Clinically Enhanced Pharmacist Independent Prescribing

Managed by the School of Pharmacy and Pharmaceutical Studies, this programme prepares pharmacists to practice as Independent Prescribers and meet the standards set by the General Pharmaceutical Council (GPhC).

It can either be undertaken as a stand-alone module (intakes September and March) or as part of a post-graduate programme e.g. Diploma (intake September) or Post-registration Foundation Training programme (intakes September and January).

Course aims

We aim to enable practitioners to become pharmacist-independent prescribers, with the appropriate knowledge, skills, attributes and competencies, relevant to their scope of practice, to prescribe safely and effectively.

Skills such as enhanced clinical, patient assessment, and differential diagnosis skills will also be developed and practitioners will further develop their critical analysis and personal reflection skills, key to lifelong professional development.

Successful completion of this module will allow the participants to become annotated as a pharmacist-independent prescribers on the General Pharmaceutical Council’s register.

Course description

We have two intakes for our 40 credit, level 7, stand-alone Clinically Enhanced Pharmacist Independent Prescribing programme. The first intake is in September and the second intake is in March.

You can also complete the 40-credit Clinically Enhanced Pharmacist Independent Prescribing module as part of one of the School’s postgraduate programmes (Programme Directors for these programmes will communicate with the students regarding the dates of the modules).

Course accreditation

The General Pharmaceutical Council (GPhC) re-accredited the programme in 2021. More details on their learning outcomes and the accreditation process can be found on the Pharmacy Regulation website and our most recent reaccreditation report, can be found here.

The programme was accredited against the new standards in 2023.

Course structure

We have developed this part-time (approximately 6 months) competency-based programme based on our experience of running non-medical prescribing programmes since 2004.

We have gained a thorough understanding of the requirements during that time and this programme is built on meeting pharmacists’ needs and providing an inspiring and excellent experience. As such, the programme will concentrate on developing consultation, patient assessment and clinical decision-making skills.

The programme consists of the following:

• 12 study days, held either online (n=4) or at Cardiff University during the week (n=8)
• directed and self-directed study
• 90 hours under the supervision of the Designated Prescribing Practitioner (DPP)
• assessments

As the course is 40 credits, you will need to dedicate approximately 400 hours to this programme, which equates to around 8-10 hours of work each week (this excludes study days and time with DPP).

Study days

You’ll participate in 12 study days which are usually split for the stand-alone module into six blocks of two days. Three of the six study blocks are currently delivered online; the other three blocks are based at the Redwood Building, Cardiff University, Cardiff.

Our teaching methods include a mixture of lectures, workshops, case studies and discussions. Consultation skills and patient assessment skills are of fundamental importance to the new prescriber, and we will therefore focus your learning in these areas. We use professional healthcare actors in realistic consultations in a controlled environment, to help you develop the core skills. These can be video recorded, allowing you to reflect upon and critique your skills. We have received exceptional feedback from previous students regarding these 'real-life' teaching methods.

It is expected that you will attend all the study days (100% attendance required).

Directed and self-directed learning

We will provide directed learning, guiding you to the appropriate reading about the prescribing competencies you’ll be developing. You’ll also be expected to undertake specific directed reading about patient assessment skills. This involves reading about the anatomy of the human body, as well as the assessment of the different human body systems. Online resources are also available to help complement the teaching and to help you develop these skills.

Time in practice

Based on the current GPhC requirement, you will need to have a minimum of 90 hours of supervised time with the DPP. This time will give you the chance to critically reflect and apply the principles of prescribing to your scope of practice.

Of the 90 hours, at least 45 hours need to be directly with your DPP and the remainder can be with other agreed healthcare professionals or personnel. At least 20 hours need to be spent with medics in the same scope of practice as yourself for portfolio-related activities.

During the 90 hours, no more than 20 hours can be observing others, you should aim to have no more than 30 hours actively participating in consultations and at least 30 hours leading consultations.

The Royal Pharmaceutical Society has developed a Competency Framework for DPPs. This is split into three domains: The DPP themselves, Delivering the role and Learning environment and governance. Please review this guidance and ensure that the DPP meets the competencies.  In particular please ensure they:

• are an experienced prescriber in a patient-facing role (defined as an active prescriber who would normally have at least 3 years of recent prescribing experience)
• are an active prescriber in a patient-facing role, with appropriate knowledge and experience relevant to the trainee’s area of clinical practice (An active prescriber consults with patients and makes prescribing decisions based on clinical assessment with sufficient frequency to maintain competence. They reflect and audit prescribing practices to identify developmental needs)
• have up-to-date patient-facing, clinical and diagnostic skills and evidence of demonstrating competence in an area of practice relevant to the trainee
• teaching and training skills

Assessments

Throughout the programme, you’ll undergo a range of assessments to ensure that all the learning outcomes for the programme are met. You will need to pass every assessment to complete the course as there is no compensation between assessments.

The current assessment schedule is below:

Description of assessment	Percentage contribution to module
Portfolio	40% of module mark
Therapeutic Framework	30% of module mark
OSCE	30% of module mark
Calculations assessments	pass/fail (must be passed at 100%)

Your prescribing portfolio will illustrate the time you’ve spent in practice under the supervision of the DPP and demonstrate your ability to integrate theory into practice. It includes information on your scope of practice, clinical logs (events that have occurred in practice), patient assessment skills, consultation skills, a log of hours with the DPP and a demonstration of how you have met the prescribing competencies.

The therapeutic framework is centred on your scope of practice and the medicines that you’ll be prescribing. It allows you to research and become more confident in the condition(s), progression and relevant guidelines that impact prescribing decision-making.

The OSCE is a practical assessment to assess your ability to undertake patient consultations, including patient assessments and their interpretation e.g. cardiovascular assessments. It is held at the University and assessed by experienced healthcare teaching staff.

The numeracy class test held online consists of 20 questions and takes 45 minutes to complete.

Skills acquired

• Consultation skills
• Patient assessment skills
• Clinical decision making

Course leaders and tutors

Programme Directors:

• Dr Rowan Yemm PhD FHEA MRPharmS (stand-alone modules)
• Professor Karen Hodson PhD, MSc, BSc (Pharm), MRPharmS (Diploma module)
• Mrs Kate Francis, DiplClin, MRPharmS (Post-registration Foundation Training Programme)

Tutors:

The course leaders are supported by numerous Independent Prescribers working in practice.

When you begin the programme, you’ll be assigned a personal tutor. Wherever possible, this will either be an experienced academic working within prescribing or an Independent Prescriber, with experience of the scope of practice.

Thanks for organising such an excellent course. It’s easily the most enjoyable and relevant course I’ve done and it was great to be able to put theory into practice immediately. It has not only given me new skills and knowledge but also changed the way I practice day-to-day. It must be a difficult course to run but it has renewed my enthusiasm for the profession and for this, I’m most grateful.

Entry requirements

English language requirements - GCSE at a minimum Grade 6/B or International English Language Testing System (IELTS) score of 7

The GPhC requires additional specific entry requirements for a pharmacist-independent prescribing programme.

These are:

• Applicants are registered as pharmacists with the General Pharmaceutical Council (GPhC) or, in Northern Ireland, with the Pharmaceutical Society of Northern Ireland (PSNI)
• Applicants are in good standing with the GPhC and/or PSNI and any other healthcare regulator with which they are registered
• To develop their independent prescribing practice, applicants must identify an area of clinical or therapeutic practice on which to base their learning
• Applicants must have a designated prescribing practitioner who has agreed to supervise their learning in practice. The applicant’s designated prescribing practitioner must be a registered healthcare professional in Great Britain or Northern Ireland with legal independent prescribing rights, who is suitably experienced and qualified to carry out this supervisory role, and who has demonstrated CPD or revalidation relevant to this role. Although an applicant may be supervised by more than one person, only one prescriber must be the designated prescribing practitioner. The designated prescribing practitioner is the person who will certify that successful pharmacists are competent to practise as independent prescribers
• Applicants must have relevant experience in a UK pharmacy setting and be able to recognise, understand and articulate the skills and attributes required by a prescriber to act as the foundation of their prescribing practice whilst training

How to apply

For applications, email the Recruitment and Admissions Professional Services Team at the School of Pharmacy to request an application pack.

The application process consists of 3 parts:

Part 1: Candidate completes the Cardiff University application process, providing details such as employment and motivation to undertake the programme

Part 2: Candidates need to fill out an application form for the programme to show how they meet the GPhC admissions criteria, the specific area of practice they are interested in (referred to as "scope of practice" in our terminology) the group of patients they will be prescribing for, and their plans for spending time learning in practice. They also need to have a professional reference form completed by their employer or an appropriate person.

Part 3: The DPP must complete the DPP's Eligibility Form, providing details to demonstrate that they meet the requirements to be a DPP. They should also include information about their experience in teaching, supervision, and assessment, and how they can support the applicant's learning in practice.

Only complete applications will be reviewed, after the submission deadline.

From the applications, the Programme Director will assess if the GPhC entry requirements have been met. Examples of sufficient evidence that normally will meet the criteria include:

• successful completion of a post-graduate programme e.g. a Diploma previously or several years of experience working within the area of clinical or therapeutics that will be focussed on during the prescribing programme
• successful completion of the first year of a post-graduate taught programme. In Wales, we now have the Post-registration Foundation Training Programme, where each pharmacist has a local Practice Supervisor and a University Educational Supervisor. It is planned that at 9 months into the programme, a review between the Practice and Educational Supervisors will occur with the student to check if the student should progress onto the Prescribing Programme.  The training programme will ensure that the student has sufficient experience in the workplace and the review will identify any potential concerns from those working with the student on the programme
• a newly qualified pharmacist working within a specific sector, where they can demonstrate they have been working within pharmacy regularly, and have completed placements within their undergraduate programmes where they have practised at the ‘do’ or ‘shows how’ level (i.e. not at the ‘knows how’ level)

Experience may be from their MPharm degree (significant evidence of experiential learning, simulation or other placements), during their foundation training year and/or pharmacy employment.

The evidence should demonstrate the provision of patient-centred care, commitment to and evidence of continuing professional development in this area, as well as the application of knowledge and skills. It may include examples of leading or participating in consultations with patients, drug history taking, shared decision-making, providing patient information, resolving queries, ethical dilemmas, etc.

You can include examples of anonymised patient cases and CPD entries. You can also include evidence from their employer, DPP or other doctor or practising pharmacist whom you work with or for whom you provide a pharmacy service.

For any questions regarding your application, contact the Recruitment and Admissions Professional Services Team at Pharmacy-IP@cardiff.ac.uk

Fees and funding

The fees for the programme are £2,430 for home students.

Health Education and Improvement Wales (HEIW) usually commission several places for pharmacists employed by Health Boards for the September stand-alone module intake. Discuss this possibility with your Health Board leads.

Sponsored or part-sponsored students (other than HEIW-sponsored) will need proof of sponsorship when enrolling. This will be in the form of a letter from your sponsor.

Additional expenses, that you may incur during the course, include:

• Books if you prefer to have your own copy
• Personal photocopying
• Travel costs to the course