Hospital pharmacy training programmes

All programmes are in line with the pre-registration requirements for pharmacists set by the regulatory body for Pharmacy (General Pharmaceutical Council (GPhC) from April 2010).

A hospital pharmacy pre-registration training year provides a variety of activities and experiences that enable you to develop your professional, clinical, technical, communication, interpersonal and management skills in preparation for your career in pharmacy.

You will undertake comprehensive training in a range of patient facing services e.g. dispensary and clinical/ward based pharmacy. You will also gain experience in a variety of specialist pharmaceutical services described below (if provided within your placement hospital).

Supply Services

Team working is a vital part of dispensary services to ensure work is carried out efficiently. Most modern hospital dispensaries have adopted new IT technologies and automation such as dispensing robots.

Hospital dispensaries provide a range of services to:

• Inpatients on hospital wards
• Outpatients attending clinics
• Patients being discharged

Pharmacist input is mainly focussed on

• Clinical checking of incoming prescriptions for accuracy and appropriateness, prior to dispensing - liaising with prescribers where necessary
• Giving information to outpatients on the safe and effective use of medicines

• How medicines are purchased (involves contracting and negotiation)
• How stock is managed in the most cost-effective way (reducing wastage)
• How pharmaceuticals are received and distributed throughout the hospital (knowledge on product availability and effective sourcing of products that are in short supply)

• Source, order, store and dispense investigational products
• Offer advice and information to patients about their study medication
• Contribute to protocol development and design of necessary documentation e.g. randomisation schedules and standard operating procedures

Clinical Pharmacy Services

Clinical Pharmacists work directly with patients and collaborate with a range of healthcare professionals to ensure medicines are used safely, effectively and in a cost effective manner. Clinical pharmacists work closely with budget holders and senior clinicians to ensure that NHS resources for medicines are used efficiently. Some senior clinical pharmacists also run hospital out-patient clinics e.g. anticoagulant clinics.

Main activities include:

• Reviewing prescription charts
• Attending medical ward rounds
• Undertaking Medicines Reconciliation (which includes taking medication histories, influencing prescribing, providing prescribing advice)
• 'Independent' or supplementary non-medical prescribing (if qualified)
• Counselling patients on the use of their medicines
• Answering medicines-related queries from both patients and other healthcare professionals
• Discharge planning in collaboration with other healthcare professionals to ensure that patients experience a seamless transition from hospital to home

Clinical pharmacists work closely with clinical pharmacy technicians with medicines management roles whose main activities include assessment of suitability of Patient Own Drugs (PODs) for reuse and One Stop Dispensing services where in-patient and discharge medication are combined into a single supply, labelled for discharge.

The pharmacy led Medicines Information (MI) service provides evidence-based, unbiased information and advice on any aspect of medicine usage to healthcare professionals and the public. The National organisation - UKMI has developed a comprehensive training pack used for pre-registration trainee pharmacists to complement the training provided at the base hospital.

Examples of MI enquiries include:

• Medication identification
• Stability information
• Medicine use during pregnancy and lactation

Other activities include:

• Evaluation of new medicines for hospital committees
• Information bulletins for healthcare professionals
• Formulary management

Technical Services

Aseptic dispensing is the preparation and supply of sterile pharmaceutical products which require dilution or other manipulation before administration. Most pharmacy departments provide aseptic dispensing services.

Aseptic services include preparation of:

• Total Parenteral Nutrition
• Cytotoxics - Chemotherapy is reconstituted and supplied to wards in ready to use syringes and infusion bags. This ensures compliance with Health and Safety regulations relating to the exposure of staff handling chemotherapy
• CIVAs (Centralised IV Additive service) – Preparation of pharmaceutical products e.g. antibiotics in ready to use syringes and infusion bags

Some pharmacy departments provide non-sterile manufacturing services which include both “one off” extemporaneous and batch products.

Products manufactured include:

• Pre-packing and overlabelling of medicinal products for use in wards and clinics
• Manufactured "specials" e.g. suspensions, creams etc. which are not commercially available to meet the specific needs of individual patients

Quality Control/ Quality Assurance are integral components of clinical governance.

Main activities include:

• Quality Control of raw materials and in–house preparations
• Medical gas testing
• Environmental monitoring of aseptic suites

External Placements

Where possible a 2-4 week placement in a Community Pharmacy will be organised.

This enables trainees to:

• Gain an appreciation of the complete patient experience across primary, secondary and tertiary care boundaries
• Identify the importance and impact of a pharmacists’ role across a patients journey

Some hospitals offer short placements at a Primary Care Trust. Pharmacists have varying roles within the medicines management team at a PCT.

Main activities include:

• Providing prescribing advice to GP practices based on evidence based practice and cost effectiveness e.g. by carrying out clinical audits and visiting GP practices
• Development of medicines management services at practice level, within community pharmacies and in the community (care homes) based on local need e.g. medication review services
• Managing the entry of new drugs by reviewing funding request for specialist drugs, inputting into the drugs and therapeutics committees and PCT medicines management committee
• Development, dissemination and implementation of local guidelines in accordance with national policy
• Commissioning of high priority medicines management services in primary care within a cash limited budget e.g. Community pharmacy led flu clinics