Pharmacist degree apprenticeships are being considered as part of NHS England’s plan to increase the workforce.
In the NHS Long Term Workforce Plan, published last week (30 June), NHS England (NHSE) said there was potential for pharmacy technicians to undertake expanded training via apprenticeships, and that consideration was being given to the potential of a pharmacist degree apprenticeship.
But the Guild of Healthcare Pharmacists (GHP) said it would await more details on the workability of an apprenticeship scheme for pharmacists before making comment, and the Pharmacists’ Defence Association (PDA) suggested that there was not much certainty around the proposal, and said that the plan would need to be ‘underpinned by significant funding for its entire life course’.
And Graham Stretch, President of the Primary Care Pharmacy Association (PCPA) said that while he supported the concept of alternative routes to pharmacist training in principle, there was a risk of exploitation of apprentices being paid very low wages.
More detail on apprenticeships needed
The Guild of Healthcare Pharmacists (GHP) said that ‘we have seen the success of the format for pharmacy technicians but await a more detailed plan on the workability of such schemes for pharmacists before making comment’.
And Paul Day, director of the PDA, commented: ‘Though the plan mentions consideration is being given to the potential of a pharmacist degree apprenticeship, unlike for some other professions and roles detailed in the plan, this published plan for the next 15 years does not include any apprenticeships for pharmacists, and the letter from the Chief Pharmaceutical Officer Team at NHS England also does not mention apprenticeships either.’
And he added that while the plan was a start, ‘it will need to be underpinned by significant funding for its entire life course’.
‘It’s a long-term plan and alongside that activity the immediate challenges faced by the health system, including retention of staff in the current costs of living crisis, need to be urgently addressed,’ he said.
Meanwhile, Graham Stretch, President of the Primary Care Pharmacy Association, told The Pharmacist last week that as long as the quality of apprenticeships was maintained – even if it meant taking twice as long for someone to train – he wouldn’t have a problem with people training as pharmacists via an apprenticeship route.
‘I think the route to which you get to MPharm and GPhC registration isn't that important. What's important is you take the same exams and assessments,’ he said.
He added that he knew of several people practicing as pharmacy technicians for whom ‘being offered an alternative route to degree – [for instance] part-time working because they’ve got childcare or caring responsibilities – can only be a good thing, as long as they pass the same exams and assessments’.
But he raised concerns about the risk of exploitation of apprentices being paid very low wages.
‘The minimum wage for apprenticeships is very, very low, and I would hate there to be any chance of any exploitation around this,’ he said. ‘Because essentially, if you had to enter an apprenticeship for eight or nine years, and are paid at the minimum wage for an apprenticeship, that's going to be exploitative because you're almost indentured to your organisation if you started there, and I think we need to be very mindful of that.’
What happened when pharmacist apprenticeships were proposed before?
Pharmacist apprenticeships were first proposed in April 2019 by a group of pharmacy employers and the sector was given just ten days to respond to a consultation on the plans.
The proposal faced criticism from pharmacy schools and from within the sector, and in May 2019 the Institute for Apprenticeships and Technical Education (IATE) decided not to progress with it.
By October 2019, a second proposal was in the works which promised to ‘take into account’ the concerns raised by the sector, with greater transparency and further sector engagement through a longer consultation period.
It was delayed again in December 2020, with the group – which included representatives from Boots UK, Superdrug, Lloyds Pharmacy and Well – citing the need ‘to dispel misconceptions’ in the sector.
While little public progress was made on the plans during the pandemic, the Pharmacists’ Defence Association (PDA) said in 2022 that ‘it seems these employers may have continued to meet and engage with others behind the scenes’ and that ‘it seems that the details of the second attempt to create a pharmacist apprenticeship are about to emerge.’
They cited comments made by Health Education England (HEE) at the Clinical Pharmacy Congress, and the confirmation from the General Pharmaceutical Council (GPhC) that they had already agreed that final assessment would be the same for anyone wishing to enter the register, whether they followed the MPharm traditional university degree or a potential degree apprenticeship route.
In 2022 the PDA said that apprenticeships ‘can be legitimate ways to learn a profession’, and would be ‘feasible’ for pharmacist trainees in some healthcare settings, ‘in a teaching hospital or GP practice for example where education and work-life can sit well together and other health professionals may have the time to supervise and mentor those who are learning’.
It raised concerns about the suitability of a community pharmacy setting ‘as being conducive to gaining a professional degree qualification’, citing poorer exam results among those who undertook their pre-registration training in community, as well as the ‘reality of conditions’ in community pharmacy workplaces.
And in its 2022 statement the PDA also raised concerns about how independent prescribing, now part of pre-registration courses, could be incorporated into apprenticeships, especially given the lack of qualified Designated Prescribing Practitioners (DPPs) to supervise trainees.
What else is in the NHS long-term workforce plan?
Training places for pharmacists will be expanded by almost a third (29%) by 2028/29, and by nearly 50% – to around 5,000 places per year – by 2031/32, it said.
While the move to increase training numbers was welcomed by the sector, leaders commented that it must be matched by support for the workforce to undertake training.
As well as considering a pharmacist degree apprenticeship, NHSE also mooted the idea of a shortened medical degree programme which enable some existing healthcare professions, including pharmacists, to train as medics.
It announced that the Additional Roles Reimbursement Scheme (ARRS) will be extended but said that this 'would be carefully managed taking into account additional training of pharmacists’, to ensure sustainable workforce growth and capacity across primary care.
And it pointed to hub and spoke dispensing as a way to free up capacity within community pharmacy to deliver more clinical services.