The College of Mental Health Pharmacists has been commissioned by the UK Psychiatric Pharmacy Group to achieve the primary aims of accrediting specialist mental health pharmacists and meeting the requirements of Clinical Governance. It has been funded solely from UKPPG resources.

Contents

§             Aims and objectives

§             Membership principles

§             Competencies

§             CMHP Council Members

 

 

Aims and objectives

Missions statement:

The College of Mental Health Pharmacists promotes its members as recognised experts in the optimal use of medicines in improving mental health and supports them by a process of ongoing accreditation and education.

Aims:

§             To drive the development and provision of high quality mental health                 pharmacy services to all service users

 

§             To establish accredited pharmacists as recognised expert practitioners                 in medicines use in mental health

 

§             To assure the competence of accredited specialist mental health                         pharmacists

 

 

Objectives

§           To liase with other professional bodies, organisations and voluntary                   groups working in mental health to promote optimal use of medicines

§           To advise on appropriate competencies for pharmacy practice and                      standards for pharmacy services in mental health

§           To set competencies for pharmacy practitioners in mental health that                  meet the requirements of clinical governance and correlate with                            competencies set for pharmacists specialising in other areas of practice.

§           To encourage and support pharmacists in achieving the competencies                 necessary to practice in mental health

§           To accredit individual mental health pharmacists as competent                           practitioners

 

Membership Principles

A. Basic requirements:

There are two basic requirements for membership of the College of Mental Health Pharmacists:

1. Registration as a pharmacist

2. Specialist expertise in mental health pharmacy. This can be through either:


2a. Five years active involvement in psychiatric care post-registration with RPSGB or
2b. Three years active involvement in psychiatric care post-registration with RPSGB, and a postgraduate certificate and diploma in Psychiatric Pharmacy or other equivalent qualification

 

Membership will continue to be open to those pharmacists with at least 5 years experience in psychiatry until at least 31/12/2007. Any decision to terminate this option will be made with a minimum of 12 months notice.

B. Membership application:

There are two components to the application for membership of the College of Mental Health Pharmacists. A range of competencies in mental health pharmacy has been defined which covers standards of practice, application of knowledge and experience. Demonstration of ability across this range of competencies will be through:

1. Completion and submission of a portfolio
2. A viva voce examination with founders

The specialist accreditation/membership will remain valid for five years. There will be a CPD commitment and re-accreditation after five years.

Prospective members need to complete a portfolio application form and send this to the College Registrar. They will then be sent 3 identical empty portfolio files which will need to be completed and returned to the registrar. Following acceptance of an adequate portfolio the registrar will invite the prospective member for a viva examination.

 

Details of the Portfolio and viva are available:

 

Competencies

The following is the range of competencies that will be assessed through the provision of a portfolio and through a viva:

1. Professional expertise in drug therapy in psychiatry/mental health

1a.     Demonstrate knowledge of the relevant pharmaceutical aspects of drug treatment choice
1b.Demonstrate knowledge of pharmacodynamics
1c.Demonstrate knowledge of pharmacokinetics
1d.Demonstrate knowledge of pharmacoeconomics
1e.Demonstrate knowledge of drug interactions
1f.Demonstrate awareness of the principles of prescribing quality
1g.Demonstrate an appreciation of the prescribing issues associated with special patient groups
1h.Demonstrate the ability to apply knowledge of drug treatments to clinical situations 1i.Interpret published papers

2. Demonstrate thorough knowledge of mental illness

2a. Classification (symptoms/description)
2b. Epidemiology
2c. Course and prognosis
2d. Pathology
2e. Biological and psychological theories of mental illness

3. Communication within multidisciplinary and user forum/fora

3a. Evidence of productive involvement within a multidisciplinary environment
3b. Medicines information
3c. Experience of productive communication with service users
3d. Demonstrate clear, concise and effective written and oral communication skills

4. Legislation and politics

4a. Knowledge of relevant mental health legislation
4b. Demonstrate knowledge of the health policy influencing mental health care in their own country

5. Service provision and development

5a. Demonstrate a wide experience of the provision of pharmaceutical services in mental health
5b. Be able to plan local service development to meet changing needs in mental health care

6. Care

6a. Demonstrate a commitment to patient care
6b. Show empathy to patients in their approach to provision of services

7. Vision and initiative

7a. Demonstrate initiative in their work
7b. Show a clear vision for personal and service development in the future of pharmaceutical mental health services

 

 

 

History of the CMHP development

Initial proposals

The concept of the CMHP developed after a UKPPG meeting in London in December 1998. The idea was developed into a set of proposals throughout 1999, initially at the UKPPG committee meeting in December 1998, with further formal meetings on 1.2.99 (Maudsley), 12.2.99, 29.3.99 (Maudsley), 8.4.99, 19.4.99 (Norwich), via the May UKPPG Bulletin supplement (see below), June 1999 and September 1999, with informal contacts with Trusts, national bodies such as NSF, Royal College of Psychiatrists etc.

The process aimed to:

  • ensure a high standard of pharmaceutical care in mental health
  • be self-regulating - since clinical governance insists on life-long learning, professional self-regulation, and
  • ensure that pharmacists are accountable to their peer group

UKPPG AGM 1999

At the AGM of the UKPPG on Friday 8th October at Latimer House, a two-thirds majority of the 119 members present voted, during a two and a half hour debate, to amend the constitution of the UKPPG to allow the establishment of a College of Mental Health Pharmacists as a sub-group of the UKPPG. The motions passed were:
1. The executive committee of the UKPPG shall to take the steps necessary to establish the College of Mental Health Pharmacists. The College of Mental Health Pharmacists will be a practice sub-group of the UKPPG.
2. The executive committee of the UKPPG will appoint the founder members of the College of Mental Health Pharmacists. Founder members must be members of the UKPPG. Founder members will be elected by acclamation in an election open to all UKPPG members. The role of the founder members will be to develop the infrastructure necessary to support the establishment and early development of the College, and to take the steps necessary for the admission of new members.
3. The UKPPG executive committee will take any actions it deems reasonably necessary to assist the founder members of the College of Mental Health Pharmacists in the establishment and development of the College.
4 The constitution of the UKPPG will be amended by adding the following paragraphs:
i. The College of Mental Health Pharmacists is a practice sub-group of the UKPPG.
ii. The College of Mental Health Pharmacists is managed by its own members. It is accountable to its own membership on professional issues, but to the UKPPG in financial matters.
iii. The College of Mental Health Pharmacists has an executive committee of five members. The officers are: President, Vice-president, and Secretary.
iv. Membership of the College of Mental Health Pharmacists is open to members of the UKPPG. Candidates will be expected to be able to demonstrate a high level of competence in the practice of psychiatric pharmacy.
5. The founder members of the College of Mental Health Pharmacists will develop a constitution for the College which will be presented to the UKPPG membership for their consideration and approval.
6. The founder members of the College of Mental Health Pharmacists will establish the process and means by which candidates for membership may demonstrate a high level of competence in the practice of psychiatric pharmacy.
7. Once the the College of Mental Health Pharmacists has reached a membership of 25 (not including the founders), the founder members shall resign and an election shall take place to elect the first elected executive committee of the College.
8. Following their resignation, if they wish to remain members of the College of Mental Health Pharmacists, the founder members shall themselves undergo the same accreditation process as other members of the College.
9. If the College of Mental Health Pharmacists has not achieved its initial target membership of 25 members within 2 years of its establishment, the continued support for the College from the UKPPG will be reviewed. The results of the review will be presented to the following AGM of the UKPPG for its consideration.

Although an open vote for members to vote in Founders was carried out in 1999, it was decided to re-run this in January 2000, with formal voting papers. The UKPPG Chairman personally wrote to all people who received votes in the original ballot. Eight people eventually stood, with five voted in a Founders. The Founders Board first met on 28.3.00 (Manchester), then 23.6.00, 8.12.00 (Luton), 8.1.01 and 12.3.01, along with discussions at UKPPG committee meetings.

There was much interest from others, and the following is part of an article that appeared in the Pharmaceutical Journal

Delivering professional competence - options for pharmacy

The Pharmaceutical Journal, 2000, 264, 928-929 (June 17)
By Clive Jackson, MSc, MRPharmS, and Bryan Veitch, PhD, FRPharmS

In this article, the authors suggested that setting up a faculty system for pharmaceutical specialisms might demonstrate pharmacy's commitment to meeting the challenge of delivering professional competence in the NHS and provide other benefits as well. The full text can be found on the PJ website.

Some points made were:

  • the reputations of all the main health care professions are increasingly suffering from the poor performance of a minority of their members
  • The representative bodies of each health care profession are currently considering what action needs to be taken in the light of this evolving, and inherently less comfortable, environment for their members and if they don't, then the Government will take action using powers provided recently under the Health Act 1999.
  • The RPSGB has been proactively consulting members on a new regulatory framework to "ensure professional competence and lifelong learning".
  • The days have long gone since the practice of pharmacy, irrespective of the area in which an individual worked, could be considered to be broadly similar. So, a single competency framework is unlikely to cover all the aspects of current practice
  • How might be possible to identify a limited set of "core" competences applicable to the majority of practising pharmacists, irrespective of the area in which they work?
  • In the current climate, society (and, therefore, the Government) will increasingly require "proof" that all professionals are appropriately trained, experienced and up to date for the specific tasks they undertake
  • We have little choice but to start addressing, in a formal way, professional standards through the development of core and specialist competency frameworks, linked to a robust system of continuing professional development, life-long learning, reaccreditation and rigorous self-regulation
  • A college/faculty system may be a way forward
  • A good example of this process can be seen in the UK Psychiatric Pharmacy Group (UKPPG) which is being proactive in creating both a professional and educational structure for its members, as well as defining the skills necessary to provide high quality pharmaceutical psychiatric services. In fact, the UKPPG plan is to set up a stand-alone College of Mental Health Pharmacists by October, 2000, which will, among other things, set out a competency framework for its members (see its website: www.ukppg.co.uk).
  • Benefits of belonging to a college or faculty could include visible recognition of membership of a (hopefully) prestigious, specialist college or faculty (eg, the Royal College of Psychiatrists or Faculty of Public Health in medicine) with additional recognition for high level achievement (eg, fellowship, merit awards, etc), provision of a focus for developing and delivering professional specialist views and input into (and, therefore, influence on) national initiatives and policy development, provision of a professional network for peer support, peer review (and peer pressure - linking into the new clinical governance agenda), provision of a system for the rapid and effective dissemination of national and local good practice, plus new clinical and service developments, accreditation (and, on occasions, commissioning or delivery or both) of bespoke education and training courses targeted at the specialism's needs

Clive Jackson is director of the National Prescribing Centre and Bryan Veitch is the chairman of the College of Pharmacy Practice
References:
1. Society starts consultation on new framework for professional regulation. Pharm J 2000;264:400.
2. Competences for pharmacists working in primary care. Liverpool: National Prescribing Centre/NHS Executive, 2000.

A relatiely low-key launch at the UKPPG annual conference in October 2000 was made. A consultation exercise with the members was carried out in May-June 2000, with 15 replies received. One of the main challenges of setting up the CMHP was that, as it is a ground-breaking development, there was nothing with which to compare or contrast, or to copy or adapt. There were different options and ways to try to achieve our ultimate goal, but the Board were fully focused on developing something that is (and is seen to be) consistent, realistic, reproducible, objective and fully assessable.

A copy of the original discussion document is included below. This was originally circulated to UKPPG members as a supplement to the UKPPG Bulletin in May 1999 to inform members and to stimulate discussion. It was, however, subsequently widely circulated and reproduced (but not by committee members), misread and misinterpreted, and taken as a final document. This was unfortunate to a large extent, but it certainly succeeded in stimulating debate.

The UKPPG discussion paper from May 1999

This paper was prepared by the UKPPG working party on Clinical Governance, and set out the current thinking on the subject, the response from the Group, and asked for members active involvement in the process.

Contents:

  1. What is Clinical Governance? - Carol Paton (Bexley)
  2. Statements by the Chairman and Vice Chairman
  3. Summary of proposals
  4. Proposals in detail
  5. Questions and answers – Stephen Bazire (Norwich)
  6. Voting and contribution form

1. Clinical Governance: What does it mean for Pharmacists?

Carol Paton, Bexley

Commercial companies have for many years been subject to ‘corporate governance’, which ensures that directors are responsible to their shareholders for maintaining good standards of practice, having a clearly defined decision making process and allow open access to information. In contrast, NHS Trusts have been accountable for their financial affairs (no pun intended!), but not their main purpose of treating patients. The NHS white paper ‘The New NHS: Modern, dependable’ changes this by making Trust Chief Executives accountable for the quality of clinical care provided within their organisation. In the wake of the Bristol enquiry, few would argue that this could be a bad thing.

The aim of clinical governance is to ‘ensure fair access to consistently high quality health care for all patients’. The National Institute of Clinical Excellence (NICE) and National Service Frameworks (NSF) will provide guidance on good quality care (the carrots), while the Centre for Health Improvement (CHImp) will monitor adherence to the standards set (the stick). One of the first NSFs is in mental health, an identified NHS priority area. Many will be watching and monitoring its impact.

Trusts must identify a senior clinician to take responsibility for the clinical governance agenda (a huge and complex task) and many have set up clinical governance boards to further allay the anxieties of the Chief executive. Clinical governance is a 10 year agenda and is not going to disappear. We need to welcome it and use the opportunities that it provides to improve the quality of care available to those with mental health problems. Who better than the lead pharmacist in mental health to take responsibility for the clinical governance agenda in respect of medicines management across a Trust? Such a person would be responsible for the quality of pharmaceutical care through a range of activities including training, drug information multidisciplinary working, protocol development, audit and error reporting. These are all roles that are well developed within our profession and we have a proven track record of delivering. The Crown review of the prescribing and supply of medicines may extend our role further. We are already ahead of the rest and should aim to stay there. Clinical governance is an opportunity and we have only ourselves to blame if we do not seize it.

2. UKPPG Chairman - David Taylor
UKPPG members will all be aware of changes in the NHS and the move to clinical governance for all the professions. The UKPPG welcomes this change, and Committee members have been working for some time to develop workable and credible proposals to ensure clinical governance in psychiatric pharmacy. We do not pretend that the proposals are perfect, but we consider that they do meet the objectives that we set out to achieve - to ensure a high standard of pharmaceutical care in mental health, to be self-regulating, and to ensure that pharmacists are accountable to their peer group.

The proposals set out in this document are radical, to say the least. They probably represent the most challenging and progressive changes in psychiatric pharmacy practice in any developed country. We hope that these proposals will be read with an open mind. Change is never easy, and one's first reaction is often to reject new ideas. Remember, though, that the broad aim of these proposals is to improve the drug treatment of mental illness by ensuring high standards in pharmaceutical care. Note also that the proposed accreditation scheme is not the view or imposition of one person, but is the carefully considered vision of every member of the UKPPG committee.

In a changing NHS, where professions are being compelled to self-regulate, pharmacists working in psychiatry cannot sit back and hope no one will notice them. Clinical governance has been designed to assure the high quality of care throughout the NHS for the ultimate benefit of patients. We hope, therefore, that these proposals will be seen not as a threat, but as a rare opportunity.

There will be a consultation period. We ask all UKPPG members to consider these proposals carefully. After all, they will influence the direction of psychiatric pharmacy practice for years to come. We urge members to offer their comments and opinions, and guarantee that they will all receive the most serious and careful consideration.

The final proposals will be presented at this year's AGM, and time has been specifically set aside to debate the proposals in detail, so all members will have the opportunity to comment, debate, and vote on the proposals. Above all, we hope that this will be a fully participative process. That more than anything else will demonstrate the vitality of the UKPPG, the crucial importance of this issue to our collective and individual professional futures, and will ensure that the end result will be the right one for pharmacists working in mental health.

UKPPG Vice Chairman - Stephen Bazire

We realise that the whole subject of Clinical Governance and Specialist Accreditation may be a little overwhelming, if not downright scary, for people who are not familiar with the current NHS guidance and instructions. Please take the time to read the white paper summary if you need to learn more.

Clinical Governance is the concept that binds the existing strands of audit, clinical guidelines, risk management, standards, quality assurance and practice research. It not only applies to the professions such as our own, but will also apply to prescribing and drug use. The one clear thing is that ignoring Clinical Governance is not an option. The Government has spoken, Chief Executives have been given a clear timetable and the professions have to either self-regulate or be regulated. Please read this paper carefully, learn more if you need to, and contribute to the developments.

The draft proposal presented to members has been devised over about 100 person hours. My feeling is that UKPPG members are lucky to have such people as Peter Pratt and John Donoghue, who have the foresight to see the considerable opportunities (and threats) posed by clinical governance, and a committee willing to give up (yet more of) their own time to develop the scheme.

The potential opportunities afforded by clinical governance for an enduring improvement in the pharmaceutical care of people with mental health needs are enormous. Let us grasp these opportunities, for the sake of our service users.

3. Summary of proposals

  • The UKPPG introduces a scheme of "Specialist Accreditation" for mental health pharmacists, involving a mixture of experience and personal qualities
  • This "Specialist Accreditation" is integral with the principles of Clinical Governance
  • The UKPPG changes it’s name to the College of Mental Health Pharmacists
  • Accredited pharmacists are recognised as full members of the new group, non-accredited practitioners as associate members

4. Clinical governance – what is being proposed?

Diane Booth (Cambridge)

The UKPPG, committee after lengthy discussion, has concluded that setting standards in psychiatry would acknowledge those people working with a specialist knowledge. As a professional body, the UKPPG would be able to raise the standard of care available to these patients, by recognising those pharmacists providing a specialist service. Although this would mean that some pharmacists would not qualify for this accreditation, it would put pressure on employers to insist on a specialist accredited service, and would lead to a review in the care provided to patients. Thus Clinical Governance is achieved.

4a. The process for accreditation

Basic qualification: It will be necessary for all specialists to share a basic qualification and experience base of at least three years working with patients suffering from a mental illness. This should be an active role, at a level which is applicable to the environment the specialist is working in. e.g. those pharmacists working in a Mental Health Trust, will be expected to demonstrate a type of active involvement to those working in the community.

Specialist expertise: There will also be a requirement to demonstrate a special interest or depth of knowledge in Mental Health. This could take the form of either further education or research, or a long history of experience in Mental Health, which would acknowledge the valued expertise of those pharmacists who may not have had the opportunity to develop academically in the past.

Portfolio: In order to demonstrate these skills, a portfolio would need to be submitted which would provide evidence of involvement, achievements and activity in the pharmacists field. This information would cover a variety of circumstances, and could provide a strong support to the application.

Viva: Submission of all this evidence at a viva would ensure any outstanding issues and problems were resolved. During this process, communication skills and the ability to apply knowledge in a variety of situations would be reviewed, in a formal one hour session, and allow an accreditation panel to assess the skills not confirmed by the applicants qualifications and portfolio.

The whole accreditation process would need to be repeated every five years, to ensure continual personal development. There would be no limit to the number of times someone could become accredited.

For those pharmacists who do not demonstrate sufficient evidence of specialising, they will be advised on the need for further activity, and asked to re-submit their application in twelve months time. There would be no limit to the number of times someone could apply to become accredited.

The proposed cost of the process is around £300, payable on every application for accreditation.

4b. Portfolio contents

The proposed portfolio contents are:

  • Current post
  • Current service
  • Publications and written work (of any type e.g. reports, reviews etc)
  • Presentations
  • Patient services
  • Quality measures
  • Process of continuous improvement
  • Personal:
  • Personal development
  • Qualifications
  • Special interests
  • Personal involvement/effectiveness
  • Achievements
  • Future service plans
  • Additional items
  • Referees

These sections are designed to place in context an applicants current work environment, and allow them to demonstrate written and verbal communication skills, initiative, ability to apply knowledge or credibility, clinical effectiveness, leadership, the application of the Principles of Clinical Governance, and anything else that may support an application. Not all applicants will complete all sections of the document. These are given as examples of information that would be considered relevant.

4c. Election of founders

Clinical Governance demands maintenance of standards within professions by one’s peers. In line with this ideal, the UKPPG committee has decided to invite members to choose, by election, the Founders whom they would see most suited to this role.

At least five founders are to be elected. These should be pharmacists practising psychiatric pharmacy at a level that affords them the ability to assess others. They should be recognised for their integrity, honesty and their prowess in psychiatric pharmacy. Academic achievements and national recognition are also important considerations. Any pharmacist working with patients suffering from mental illnesses should be considered for this role. They do not have to be committee members, nor of a national profile. Specialism and competence are the important points.

4d Introduction of the proposed changes

Currently, various sub-groups of the UKPPG committee are working on the implementation of these proposals for accreditation. It is hoped that it will be possible to meet a number of deadlines.

  1. A copy of this pamphlet will be sent to each member in May of this year. All members will be encouraged to make any comments or criticisms by the deadline, in order that they can be addressed as soon as possible by the relevant sub-groups
  2. Voting papers for the election of the founders will be attached to this pamphlet. All members will be encouraged to vote regardless of whether they agree with the proposals.
  3. At the annual AGM in October, all changes to the constitution will be discussed in full and then voted on. All members will have an opportunity to be heard, and all opinions will be considered.
  4. Depending on the result of the vote, the proposed changes will either be introduced as soon as possible, or will be taken back to the committee for review.
  5. If the vote is not carried, the changes will be reviewed, and re-submitted to the members as soon as possible for approval.

4e Implementation of the process

Assuming approval of the final proposals by the UKPPG members at the AGM in October, a number of steps will be taken.

  1. A finalised version of the requirements for accreditation and a portfolio will be drawn up.
  2. A brochure will be available for all interested parties.
  3. This will be presented to both the Pharmaceutical Society and the Royal College of Psychiatrists for their acknowledgement.
  4. All relevant Trusts and employers will be provided with information and urged to ensure their pharmacy manager is accredited.
  5. Pharmacist managers will be approached with a view to becoming accredited.
  6. The founders will be appointed, and the first accreditations will begin.

Other pharmacists who have a specialist knowledge will be encouraged to becoming accredited.

5. Questions and answers on specialist accreditation

Stephen Bazire (Norwich)

Why is the UKPPG doing this now, when other groups e.g. Renal Pharmacists Group, are not?

(a) Accreditation and Clinical Governance are concerned with provable standards in practice, including mental health and pharmacy.

(b) Other groups are developing schemes such as this e.g. O.T’s, Physiotherapists, the Scottish Hospital Pharmacists Vocational Training Scheme etc. In the USA, the "Specialty Council on Psychiatric Pharmacy" is currently introducing "Board certification" (more details on the BPS website at www.bpsweb.org).

(c) Mental health is the largest speciality within pharmacy, and deserves such a scheme

(d) Mental health is a priority within current government guidelines

(e) The UKPPG is taking a lead, and is probably well ahead of most other bodies

(f) The whole object is to help ensure and facilitate quality pharmaceutical care for people with mental health problems, not to create unnecessary hoops or obstacles

(g) It would be unreasonable to rely on the RPSGB to develop specialist schemes such as this

Why has Clinical Governance come up now?

The NHS Executive guidelines on Clinical Governance have just been released, and demand systems such as that proposed. It will take the UKPPG most of the summer to take account of member’s suggestions and views, fine-tune the accreditation process, present to the AGM and, if approval is gained, prepare a "marketing" strategy. To wait until the AGM for the election of founders would be too late. The election of founders allows the process to proceed before the AGM.

Can the members vote against the scheme at the AGM?

Yes, they can. That is the object of the AGM. Members would, however, need to consider:

  • that Clinical Governance is now a statutory requirement for Trusts and action will be needed
  • if the final proposals are rejected in October, there will need to be a credible alternative
  • the consequences of not being involved with the process of "Professional self-regulation". The alternative is that it would be imposed on us by others, from other professions.
  • that reject of an accreditation scheme might be seen by as a vote of no confidence in ourselves (sic)

We would ask members to take the numerous opportunities being presented for input into the discussion, as a negative discussion at the AGM would waste precious time and resources. If members feel really strongly about the C.G. issue, a Special General Meeting may be called at any time by written request to the secretary by a minimum of ten members. It requires 30 days notice to all members.

Why do we need "Founders"?

Well, you have to start somewhere! Who were the first driving instructors? Who tutored the first clinical diplomas and MSc’s?

What qualifies the Founders to judge others?

You will do. The concept of a democratic election open to all members is sound and reasonable. All members’ votes will carry the same weight. "Professional self-regulation" is specifically stated in the Government Guidelines and advice on Clinical Governance. All Founder Members will have to qualify in 5 years anyway.

Who will judge the Founders? Who would dare fail them?

All accredited members will have been through the portfolio and viva stages, and will know the standards set by those Founders, and will be able to set a similar standard.

Can ordinary pharmacists become accredited?

It depends what you mean by ordinary. If you mean "ordinary" pharmacists practising competently and providing a quality service, the answer is an emphatic yes. The scheme, however, is aimed initially at senior pharmacists e.g. those leading each service. Accreditation of service leaders will imply that the services they run will be provided on the principles of Clinical Governance. Having said that, the criteria for each stage are wide and would include virtually all experienced pharmacists, including e.g. community pharmacists. There is no specific mention of any particular location of pharmacists, although there is likely to be a greater demand within Trusts.

How have the accreditation criteria been devised?

(a) With the aid of caffeine.

(b) The principles of Clinical Governance

(c) Flexibility ie the criteria can be unique in relationship to your particular situation

(d) Principles of Quality Assurance of clinical services

(e) To encourage higher standards of leadership and practice

It’s OK for people in the big "high profile" departments, but what about me?

High profile does not mean competence. Low profile does not mean a lack of competence. The criteria for stage 3 include a range of alternatives. The practice portfolio allows the pharmacist to explain their particular work situation and how they practise within that, in line with the NHS Executive principles of Clinical Governance. A single-handed pharmacist can practise to an accreditable level as easily as someone from a larger department. It is an ideal opportunity, in fact, for local (sic) and national recognition for someone who might otherwise not receive it.

Will there be sanctions for non-accredited pharmacists?

Not from the UKPPG. Chief Executives, however, will need to ensure a competent service. The UKPPG will remind Chief Executives of the risks they run in having a pharmacy service led by a person who is not accredited and thus falls below the standards set by their peers.

What will happen if I don’t get accredited?

All Trust Chief Executives have a statutory responsibility to ensure Clinical Governance, and will want to be confident about the quality of all services and staff, including pharmacy. If such a scheme exists, a Chief Executive may wish to know the reasons why the service leader or other senior employee is not accredited, and does not meet Clinical Governance standards. In some cases this may stimulate discussion about resources, training, staffing etc.

Won’t it make recruitment more difficult?

It is difficult to predict the likely impact on recruitment. On the positive side, with continued professional development within a speciality, recognition of this expertise is more likely, and the view that our speciality is one with known standards will enhance it. In the USA, broadly similar schemes operate, and accredited professionals are able to command higher grades. Such accreditation would also undoubted help future roles of individual pharmacists as dependent prescribers under the Crown Review recommendations.

Will there be any personal benefits if I become accredited?

Apart from a satisfied and superior feeling, your employability and job security would be enhanced, regrading appeals would be stronger, and there would be some additional recognition and kudos from both your peers AND within your Trust or organisation.

What if I don’t have the time or resources to become accredited?

To start with, there is no time limit involved. If e.g. a Trust has a pharmacy service with no accredited specialist, then it would be the responsibility of the Chief Executive to ensure the service is lead by an accredited specialist. This might mean making more resources available to you.

Won’t accreditation divide the speciality into the "haves" and the "have nots"?

This is not the object of the exercise. The aim of the scheme is to raise standards of practice of pharmaceutical care for users of mental health services. There would be those who were accredited (and competent) and those who were working towards that. A competent pharmacist is not necessarily a competent mental health pharmacist.

Where can I find out more about clinical governance?

Suggested reading includes:

  • Clinical Governance: Quality in the new NHS (Health services Circular), available from Department of Health, PO Box 410, Wetherby LS23 7LN, fax 0990-210-266. or on http://tap.ccta.gov.uk/doh/coin4.nsf.
  • Pharmacy in Practice 1999, February, 50
  • "What clinical governance means", Smith, Pharmacy in Practice 1998 (December), 479-482.
  • "Clinical governance: application to psychiatry", Oyebode et al, Psych Bulletin 1999, 23, 7-10

This document has been prepared by the UKPPG committee in order to provide members with as much information as possible at an early stage. Members are actively encouraged to help the committee continue to evolve the scheme between now and the AGM. UKPPG members currently involved include:

David Taylor, Chief Pharmacist, Maudsley Hospital, Denmark Hill, London SE5 8AZ, Stephen Bazire, Hellesdon Hospital, Norwich NR6 5BE, John Donoghue, 4, Wrenfield Grove, Liverpool L17 9QD, Celia Feetam, 62, Park Hill, Moseley, Birmingham B13 8DT, Dr. David Branford, Director of Pharmacy, Southern Derbyshire Mental Health NHS Trust, Kingsway Hospital, Derby DE22 3LZ, Morag Martin, Pharmacy, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, Lynn Haygarth, 23, Wheatley Grove, Ben Rhydding, Ilkley, West Yorkshire LS29 8SA, Alan Pollard, Mental Health Directorate, Newtown Hospital, Worcester WR5 1JG, Peter Pratt, Chief Pharmacist, Community health Sheffield, Lightwood House, Lightwood Lane, Sheffield S8 8BG, Diane Booth, Fulbourn Hospital, Fulbourn, Cambridge CB1 5EF, Gill Hawksworth, Old Bank Chemist, 54, Old Bank Road, Mirfield, Yorkshire WF14 0JA and Carol Paton, Chief Pharmacist, Bexley Hospital, Old Bexley Lane, Bexley, Kent DA5 2BW