For the Pharmacist Independent Prescribing course you will need to have a minimum of 90 hours of supervised time with the Designated Supervising Medical Practitioner (DSMP).

This time will give you the chance to critically reflect and apply the principles of prescribing to your scope of practice.

Pharmacist Independent Prescribing

Since 2006, a pharmacist independent prescriber has been able to prescribe autonomously for any condition within their clinical competence. This currently excludes three controlled drugs for the treatment of addiction.

In order to become a prescriber, the pharmacist must complete a General Pharmaceutical Council (GPhC) accredited course.  Information on the accreditation process and the learning outcomes for the programme can be found on the General Pharmaceutical Council (GPhC) website.

You must organise your own DSMP before applying. The University is not responsible for the allocation of DSMPs.

DSMP requirements

The doctor (or dentist if relevant to the student’s scope of practice) must be a registered practitioner who:

• has normally had at least 3 years recent clinical experience for a group of patients/clients in the relevant field of practice;
• is within a General Practitioner (GP) in a General Practice and is either vocationally trained or is in possession of a certificate of equivalent experience from the Joint Committee for Postgraduate Training in  General Practice Certificate (JCPTGP) or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other NHS employer. This could be a private hospital or practice if appropriate;
• has the support of the employing organisation or GP practice to act as the DSMP who will provide supervision, support and opportunities to develop competence in prescribing practice;
• has some experience of teaching and/or supervising in practice.

Time commitments

The prescribing programme usually runs over 7 months. The GPhC states that the student must have at least 12 x 7.5 hour days of supervised practice.  At Cardiff University we believe that at least 60 of the 90 hours should be directly with the DSMP and that the other 30 hours can be with other healthcare professionals, prescribers or time with others that allows the student to fully understand the area in which they will practice as a prescriber.

How many students can a DSMP supervise at one time?

It is anticipated that the DSMP will be the primary supervisor for one student on the course at any one time.  If there are two students enrolled on the course from the same area at the same time, with two primary supervisors, then a number of joint teaching sessions could be agreed, to avoid duplication of effort.

DSMP role

The DSMP has a crucial role in educating and assessing the pharmacist independent prescriber. It involves:

• developing the prescribing role
• planning a learning programme with the student
• facilitating the student’s learning by encouraging critical thinking and reflection
• supporting the student to develop an awareness of their limitations and available clinical support within their new role
• providing dedicated time and opportunities for the student to observe how the DSMP conducts consultations with patients and /or carers and develops management plans
• observing the student undertaking consultations and providing feedback to them
• helping the student to integrate theory into practice
• assessing and verifying that, by the end of the programme, the student is competent to assume a prescribing role (see below).

From our experience at Cardiff University of running the course since 2004, the key skills the pharmacists need to develop are:

• consultation skills
• patient assessment skills
• clinical reasoning and judgement.

Assessment

The GPhC requires that the DSMP signs a final declaration stating that the student has demonstrated the skills in practice to confirm that the pharmacist is suitable for annotation as an Independent Prescriber of the GPhC’s register.  In order for the DSMP to feel confident in this declaration, Cardiff University requires the DSMP to be involved in a number of things.  These include:

• an initial meeting with the student to confirm their scope of practice and a plan for the time in practice element of the course;
• to review and provide feedback on different activities within the portfolio, for example the student’s clinical logs and  confirmation of the time spent in practice (equivalent of 12 x 7.5 hrs);
• to oversee the completion of the patient assessment skills section of the portfolio.  All of these skills are taught on the study days, however in order for the student to develop competence in them we suggest that they practice them on ‘real’ patients. Formative (for feedback only) and summative assessments are required.  Whilst you need to oversee this section of the student’s development, you do not have to observe each skill, for example you can delegate this to a nurse practitioner if they are more appropriate;
• to sign-off the prescribing competencies;
• to assess a consultation undertaken by the student in their scope of practice.  This needs to be completed twice; once to provide feedback on their performance and identify areas for improvement (formative feedback) and again at the end of the course where they must demonstrate competence (summative assessment).  The University provides guidance on this.

Support

Each DSMP will ideally attend a 2 hour training session, which is held prior to the course starting. In addition they will be provided with a specific handbook for DSMPs, providing them with all the relevant information about their role and the course.

They will be notified of their student’s personal tutor and the Course Director’s contact details and encouraged to contact either, at any time. If the DSMP is unable to attend the DSMP training, then a ‘event capture’ of the event or a webinar will be offered to them, in addition to a teleconference if necessary.