Pharmacy professionalism and
professional identity: what do regulators
need to know?
Improving professional regulation in health and social care:
interdisciplinary insights
March 2014
Rebecca Elvey, Karen Hassell, Ellen
Schafheutle, Sarah Willis
Centre for Pharmacy Workforce Studies
Manchester Pharmacy School
This presentation
• Pharmacy professionalism and professional identity
• Context – the GB pharmacy profession and the
pharmacy regulator
• Insights from our research
• Implications for the pharmacy regulator,
professionals and the public
Professionalism and professional
identity
• Regulators work to promote and protect the
wellbeing of patients and the public.
• Interest in healthcare professionalism has grown in
recent years.
• Professionalism and professional identity are abstract
concepts, often expressed through attributes and
qualities that professionals (should/must) possess.
• Standards for pharmacy in GB mention professional
knowledge, competence, judgement, behaviour…
• But how well are these concepts defined and
understood?
The pharmacy profession in GB
• Third largest healthcare profession (47,000)
• Trained in 26 schools of pharmacy (10,599 students
in 2011)
• Most pharmacists practice in community or hospital
pharmacy
• Culturally complex and diverse workforce
Changes to pharmacy roles and
regulation
• Pharmacists’ roles have evolved; supplying medicines
is still core, but increasingly expected to provide
‘clinical’, ‘cognitive’ and ‘public health’ services.
• The regulator, the General Pharmaceutical Council
(GPhC), sets standards for:
– The individual registrant (Standards of conduct,
ethics and practice)
– education, initial training (undergraduate and preregistration) and CPD
– pharmacy premises, including staffing
Our research on pharmacy professionalism
and PI
Study
Publication(s)
Professionalism in pharmacy
education
Schafheutle E, Hassell K, Ashcroft D, Hall J, Harrison S.
How do pharmacy students learn professionalism?
International Journal of Pharmacy Practice, 2012 20:2,
118-128
The development of
professionalism during
pharmacy pre-registration
training
Jee SD, Schafheutle EI, Noyce PR. The professional
socialisation of trainees during the early stages of preregistration training in pharmacy. HSRPP conference
presentation, 2013.
Patient-centred
professionalism in early
career pharmacists
Elvey R, Lewis P, Schafheutle E, Wilis S, Harrison S,
Hassell K. Defining professionalism (and its elements) in
early career pharmacists. RPS conference, 2011.
Professional identity in
pharmacy
Elvey R, Hassell K, Hall J. Who do you think you are?
Pharmacists’ perceptions of their professional identity.
International Journal of Pharmacy Practice, 2013 21:5,
322-332
Describing and defining pharmacy
professionalism and PI (i)
Competence
• Professional
knowledge and skills
I’ve got a patient that’s refusing [to swallow tablets]…we’re crushing a
drug we probably shouldn’t crush…because that’s the only way she’ll have
• Knowing
about
medicines,
working
with
accuracy,
Knowledge
obviously
is vital
advice.
it…she’s taken
that risk
on,and
the portraying
patient andthe
theright
consultant’s
…said ‘yes,
(Early
career
community
pharmacist)
abilitycrush
to it’…deviating
use[a good
professional
from a set is]...one
of judgement
SOPs…you’ve
got
to
weigh it up…risk
pharmacist
who’s
full
of
information
the
Patients
into
a pharmacy
and,,,as
a professional
theythat….(Early
see about
benefitcome
…to
be
able
to
weigh
up
a
clinical
situation
like
career
product,
andsubject…(Tutor,
who knows about
the product...(Community
as the expert
inas
your
community
pharmacy) of
• Theyou
pharmacist
scientist,
adviser,
supplier
hospital
pharmacist)
pharmacy user)
medicines
• Applying professional judgement can involve deviating
from SOPs or ‘rules’
Describing and defining pharmacy
professionalism and PI (ii)
Values
• Honesty, trustworthiness, integrity, compassion,
putting the patient first, going the extra mile, resisting
pressure from incentives/targets
Most pharmacists I know want to put the patient first…they get
all these targets thrown at them…it’s not what they want, they
want to be patient-centred (Early career community pharmacist)
Describing and defining pharmacy
professionalism and PI (iii)
Communication
• Ability toI think
communicate
clearly
andthey’re
effectively
it’s approachability
and the way
greeted…if it’s a
friendly, warm ‘How are you Mr Jones? How are you getting
• BeingNice
polite,
respectful,
listening
to apatients
on?...then
theypetrified
just loveofthat….it
can makehad
difference
young lad but
everything…we
an addictto
them…they’re
welcome…and
free towhen
ask for
and advice if
in…[he had and
not
collected
his feel
medicines
hehelp
should
• Beingcome
confident
assertive
to…I
always
encourage
askday]
me questions,
havethey
doneneed
so was
not
allowed
a furtherpeople
supplytothat
and he but
around
others,
a lotpharmacist
of pharmacists
in the back
werelooking
like proper
kicking
off…the
saidwould
‘I don’tstay
know
not venture
oftenI said
unless
whatand
to do…shall
I justforth
givevery
it him?’
‘dothey
not really
give ithave
him, to.
no’ I
(Community
pharmacist)
told [the
patient] straight
[I’m used to these situations so they
don’t bother me at all]. (Support staff, community pharmacy)
Where and how professionalism is
learnt.
• Through lectures and formal curriculum content on
law, ethics at university.
• Communication skills are taught and assessed using
role plays.
• Through observing teachers and other role models.
• Pre-registration tutors, other pharmacists and
pharmacy support staff in practice.
Discussion and developments in
pharmacy regulation
• This presentation has drawn out strong and
challenging areas of pharmacy professionalism.
• There are similarities and differences between
professionalism as understood in pharmacy
and other healthcare professions.
• GPhC are working with new models for
regulating premises and individuals.
rebecca.elvey@manchester.ac.uk