us about this using the change of training details form. You will need a new learning contract at your new site and you should send us this with the change of training details form.

If this also involves a change of tutor, you must also tell us about this on the change of training details form and fill in the learning contract section. This is because you and your tutor will be entering into a new learning agreement.

If you are changing training site address because the pharmacy you are training at has moved, you must make sure that the new site is approved for training.

Check with your tutor that they have submitted an Application for provision of pre-registration training form with the application to register the  pharmacy premises.

Changing to another organisation

Before choosing this option, remember:

• you may be under contract to your employer for the full training period
• it could be seen as unprofessional conduct to break an agreement you have made with your employer
• if you are having problems with your employer, then sorting them out will help you to manage similar challenges in your future practice
• changing to another site will not necessarily mean an improvement in training. Consider what you are expecting to get out of the change, and check how you can make sure this happens
• your new site must be approved as a training site by the GPhC for the full training period
• you need our approval for the new training arrangement before the change, so you need to send us a change of training details form for approval before you move to the new site
• all previous progress reports must be disclosed to your new tutor. You should be open and honest with the new site about the circumstances leading to your need to move

We would not expect you to stay in a situation where you feel that your personal safety is at risk.

Your eligibility to sit the registration assessment for the first time may also be affected. We only recognise 13-week blocks of satisfactory training. So your training at a new site will ‘start again’ from the week following the date on which your last documented satisfactory progress review was due.

However, if this is the 39-week progress review, your training will go back to week 27. This is to make sure there is enough time to make a full and fair assessment of your competence. To make an application to register, you must have completed at least 26 weeks' training at the new site. But you would be able to apply for the registration assessment if you have a documented satisfactory week-39 progress review.

If you feel that a move to another organisation is your best training option, please contact us to discuss arrangements.

Changing to another organisation due to a change of ownership of your training site

You should contact us as soon as you are aware that a change of ownership is planned at your training site. Even if you stay at the same site, we would class this as a change of organisation if the ownership changes. Your eligibility to sit the registration assessment for the first time may also be affected. We only recognise 13-week blocks of satisfactory training. So your training at a new site will ‘start again’ from the week following the date on which your last documented satisfactory progress review was due.

However, if this is the 39-week progress review, your training will go back to week 27. This is to make sure there is enough time to make a full and fair assessment of your competence. To make an application to register, you must have completed at least 26 weeks' training at the new site. But you would be able to apply for the registration assessment if you have a documented satisfactory week-39 progress review.

Important: If you want to continue training at the site after the change of ownership, the new owner will need to apply to us for the site to be approved to provide pre-registration training.

2.23  Recognising and ‘banking’ blocks of training

If your training is interrupted, or if you change your training provider, you may need us to recognise blocks of training you have already completed satisfactorily. This is so that you can ‘bank’ the training and transfer it to another provider, in case you cannot pick up your training with your present one.

You will need to send us a request to bank training form to allow us to recognise the progress you have achieved.

You will also need to do this if you do not have a satisfactory final declaration at the end of your pre-registration training and you are not able to stay on with your present training provider. This applies even if you have already made a satisfactory attempt at the registration assessment.

You may only bank training:

• that has been signed off as satisfactory by your tutor
• in 13-week blocks that have been assessed by your tutor using the GPhC progress report form.
• up to a limit of 26 weeks. This is to make sure that your new training provider has enough time to make a full and fair assessment of your competence to practise.

We are able to accept a satisfactory week-39 progress review from a previous training provider as meeting the assessment entry criteria. However, you should be sure that you feel ready to attempt the assessment, particularly if you have had a break in your training or if your reason for changing sites is related to your competence.

If you have not had any progress reports signed as satisfactory, but your tutor, at the site where you are moving from, considers that you do not need to start training again from day one, your tutor can reassess you to see if you meet the standard for week 13 or 26 to be marked as satisfactory.

If you do not have any satisfactory progress reports at all you will be expected to restart training from day one.

2.24  Pregnancy during training

Most of the issues connected to pregnancy will be covered by employment law, and will therefore be outside the scope of the GPhC as a regulator.

The effect pregnancy may have on your training will depend on your circumstances and where you are in your pre-registration year. But as a guide, the main issues you might like to consider are:

• Any health issues you have during pregnancy may mean you exceed the 40 days’ permitted absence this would mean you would need an extension to your training to cover the extra days.
• Your eligibility for a particular assessment sitting may be affected if your training needs to be cut short before the assessment entry deadline for that particular sitting.
• Your ‘fit to sit’ status may change between the assessment entry deadline and the day of the assessment. If you apply for a particular sitting, you can decide on the day whether you feel you are ‘fit to sit’.
• If you think you will need any ‘reasonable adjustments’ to allow you to take the assessment, you need to apply for them by the advertised deadlines. These cannot be arranged for you on the day without getting our agreement first.

Maternity leave

• We do not dictate how much maternity leave you are allowed to take. But there are registration deadlines that you need to consider. Contact us if you think your maternity leave will affect your ability to meet these deadlines.
• Your intended plan for returning to training following maternity leave may have changed by the time you are actually ready to return. So, although we are happy to discuss any plans you are proposing, we will only agree the training arrangement at the point when you are actually due to return.
• When you start your maternity leave you must formally notify us within 7 days of the last date you worked. You must also let us know at least 2 weeks before the date you intend to return to training.
• The date you return may affect your eligibility for a particular assessment. This will be especially so if you work part time when you return, or if you are not able to return to the same training arrangement.

You should consider ‘banking’ your training at the point when your training is interrupted. Then it can be recognised by us in case you cannot return to the same training organisation for any reason. Please see section 2.23.

 

4.3 Performance standards

The performance standards are a list of 76 performance outcomes which must be signed off by your pre-registration tutor.

There are three units of performance standards, covering:

1. Personal effectiveness
2. Interpersonal skills
3. Medicines and health

The standards are statements of what the GPhC expects you to be able to do and how you should behave if you are to register as a pharmacist. You must meet the standards consistently in order to be assessed as competent in them.

You will find more information in the Performance standards section.

4.4 Standards for initial education and training of pharmacists – required outcomes for pre-registration trainees

These are the outcomes that pre-registration trainees are expected to either know how to do, show how to do, or do competently to meet the level expected of a newly-registered pharmacist. They are linked to the units of the performance standard that they are most likely to demonstrate, but they may apply to other units too. You will find the outcomes (from section 10 of the education standards) in the Performance standards section.

Performance standards have to be met ‘in an appropriate way’ or ‘appropriately’. Your pre-registration tutor is responsible for using their professional judgement to decide whether a particular action or behaviour is acceptable.

If you do not meet a standard to the satisfaction of your tutor, they should explain to you why this is so. If you don’t understand or agree with their evaluation, you should ask them for more information.

 

4.5  Developing your competence

You should develop your competence by:

• agreeing development objectives
• agreeing your learning contract
• developing an outline training plan
• gathering a portfolio of evidence to prove your competence
• taking responsibility for your own development
• meeting all the GPhC’s pre-registration performance standards and learning outcomes
• passing the GPhC’s registration assessment

4.6  Assessing your competence as it develops

We encourage you to keep a learning log of daily activities and significant events. You can use this later to create:

• a CPD entry  - see our main website where you can download forms (with guidance) to record CPD entries, or
• another reflective account that records evidence of your competence in the relevant performance standards.

See the section below on recording your progress for more information.

Satisfactorily performing an activity just once is unlikely to prove your competence. You must demonstrate your competence consistently, in a variety of circumstances, to the standard expected of a newly registered pharmacist.

Your tutor is responsible for judging whether you have reached the necessary level of competence. This judgement should be evidence based and not a subjective decision. It should be supported by written and observed examples. If you do not agree with a judgement, ask your tutor for specific examples of your practice to clarify why they made it.

Your tutor should also assess whether you have the knowledge that you will need to demonstrate in the registration assessment, as you will need to have this knowledge to practise competently. This is part of the ongoing monitoring of your performance and should be done by open questioning such as:

• what would you have done if …?
• what factors did you take into account when you decided to…?
• what else would be important if …?
• in what circumstances would you ...?
• how would you ...?

4.7  Once you have achieved a performance standard

Once you have achieved a performance standard to the level required of a newly registered pharmacist, your tutor can sign it off. They do this on the assessment summary form.

Once you have achieved a standard you no longer need to collect evidence about it. But you will still be expected to demonstrate competence in practice. Your tutor may, if they have a good reason, reverse their decision if your performance becomes unsatisfactory in a performance standard you have already achieved.

If you have more than one tutor during your training, the expectations of each tutor could be different- which could lead to different opinions of your overall performance.  

The tutor who signs off your final declaration ultimately takes responsibility for the overall decision that you are competent. 

If you change tutors during the year, it is reasonable for a new tutor to ask you to provide further evidence to confirm that you meet any standards that have previously been signed off.  This will help to make sure that they are able to make an informed decision.

Where there is a joint tutoring arrangement in place, or a planned handover of responsibility, we would expect the tutors to communicate with each other to inform their assessment decisions.

4.8  Feedback

Feedback tells you how you are progressing. It can be good motivation to focus on things you have performed well. It can also be developmental – getting feedback about what you need to achieve or something that you need to improve. It may be an area that needs you to take ownership of tasks and decision-making processes.

As part of a constructive feedback process you should remember the following:

• lead the process, with your tutor asking for your views on your own performance before commenting
• use evidence such as facts and observed examples, rather than hearsay or assumptions
• give and receive feedback regularly – this stops you being overwhelmed with lots of it all in one go
• choose a suitable environment that allows honesty and openness in the discussion
• use appropriate verbal and non-verbal communication such as tone, pitch and body language
• be positive and act upon feedback as an aid to your personal development
• respect and ask for your tutor’s opinion
• reflect on the possible consequences of the course of action you are discussing and consider the possible outcome, whether better or worse, if you had chosen a different course of action
• identify and agree ways to improve your performance, with an appropriate time limit for reassessing your performance in that particular area
• remember it is a two-way process – you should provide constructive feedback for your tutor and their development

Most of these ideas depend on you and your tutor working together, so you both need to be committed to them. If you feel something isn’t happening in the way it should, be sure to talk to your tutor about it.

4.9  Managing problems and raising concerns

When issues crop up in the workplace, it is important that you try to sort these out locally and as soon as you can. However difficult a problem may seem, the experience of recognising, managing and resolving it can benefit you. It will help you develop the skills to manage the difficulties that you are bound to face during your future practice. You can manage and resolve problems between you and your tutor, and benefit from the experience.

If you feel a problem between you and your tutor is impossible for you to solve, you should first try to get help from a more experienced colleague or a senior manager. If there is a pre-registration manager, ask them for guidance. In some organisations you can get support from the regional or national pre-registration coordinators. It is important to tell them about any significant issues.

Performance standards A3.1 to A3.5 say you must demonstrate your competence in defining problems, and evaluating options to resolve or manage them. This does not only mean managing problems relating to patient care. Skills in this area apply in other circumstances too.

Problems with your personal training can be complicated, as they may have several causes. It is therefore important for you to define the elements of your problem. Often, the problem can be mainly about employment issues that the GPhC (as the pharmacy regulator) can’t help with. But there are several organisations that will be able to help you  with these types of problem.

Once you have planned how to deal with the employment aspects of your problem, you should consider any other aspects. Then see our guidance to help you decide whether it is appropriate to raise a concern with us.

If you would like to discuss an issue further, you can email a pre-registration training facilitator at prereg@pharmacyregulation.org.

4.10  Recording your progress

You should produce a portfolio of evidence throughout your training period which includes copies of all your documentation and evidence to support your performance. We recommend you use the revalidation CPD recording resources on the main GPhC website, to help you prepare for future practice.

It is very important to keep an up-to-date working portfolio. If you had an unexpected change of circumstances, such as a period of absence or a move to a different training site, it would help you continue your training ‘seamlessly’.

We do not specify how much evidence you need to meet the satisfactory level of competence. Mainly, it is the quality not the quantity of the evidence that is most important. However, one piece of evidence would rarely be enough to demonstrate competence. There are some exceptions to this – for example, the first-aid certificate you need to achieve performance standard C2.10.

One piece of evidence might apply to several of the performance standards, and we expect this to be documented in the written evidence.

Make sure you can justify, if challenged, why you consider that the evidence demonstrates competence against the standards claimed. If a piece of evidence clearly demonstrates competence against standards that you may not have considered, your tutor should point this out to you.

4.11  Reporting your progress to the GPhC

As well as having your regular discussions, you and your tutor must carry out a formal progress review every 13 weeks. You must then fill in a progress report form. Your assessment summary should also be updated to show how much progress you have made towards demonstrating the performance standards.

Progress must be assessed as ‘satisfactory’ or ‘unsatisfactory’.

You should then agree an action plan for the next period of your training, based on:

• any development needs identified in your progress report
• the opportunities available in your training plan, and
• the performance standards you have yet to satisfy

If you cannot carry out your progress reviews at, or near, the time they are due, you should tell us. If the week-39 report cannot be done on time please contact us.

If you have a split, joint or sandwich placement, your final declaration must be signed at the end of that placement, at 26 weeks before you leave. This will tell us when you apply to register that your training at that site has been completed successfully. You can send us a change of training details form once you have started your second six-month placement, to ensure that we have the correct address for you.

You and your tutor should keep copies of all your reports as we may ask for them at any time. If your progress report is unsatisfactory at the 13- or 26-week stage, you must send it to us when it is completed. If your report is unsatisfactory please see section 5.2. of the manual.

 

4.12  Final declaration

Your tutor will make a final assessment of your competence via myGPhC. You can request that your tutor completes your final declaration from week 49 of your training, through your myGPhC account.

This form overrides all your other progress reports. When it is signed off, the GPhC knows that the tutor has decided you are ready to start work as a newly qualified pharmacist.

If you have more than one tutor, the tutor who signs off your final declaration takes ultimate responsibility for that decision.

Once the tutor signs the declaration, they are not able to revoke it. We expect that if one of the joint tutors has concerns about your performance, they discuss this with the other tutor, and that they both agree the most appropriate outcome before completing the declaration.

We would expect your tutor(s) to consider whether they think:

• you are safe (you might be slow, for example, but do you have insight into the consequences of your actions, and are your decisions likely to have an outcome of harm?)
• you could work autonomously as a pharmacist on day one of registration (that is, that can you work unsupervised)
• your fitness to practice impaired (that is, you behave as we would expect a pharmacist to behave)
• you have met and been signed off on all the performance standards?

4.13  If a trainee cannot be signed off as competent

Tutors and trainees should always document any performance issues that have arisen throughout the year, as well as the meetings about them and actions taken to improve performance.

If a trainee has not met all the performance standards because of problems or slow progress and needs to have an extension to their training, this should have been identified and discussed before their entry to the registration assessment. You should also have told us about the proposed revised finish date using a change of training details form

Training can continue at the site for the length of time needed to achieve the required standard. But this needs to take into account the eight-year time limit from entry into the MPharm degree, or four years for OSPAP qualifications.

If an employer cannot extend the training period and the trainee has to relocate, they will usually need to spend at least six months in the new placement.

4.14  Observed evidence

There are various types of observed evidence. Here are some examples:

Summative assessment

This is when you take a formal assessment at the end of a set activity. This should be planned in advance and it assesses learning by awarding marks or – in this context – whether performance standards are signed off.

Examples could include:

• taking an in-patient medication history in hospital
• demonstrating how to use inhalers
• measuring and fitting hosiery
• preparations prepared ‘on the spot’ including formula, calculation and procedures
• an accuracy log of dispensed or final checked medications

Formative assessment

This is when you take part in a reflective process, involving feedback, that assesses a set activity. It should be used as a platform for you to highlight good practice or areas for improvement.

Examples could include:

• counselling a patient who has come to the pharmacy to collect their prescription
• dealing with a request for an immediate supply of a prescription-only medication
• involvement in a heated discussion with other staff members, either as a participant or to calm things down
• challenging a prescriber directly to change a prescription
• answering the phone and managing the enquiry

Simulation

This is when you make an observation of a hypothetical situation. It could be based on an issue you have previously managed in practice, an objective structured clinical examination (OSCE) or a role play during a study day.

Examples could include:

• case presentation or care plan based on actual or hypothetical problems
• patient counselling examples practised with other staff members
• one-to-one hypothetical discussion with the practice supervisor
• case studies in an online or paper-based training package

Written evidence

There are various types of written evidence. Here are some examples:

CPD entry – Continuing professional development is a key part of revalidation, which pharmacists and pharmacy technicians must carry out as part of their registration requirements. It helps them to keep their professional skills and knowledge up to date, to reflect on how to improve and to show how they provide the safe and effective care that patients and the public expect. There is more information about revalidation on our main website, and you can download forms (with guidance) to record CPD entries and share them with your tutor.

Witnessed accounts – You can write an account of how you carried out a task or managed a situation. You can have this verified by a witness that was present at the time, but who does not have responsibility for training or supervising your practice. A witnessed account can also be in the form of patient feedback.

Projects and assignments in the workplace – A classic example of this is that all trainees have to successfully engage in a quality-improvement process if they are to meet performance standard A4.8. Accredited certificates for internal and external learning events or a first-aid certificate would come into this category.

Documented workplace assessments – Examples could include:

• a sterile technique broth test
• dispensing accuracy logs
• using clinical assessment tools, as used by doctors in training or pharmacy diploma practitioners, such as mini-CEX, mini-PAT or mini-TAB
• anonymised copies of prescriptions and other patient information

These can be excellent examples for you to demonstrate when you have identified a clinical issue such as a drug interaction, and also allow you to write up how you resolved the issue.

5.4  Preparing for the registration assessment

After each assessment sitting, the board of assessors - who are responsible for setting and assuring the registration assessment - produce feedback about the topics that candidates found difficult. Use the latest feedback documents below to help you prepare for your attempt:

• July 2021
• March 2021
• September 2019
• June 2019
• September 2018
• June 2018

The registration assessment framework  [PDF 209.46 KB] sets out the outcomes that will be tested and gives an idea of some of the topics this may cover.

Sometimes there are changes in practice close to the assessment day. You should answer any questions in the assessment as you would in practice on that day. If there has been a change in practice that affects a question after it has been written, this will be considered by the Board of Assessors after the sitting.

Make sure that if you attend any study days, or use any study materials, that they are up to date.

5.5  Requesting a reasonable adjustment for the registration assessment

If you have a specific need which you feel could disadvantage you when sitting the registration assessment, you can request a ‘reasonable adjustment’ to the assessment conditions. The specific need can be a temporary or permanent one.

You can find out more about requesting an adjustment on the registration assessment application page of the main website.

When you request an adjustment, you must tell us:

• the nature of your specific need
• how this specific need would affect your ability to sit the assessment
• what reasonable adjustment you are requesting and how it will support you during the assessment

You also need to include evidence to support your request. This evidence must be from a doctor or another appropriately qualified person, and must give details of how your specific need would affect you during the assessment. The person providing supporting evidence will need to have read and understood the assessment specification.

It is important that the evidence relates directly to the reasonable adjustment you are requesting.

Your request will be considered by the GPhC’s adjustment panel. This is an independent panel made up of an educational disability specialist and two members of the GPhC board of assessors (which sets and moderates the registration assessment).

If your request for an adjustment is not granted you have the right to appeal the decision. You must do this by the deadline given for the sitting. 

5.6  Making a decision to sit the registration assessment

Am I ‘fit to sit’?

It is very important that you only sit the registration assessment if you are fit to do so. Being ‘fit to sit’ means that you do not know of any reason why your performance would be adversely affected on the day of the assessment.

If you are aware of anything that might affect your performance on the day, you should not sit the assessment – even if it is a difficult decision to make.

You are eligible to withdraw from a sitting at any time up until the assessment begins. Once you have decided to withdraw, you will not be able to attempt the assessment. The final point at which you are able to withdraw from the sitting will be made clear to you. By continuing with the sitting after this point, you have declared yourself 'fit to sit'. This means that we will not consider as grounds for an appeal any reason that was known to you before your decision to sit the assessment.

You can find more information about deciding if you are fit to sit in the registration assessment application section of the main website.

5.7 Nullification requests

If you start the assessment and then have problems during the sitting which significantly affect your performance, you can request that your attempt is ‘nullified’ under the registration assessment regulations that apply to the sitting. You must let an invigilator know as soon as possible if you have problems during the sitting. They will fill in a report form to verify your problem. It is very important that you do not wait until receiving a 'fail' notification before contacting us to tell us anything that has affected your performance.

If your attempt is nullified, it will not count towards the three attempts you can have to pass the assessment, and you will not find out your result.

The decision to grant the nullification will be made by the board of assessors based on your request, and is not guaranteed to be accepted. They will not know what your marks were.

You cannot request a nullification after you have received your results.

If you decide to sit the assessment again, you must apply as normal and you will need to pay another entry fee.

You can find more information about nullification requests in the registration assessment section of the main website.

 

5.9 Registration assessment outcomes

10.1     Expectations of a pharmacy professional
Future pharmacists outcome		Indicative assessment topics
Low	Recognise the duty to take action if a colleague’s health, performance or conduct is putting patients or the public at risk	Regulatory standards and guidance documents Action to take if a colleague’s conduct has the potential to affect patient or public health
Low	Apply the principles of clinical governance in practice	Purpose and principles of clinical governance Risk management in pharmacy and other healthcare contexts Systems to reduce medication errors
Low	Demonstrate how the science of pharmacy is applied in designing and developing medicines and devices	Factors affecting the stability of medicinal products Procedures for the dilution of solid, semi-solid and liquid dosage forms
Medium	Respond appropriately to medical emergencies, including providing first aid	Appropriate responses to medical emergencies

 

10.2	The skills required in practice
10.2.1	Implementing health policy
Future pharmacists outcome		Indicative assessment topics
High	Access and critically evaluate evidence to support the safe, rational and cost-effective use of medicines	Principles of obtaining and applying evidence for use in current practice Interpreting and applying information to improve patient care
Medium	Apply knowledge of current pharmacy-related policy to improve health outcomes	Principles of promoting healthy lifestyles including current pharmacy-related policy Collaboration across the healthcare professions to improve patient outcomes Purpose of prescribing guidelines

 

10.2.2	Validating therapeutic approaches and supplying prescribed and over-the-counter medicines
Future pharmacists outcome		Indicative assessment topics
High	Identify and employ the appropriate diagnostic or physiological testing techniques in order to promote health	Selecting appropriate diagnostic or physiological testing techniques for use in clinical decision-making and to promote health Normal ranges for test results, and actions to take when results are out of the normal range
Medium	Identify inappropriate health behaviours and recommend suitable approaches to interventions	Concepts of health promotion, health education and health improvement programmes, based on national and local health priorities and parameters Role of pharmacists and pharmacy support staff in promoting health and preventing disease Behavioural change as a tool to support health promotion Social, environmental and dietary factors that influence health
High	Instruct patients in the safe and effective use of their medicines and devices	Identifying appropriate advice on the use of medicines
Medium	Analyse prescriptions for validity and clarity	Legal and professional requirements for prescriptions, to enable the safe and legal supply of medicines
High	Clinically evaluate the appropriateness of prescribed medicines	Appropriateness of prescribed medicines, for example in the context of presenting conditions, associated diseases, and test results Circumstances in which prescribed medicines are contra-indicated Interactions that occur between medicines (either prescribed or purchased), and between these medicines and food or other substances Use of licensed, off-label and unlicensed medicines including providing information to patients
High	Provide, monitor and modify prescribed treatment to maximise health outcomes	Principles of medicines management, medicines optimisation and pharmaceutical care Dosages and dose adjustments, especially for people with particular needs due to, for example, age or health conditions Reasons for treatment failures Recognising and managing adverse effects of medicines Mechanism of action, administration, absorption, distribution, metabolism and excretion of medicines
Low	Record, maintain and store patient data	Maintaining confidentiality, and disclosing information both with and without the subject’s consent Information governance Requirements for recording, maintaining and storing data
Med	Supply medicines safely and efficiently, consistently within legal requirements and best professional practice. NB: This should be demonstrated for both human and veterinary medicines	Statutory regulations and professional requirements for the supply of human and veterinary medicines

 

10.2.3	Ensuring that safe and effective systems are in place to manage the risk inherent in the practice of pharmacy and the delivery of pharmaceutical services
Future pharmacists outcome		Indicative assessment topics
Low	Ensure the quality of ingredients to produce medicines and products	Quality assurance processes for medicines and ingredients Storage requirements for medicines and ingredients
Med	Apply pharmaceutical principles to the formulation, preparation and packaging of products	Formulation, preparation and packaging of products
High (Part 1)	Use pharmaceutical calculations to verify the safety of doses and administration rates	Accurately perform calculations affecting patient care
Low	Procure and store medicines and other pharmaceutical products working within a quality assurance framework	Procurement and storage of medicines Additional precautions necessary for particular formulations
Low	Dispose of medicines safely, legally and effectively	Statutory regulations covering the safe, legal and effective disposal of medicines Procedures for the disposal of special and controlled waste from the pharmacy
Low	Identify, report and prevent errors and unsafe practice	Supervising others involved in service delivery Identifying, reporting and preventing errors and unsafe practices Responding to complaints and concerns

 

10.2.4	Working with patients and the public
Future pharmacists outcome		Indicative assessment topics
High	Identify and employ the appropriate diagnostic or physiological testing techniques to use in clinical decision-making	Identifying appropriate diagnostic or physiological testing techniques, and interpreting results Identifying conditions that need referring to another healthcare professional Identifying conditions that may be treated by non-prescription medicines

 

10.2.5	Maintaining and improving professional performance
Future pharmacists outcome		Indicative assessment topics
Low	Demonstrate the characteristics of a prospective professional pharmacist as set out in relevant codes of conduct and behaviour	Characteristics and expected behaviours of a pharmacist as set out in the relevant standards and guidance Principles and application of the professional duty of candour
Low	Participate in audit and in implementing recommendations	Purpose of audit and principles of audit procedures Principles of change management
Low	Contribute to the development and support of individuals and teams	Principles of identifying, and responding to, the learning and development needs of professional team members Principles of revalidation and regulatory requirements

Therapeutic areas

Questions in part two that relate to clinical care are linked to key therapeutic areas. An individual question may link to multiple therapeutic areas: for example, a patient may be described who has hypertension and type 2 diabetes. The weighting given to individual therapeutic areas is shown in the table below.

Therapeutic area	Weighting
Cardiovascular system	High
Nervous system	High
Endocrine system	High
Infection	High
Genito-urinary tract system	Medium
Gastro-intestinal system	Medium
Respiratory system	Medium
Immune system and malignant disease	Medium
Blood and nutrition	Medium
Musculoskeletal system	Low
Eye	Low
Ear, nose, and oropharynx	Low
Skin	Low
Vaccines	Low
Anaesthesia	Low

 

High-risk drugs

Each assessment is likely to include at least one question on each of the following drugs or drug groups:

• antibiotics
• anticoagulants
• antihypertensives
• chemotherapy
• insulins
• antidiabetic drugs
• drugs with a narrow therapeutic index
• non-steroidal anti-inflammatory drugs
• methotrexate
• opiates
• parenteral drugs
• valproate

Paediatrics

Around 20 per cent of questions in the assessment will relate to paediatric patients.

Calculations

Each assessment is likely to include at least one calculation question involving each of the following in part 1:

• doses and dose regimens
• dosage and unit conversions
• estimations of kidney function
• displacement volumes and values
• concentrations (e.g. expressed as w/v, % or 1 in x)
• dilutions
• molecular weight
• using provided formulae
• infusion rates
• pharmacokinetics
• health economics
• quantities to supply

Some questions in part 2 will require some calculation.

Additional resources
Additional resources are provided for up to 25% of questions in part 1 and part 2 of the registration assessment. Examples of additional resources include photographs and dosing information.

 

Personal effectiveness

These standards cover the aspects of performance and behaviour that support effective professional activity. They can be applied to any situation. Your conduct must be consistent with ethical behaviour expected by the GPhC, and you must:

• have a proper regard for accepted standards of behaviour both within and beyond professional practice
• promote and safeguard the interests of the public
• justify public trust in your knowledge, ability and judgement
• promote the good standing of the profession
• avoid any act or omission which would damage confidence in the profession

 

A.1  Manage self

You must at all times demonstrate a level of self-awareness, responsibility and self-management that will allow you to practise effectively, both independently and within teams or groups.

As a trainee you must show that you:

A1.1 Behave in a manner consistent with membership of the profession

A1.2 Manage your time effectively (1)

(1) This will include time at work and using time outside work for personal and professional development. It will include prioritising tasks, planning, timekeeping and managing interruptions.

A1.3 Recognise your personal and professional limitations and refer appropriately (2)

(2) In this context, ‘appropriately’ means referring when necessary, to the correct person, in a suitable way.

A1.4 Respond with willingness and flexibility to new situations and to change

A1.5 Remain composed and personally effective (3) in all situations (4)

(3) This may, in extreme circumstances, include removing yourself from a situation to maintain your self-control and to minimise risks to patients.

(4) Situations will include challenging behaviour from colleagues or clients, periods of heavy workload and times of stress.

A1.6 Make decisions which demonstrate clear and logical thought

A1.7 Take responsibility for, and accept outcomes of, your own decisions

A1.8 Amend your behaviour, when necessary, based on evaluation of your performance by yourself or others

Required outcomes from the GPhC standards for initial education and training of pharmacists say that a pre-registration trainee must:

• recognise ethical dilemmas and respond in accordance with relevant codes of conduct
• know when there is a duty to take action if a colleague's health, performance or conduct is putting patients or the public at risk
• identify, report and prevent errors and unsafe practice
• recognise personal health needs, consult and follow the advice of a suitably qualified professional, and protect patients or the public from any risk posed by personal health
• apply the principles of clinical governance in practice
• demonstrate the characteristics of a prospective professional pharmacist as set out in relevant codes of conduct and behaviour

 

A.2 Manage work

Trainees must at all times work efficiently and effectively, and within legal and ethical constraints.

As a trainee you must show that you:

A2.1 Carry out tasks effectively (5)

(5) In this context ‘effectively’ means correctly, in an organised manner, with proper attention to detail and at a pace appropriate to the level of business. It includes prioritising and completing tasks within agreed deadlines.

A2.2 Approach tasks and situations in accordance with the law and with the GPhC standards for pharmacy professionals.

A2.3 Follow work systems correctly (6)

(6) Work systems include your own working practices, standard operating procedures, Sale of Medicines protocol, and your organisation’s systems and security procedures.

A2.4 Use resources effectively (7)

(7) Resources include colleagues, other healthcare workers, workspace, equipment, material and both text-based and electronic references.

 

A.3 Manage problems

Trainees must demonstrate that they can handle a wide variety of problems, whether by resolving them themselves or by contributing to their resolution.

As a trainee you must show that you:

A3.1 Recognise and define actual or potential problems (8)

(8) Problems include difficulties, minor and serious, needing resolution

A3.2 Identify workable options to resolve the problem

A3.3 Select the best solution, based on sound analysis (9) and appropriate evidence

(9) Sound analysis will include:

• exploring the strengths and weaknesses of options
• considering barriers to resolving the problem
• discussion with others.

A3.4 Suggest and, if appropriate, implement solutions to problems

A3.5 Evaluate the outcome of the solution after implementation, and if necessary re-define the problem. See section A3.1.

 

A.4 Demonstrate a commitment to quality

Products and services should be delivered to the highest standard by ensuring quality. The prime concern must be the welfare of the patient and other members of the public.

As a trainee you must show that you:

A4.1 Work to an acceptable standard (10) when preparing products and delivering services

(10) As defined by GPhC standards for pharmacy professionals with a focus on providing safe and effective care.

A4.2 Check your own work effectively

A4.3 Minimise error by others through effective supervision

A4.4 Identify and rectify your own and others’ mistakes promptly and effectively

A4.5 Minimise health and safety risks to yourself and others

A4.6 Base your actions, advice and decisions on evidence (11)

(11) rather than assumption, anecdote or hearsay.

A4.7 Obtain and process the evidence you need to meet A4.6 (12)

(12) by effectively gathering, reviewing, evaluating and applying research evidence.

A4.8 Have successfully engaged in a quality improvement process (this could be achieved, for example, by carrying out a small audit assignment, or completing a PDSA cycle)

Required outcomes from the GPhC standards for initial education and training of pharmacists say that a pre-registration trainee must:

• show how to manage resources in order to ensure work flow and minimise risk in the workplace
• take personal responsibility for health and safety
• ensure the application of appropriate infection control measures
• show how to participate in audit and implementing recommendations
• show how to anticipate and lead change.

 

A.5 Demonstrate ongoing learning & development

Trainees must provide evidence that they are continually developing professional competence by applying what they have learned from daily activities and incidents, and from formal learning opportunities.

As a trainee you must show that you:

A5.1 Identify and prioritise your own learning and development needs, based on self-reflection/evaluation and on feedback from others

A5.2 Develop your own plans to meet identified needs, using SMART learning objectives. Plans should include a variety of learning activities, such as:

• using reference sources
• undertaking distance or IT learning packages
• work shadowing (observation of others at work)
• discussion with tutor or colleagues in and outside the pharmacy
• attending local practice forum meetings
• giving talks/presentations
• attending events e.g. courses, seminars, conferences, British Pharmaceutical Students' Association (BPSA).

A5.3 Make full use of learning and development opportunities(13)

(13) opportunities will arise from the activities listed in A5.2 and from daily activities (for example, dealing with new tasks and situations, handling problems).

A5.4 Evaluate whether your learning objectives have been met

A5.5 Identify your further learning needs

A5.6 Record your own learning and development process and outcomes

A5.7 Apply learning to practice

Required outcomes from the GPhC standards for initial education and training of pharmacists state that a pre-registration trainee must:

• reflect on personal and professional approaches to practice
• create and implement a personal development plan
• review and reflect on evidence to monitor performance, and revise a professional development plan

 

Interpersonal skills

These standards cover the aspects of performance and behaviour that involve any interaction with others. You must demonstrate your ability to communicate at all levels and to work with others in the pharmacy and healthcare team. In doing this, you will show that you possess the core characteristics of an empathetic healthcare professional:

• seeing and understanding things from the perspective of others, especially patients
• communicating effectively
• working with people from other disciplines

B.1 Communicate effectively

Trainees must demonstrate communication skills that promote the provision of a quality service

As a trainee you must show that you:

B1.1 Communicate effectively ⁽¹⁾ in English

⁽¹⁾ ‘Effectively’ here means that you are competent enough in English to understand and be understood in writing, on the phone and in person.

B1.2 Behave in a polite and helpful manner

B1.3 Sensitively approach people who need or who may need assistance

B1.4 Elicit all relevant information by the use of appropriate questions

B1.5 Listen effectively to the whole message ⁽²⁾

⁽²⁾ this includes the spoken word, body language and tone of voice

B1.6 Respect and observe confidentiality

B1.7 Act appropriately in response to spoken and unspoken needs of others ⁽³⁾

⁽³⁾ ‘Others’ will include people with special needs and people from different backgrounds and with different lifestyles.

B1.8 Behave in a manner which instills confidence

B1.9 Behave assertively

B1.10 Use appropriate body language

B1.11 Provide information and advice appropriate to the needs of the recipient(s) ⁽⁴⁾

⁽⁴⁾ ‘Recipients’ must include individuals, groups and people with particular needs, for example people with diabetes, asthma and so on.

B1.12 Handle conflict ⁽⁵⁾ appropriately ⁽⁶⁾

⁽⁵⁾ this will include taking action to prevent conflict wherever possible.

⁽⁶⁾ evidence must cover conflict arising from complaints, aggressive behaviour and from disagreements with or among colleagues.

Required outcomes from the GPhC Standards for initial education and training of pharmacists say that a pre-registration trainee must:

• communicate with patients about their prescribed treatment
• optimise treatment for individual patient needs in collaboration with the prescriber
• support the patient in choosing an option by listening and responding to their concerns and respecting their decisions
• communicate information about available options in a way that promotes understanding
• conclude consultations to ensure a satisfactory outcome
• provide accurate written or oral information appropriate to the needs of patients, the public or other healthcare professionals

B.2 Work effectively with others

Trainees must contribute positively to any team or group they are associated with, so that targets and goals are achieved. They must develop and demonstrate the skills involved in managing and supervising others. This recognises that most pharmacists have these responsibilities.

As a trainee you must show that you:

B2.1 Acknowledge the ideas and opinions of others ⁽⁷⁾ and act on them when appropriate

⁽⁷⁾ ‘Others’ must include junior and senior colleagues and external contacts.

B2.2 Present your own ideas and opinions appropriately when speaking and in writing

B2.3 Meet commitments ^{(8 )}made to others within agreed deadlines

⁽⁸⁾ this will include giving a clear explanation if you cannot meet a commitment.

B2.4 Give constructive feedback ⁽⁹⁾ to others based on accurate evaluation of their performance

⁽⁹⁾ This must include both positive and negative feedback.

B2.5 Secure help from others when necessary in an appropriate manner

B2.6 Assist others when necessary

B2.7 Delegate tasks appropriately ⁽¹⁰⁾

⁽¹⁰⁾ when necessary and in a manner that supports team working.

B2.8 Supervise others in an appropriate manner to ensure that agreed outcomes are achieved

B2.9 Use your knowledge and skills effectively when helping others learn

Required outcomes from the GPhC Standards for initial education and training of pharmacists say that a pre-registration trainee must:

• contribute to the education and training of other members of the team, including peer review and assessment
• show how to contribute to the development of other members of the team through coaching and feedback
• engage in multidisciplinary team working
• work effectively within teams to ensure that safe and effective systems are being followed
• supervise others involved in service delivery
• establish and maintain patient relationships while identifying patients' desired health outcomes and priorities
• contribute to identifying the learning and development needs of team members
• contribute to the development and support of individuals and team

 

Medicines and health

These standards include aspects of performance and behaviour that are specific to pharmacy practice. Trainees must demonstrate their ability to provide an effective pharmaceutical service.

Developing the following skills and abilities will be at the heart of your role as a provider of pharmaceutical care:

• identifying health needs and understanding the opportunities for health promotion as well as treatment and care
• working with patients and carers to manage their medicines and making sure they can play an active part in the decisions and choices affecting their treatment or care
• understanding and using the whole health and social care system for the benefit of patients

To achieve this unit you must have experience in or awareness of all the following:

• the pharmacist’s role in both the community and hospital
• the way the healthcare system works for patients in the community and hospital
• supply of medicines in both the community and hospital
• providing advice about medicines and health
• using patient medication records and histories
• working with local formularies and prescribing guidelines
• using the full range of reference sources specified by the GPhC
• using a full range of dispensary equipment

C.1 Manage the dispensing process

Trainees must be able to provide an effective service for the supply of prescribed medicines, dressings and appliances. You should demonstrate your ability to deliver this service by carrying out dispensing and by effectively managing dispensing carried out by others.

As a trainee you must show that you:

C1.1 Correctly ⁽¹⁾ receive prescriptions into the pharmacy

⁽¹⁾ ‘Correctly’ includes following protocols, correct charging and exemption procedures, and providing necessary information.

C1.2 Check the prescription is valid ⁽²⁾

⁽²⁾ ‘Valid’ means legible, accurate, complete, following legal requirements, not fraudulent.

C1.3 Assess the prescription for safety and clinical appropriateness. This will include:

• appropriateness according to patient's condition, if known
• meeting the patient's need with view to minimising waste dosage within therapeutic range
• appropriate dosage form
• appropriate route of administration
• appropriateness according to patient's parameters (age, weight, etc) and previous medication
• compatibility with other medication, if known
• consistency with formularies, clinical guidelines and protocols, if known
• possible side effects
• risk of adverse drug reactions
• potential for non-compliance, inappropriate use or misuse by patient
• any other contra-indications

C1.4 Resolve any identified problems ⁽³⁾ appropriately

⁽³⁾ this will include any problems arising from C1.2, C1.3 or from stock availability.

C1.5 Perform calculations ⁽⁴⁾ correctly

⁽⁴⁾ Calculations must include all the following:

• formulations for creams and ointments
• complex solutions and suspensions
• IV formulations including cytotoxics
• parenteral nutrition and infusions
• doses and dosing schedules
• dose adjustment in paediatrics and in particular conditions such as renal failure
• IV dosing quantity to supply
• loading dose/steady state calculations
• calculations for syringe pumps and drivers, infusion pumps and nutrition pumps

C1.6 Assemble ⁽⁵⁾ the prescription correctly

⁽⁵⁾ this includes packaging and producing computer-generated labels.

C1.7 Supply ⁽⁶⁾ extemporaneously prepared products according to the correct formula

⁽⁶⁾ both by preparing and by ordering from a specialist manufacturing unit.

C1.8 Correctly issue dispensed item(s) to patient or representative, with appropriate information and advice

C1.9 Ensure stock is managed ⁽⁷⁾ correctly

⁽⁷⁾ this will include ordering, checking on delivery and dealing with discrepancies, stock rotation, dealing with recalls and returned items, storage and disposal.

C1.10 Respond appropriately to requests ⁽⁸⁾ to dispense prescription-only items without a prescription ⁽⁹⁾

⁽⁸⁾ requests from patients or their representatives and from prescribers.

⁽⁹⁾ By law, a pharmacist must have interviewed the patient and made the decision to supply. To meet this standard you should, with the patient's consent, listen to the interview, dispense the product and make the entry in the register (with checking by the pharmacist).

C1.11 Correctly process necessary documentation ⁽¹⁰⁾

⁽¹⁰⁾ this includes endorsing in hospital and the community, filing, stock control and completing PMRs, CD records and the prescription register.

C1.12 Effectively check prescriptions dispensed by others.

Required outcomes from the GPhC standards for initial education and training of pharmacists state that a pre-registration trainee must:

• analyse prescriptions for validity and clarity
• clinically evaluate the appropriateness of prescribed medicines
• provide, monitor, and modify prescribed treatment to maximise health outcomes
• know how to demonstrate how the science of pharmacy is applied in the design and development of medicines and devices
• record, maintain and store patient data
• show how to develop quality management systems, including maintaining appropriate records
• manage and maintain quality management systems, including maintaining appropriate records
• supply medicines safely and efficiently, consistently within legal requirements and best professional practice. NB - this should be demonstrated in relation to both human and veterinary medicines
• show how to ensure the quality of ingredients to produce medicines and products
• show how to apply pharmaceutical principles to the formulation, preparation and packaging of products
• use pharmaceutical calculations to verify the safety of doses and administration rates
• procure and store medicines and other pharmaceutical products working within a quality assurance framework
• distribute medicines safely, legally and effectively
• dispose of medicines safely, legally and effectively
• know how to procure, store and dispense and supply veterinary medicines safely and legally

C.2 Provide additional clinical and pharmaceutical services

Trainees must demonstrate the application of up-to-date clinical and pharmaceutical knowledge.

It must be used effectively in the following areas:

• the management of prescribed medicines, long-term conditions and common ailments
• the promotion and support of healthy lifestyles
• the provision of advice and support to patients and other healthcare professionals

Competence in this element underpins the ability to manage medicines and provide pharmaceutical care.

As a trainee you must show that you:

C2.1 Provide considered and correct answers to queries, founded on research-based evidence ⁽¹¹⁾

⁽¹¹⁾ Evidence sources will include clinical textbooks, journals and pharmaceutical company information (paper based or electronic).

C2.2 Pro-actively ⁽¹²⁾ assist patients ⁽¹³⁾ to obtain maximum benefit from their treatment

⁽¹²⁾ this will include identifying opportunities to help, providing information, positive reinforcement, reassurance, testing understanding, and encouraging the recipient to ask questions.

⁽¹³⁾ Directly or through their representatives.

C2.3 Identify and take action to minimise risk to patients from their treatment

C2.4 Actively provide information and advice to healthcare professionals

C2.5 Construct medication histories ⁽¹⁴⁾ using a range of sources

⁽¹⁴⁾ These must include basic and comprehensive histories.

C2.6 Use medication histories correctly ⁽¹⁵⁾

⁽¹⁵⁾ Access existing information, record new information and apply the information.

C2.7 Recognise possible adverse drug reactions, evaluate risks and take action ⁽¹⁶⁾ accordingly

⁽¹⁶⁾ this may include advising and informing the patient or their representative, discussions with colleagues and reporting in line with local and national protocols.

C2.8 Provide appropriate information and advice on the management of minor and common ailments ⁽¹⁷⁾

⁽¹⁷⁾ Information and advice must include both appropriate self-medication and appropriate non-drug actions.

C2.9 Effectively use opportunities ⁽¹⁸⁾ to promote and support healthy lifestyles and prevent disease

⁽¹⁸⁾ with individual patients and at formal events such as presentations to patient or public groups.

C2.10 Demonstrate awareness ⁽¹⁹⁾ of emergency first aid

⁽¹⁹⁾ by successfully completing a training course from a recognised provider such as St John Ambulance - there is special guidance on first aid below. 

C2.11 Refer, or direct the person, to a more suitable source ⁽²⁰⁾ of help or information, when necessary

⁽²⁰⁾ For example: support groups, GP, hospital A&E department

Required outcomes from the GPhC Standards for initial education and training of pharmacists say that a pre-registration trainee must:

• provide evidence-based medicines information
• show how to respond appropriately to medical emergencies, including provision of first aid
• promote healthy lifestyles by facilitating access to and understanding of health promotion information
• know how to access and critically evaluate evidence to support safe, rational and cost-effective use of medicines
• use the evidence base to review current practice
• apply knowledge of current pharmacy-related policy to improve health outcomes
• show how to collaborate with patients, the public and other healthcare professionals to improve patient outcomes
• know how to play an active role with public and professional groups to promote improved health outcomes
• know how to contribute to research and development activities to improve health outcomes
• show how to identify and employ the appropriate diagnostic or physiological testing techniques in order to promote health
• show how to identify and employ the appropriate diagnostic or physiological testing techniques to inform clinical decision making
• identify inappropriate health behaviours and recommend suitable approaches to interventions
• instruct patients in the safe and effective use of their medicines and devices
• obtain and record relevant patient medical, social and family history
• maintain accurate and comprehensive consultation records

Special guidance on first aid

The public expects a pharmacist to be able to help if there is an accident or emergency near the pharmacy or in the pharmacy itself. It also expects a pharmacist to be an appropriate person to phone for advice in an emergency.

The GPhC wants to make sure that all new pharmacists are ready for this role if they need to perform it. However, most employers have a policy of designating certain members of staff as first-aiders to handle all health emergency situations, and this may not be the pharmacist.

Pharmacists can take professional indemnity insurance to cover for first aid activities.

Meeting the standard 

This standard can be met by attending a first aid course by a recognised provider such as St John Ambulance. Or, it may be appropriate for a registered first-aider at the training site to train and assess pre-registration trainees.

The course or training should teach you how to assess and identify the nature of emergency situations and, after this, the appropriate action you should take including referral where appropriate.

As a minimum, training should cover the following conditions:

• obstruction to airways
• CPR
• shock
• electric shock
• overdoses and poisoning
• a seizure
• hypoglycaemia or hyperglycaemia
• loss of consciousness
• severe bleeding
• burns and scalds
• head injuries and concussion
• severe pain in head, chest or abdomen
• allergic reactions

Also, training for situations that need first aid but are not usually life threatening should include, as a minimum:

• minor allergic reactions
• foreign bodies or chemicals in the eye
• mild shock
• minor burns and scalds
• injuries to bones, muscles, joints
• minor bleeding.