Higher level practice in clinical pharmacy specialities application of the advanced level competency framework and implication for consultant pharmacists

Due to inconsistency in the practice of clinical pharmacy, the maintenance of healthcare workforce competence in order to ensure fitness for practice has become a key issue in the NHS restructuring process. The competence of healthcare professionals is directly linked to the quality of care provision. To deliver good care, well prepared practitioners are needed. Establishing a framework for practice that provides a reference for the competencies desired at general level in hospital pharmacy practice, primary care and community pharmacy has been shown valuable to offer the practitioner a clear pathway for personal and professional development and therefore, progress individual performance. The work presented here aims to identify and evaluate advanced and consultant level practice. To achieve this, it is needed to clarify what is expected from pharmacy practitioners at Higher Level Practice (HLP), Advanced Specialist level and newly proposed consultant posts. In order to assess competency levels across a range of NHS practice, the Advanced and Consultant Level Competency Framework was used. The framework consisted of patient- related, personal and problem-solving clusters of competencies assessed on frequency scales. It was applied to a wide range of practice groups in the form of a membership audit, aimed at profiling NHS Consultant Pharmacists. A purposive sample of practice groups was approached and their members were invited to undertake a self-completed mapping exercise using the Advanced and Consultant Level Competency Framework (ACLF). Interviews and consensus group discussions were conducted as well to explore and evaluate expert practitioners' perceptions of the ACLF, of consultant practice and to define the profile expected for a Consultant Pharmacist. The ACLF has been shown to be a valid and applicable tool for practitioner development aimed at advanced level practice and Consultant Pharmacists. The respondents in this evaluation were able to use the framework to make a self-assessment of their current level of practice. Key competencies that are associated with consultant status were identified using the framework and adopted as part of the guidance on Consultant Pharmacists in England. This analysis allowed for a description of the type of evidence needed to define higher level practice in order to provide further guidance for career development. The creation of a Consultant Pharmacist post is a significant step forward for practitioner development, an essential anchor in the healthcare workforce and an elevation of professional standards. The competency requirements for Consultant Pharmacists are drawn from the ACLF, which supports pharmacists' professional development from advanced to Consultant level (Department of Health 2005, p11). This work provides evidence that the ACLF is valid and crucial for this development to occur.