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Revalidation

Revalidation: how to complete a peer discussion record

A step-by-step guide for pharmacists and pharmacy technicians to undertaking and documenting this vital part of revalidation, according to General Pharmaceutical Council requirements.

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Pharmacists and pharmacy technicians must complete peer discussions as part of the revalidation process

Revalidation officially began for pharmacists and pharmacy technicians on 30 March 2018, replacing the old continuing professional development (CPD) process[1]. Pharmacists and pharmacy technicians entering their second year of revalidation now need to submit one peer discussion and one reflective account, as well as four CPD entries covering planned and unplanned learning.

The purpose of the peer discussion is to help you reflect and evaluate your practice and learning with a trusted professional, ultimately for the benefit of the people using your services. It is thought that having another person’s point-of-view can help reduce the potential for professional isolation[2].

The discussion itself should not relate to performance or assessment. Therefore, the role of the peer is to prompt you and ask questions during the discussion, in order to facilitate open and honest conversations to challenge your thinking and the way you do things (where appropriate). They may be performed face-to-face or by phone, web-chat or video call, or in a group setting[2].

The discussion should take around one hour; however, it can be shorter or longer, or be a series of discussions, if you think this is beneficial to you.

The detail of the discussion does not need to be recorded; rather, there should be a record of your reflections on the benefit your peer discussion has had on the people using your services.

Who can be a peer?

You are free to choose your own peer, and you should only have a peer selected for you if you are comfortable with the selection[3]. Neither you nor your peer need to be based in the UK, but your peer must consent to providing some contact information. For more information about who you can and cannot select to be your peer, see Box 1.

Box 1: What are the criteria for a peer?

A peer does not have to be another pharmacy professional — they do not even have to be a health and social care professional. The main things are that they are someone who understands the aspects of your role, and they are someone who you trust and respect. This can include:

  • Someone you work with;
    • For example, if you are a community pharmacy technician, this could be the pharmacist in your place of work.
  • Someone with a similar role to you;
    • For example, if you are an academic pharmacist, this could be an academic from a different discipline.
  • Someone with the same or similar professional background to you;
    • For example if you are a public health pharmacist, this could be another public health specialist.
  • A colleague from a multidisciplinary team.
    • For example, if you are a hospital pharmacy technician, this could be a group of healthcare professionals.

A peer can also be a different level of authority to you, for example your line manager, mentor or coach. You do not have to use the same peer each year.

However, a person cannot act as your peer if:

  • You have too close a personal relationship (i.e. a partner or family member) and either of you feels they cannot be objective;
  • You or they have a conflict of interest, or a perceived conflict of interest, such as a commercial relationship that undermines objectivity;
  • They are a healthcare professional currently under sanction from a regulator.

Source: General Pharmaceutical Council[3]

How do you prepare for a peer discussion?

After identifying and reaching an agreement with your peer to facilitate the discussion, you should plan the logistics of the meeting. Select a time that is appropriate for both of you, in an appropriate setting (i.e. away from distractions and interruptions). Ensure that the discussion is booked well in advance to allow you time to write it up, demonstrate the impact it had on your practice, and submit it by your personal revalidation deadline.

You should decide what you want to discuss in advance and then provide a brief for your peer. Potential topics for discussion could include:

  • The learning you have been doing or intend to do this year, and how you apply it in practice;
  • Any successes or challenges you have had this year and how this affects people who use your services;
  • Any incidents, events, complaints or compliments that you have received this year, including what changes you made to your practice as a result of this feedback;
  • Examples of where you feel you have met or exceeded the General Pharmaceutical Council’s (GPhC’s) standards for pharmacy professionals for the benefit of the people using your services;
  • Any quality improvement activities that you have undertaken and how they have benefited the people using your service users[2].

You might find it helpful to share a professional development plan, your CPD records, and any training or quality improvement activities you have been involved in with your peer prior to the discussion[2]. If your chosen peer is not a pharmacy professional, it may be helpful to share the GPhC standards for pharmacy professionals with them, as well as resources to support them (see Box 2).

Box 2: What to do if you are a peer

Before the discussion

The person completing the record may want to share some documents with you prior to the discussion. If they do, it would help to look through them and think of some questions to guide the conversation.

If you are the registrant’s line manager, the peer discussion must be separate from their annual appraisal.

During the discussion

The discussion should take around one hour. Ask the registrant open questions about their practice, and successes or challenges, for example:

  • What happened?
  • Who was involved?
  • Why did you decide to do it that way?
  • Were there any other options?
  • What happened next?
  • What did you do in response?
  • How do you think that made them feel?
  • What would you do differently?
  • What were the final outcomes?
  • What successes have you had this year?
    • How has this affected people using your service?
  • What challenges have you had this year?
    • How has this affected people using your services?
  • What quality improvement activities have you undertaken this year?

You do not need to make any notes about the content of the discussion as this will remain confidential.

In the unlikely event that, during the peer discussion, an issue is raised that you are concerned about, please refer to the General Pharmaceutical Council’s (GPhC’s) guidance for raising concerns and, if necessary, follow the relevant processes.

Remember to take some time at the end to facilitate reflection on the overall discussion — it would be useful to get the participant to think about what they have learnt and what they will do following the discussion.

After the discussion

You must supply your name, role, organisation, telephone number and email address to the registrant. This is in case the GPhC needs to contact you to confirm if the discussion took place. Therefore, it will be helpful to make a note of the date(s) of the discussion and the name of the registrant. The GPhC will not request any other information about the discussion.

Source: General Pharmaceutical Council[4]

What happens during the discussion?

Your peer should ask open-ended questions about your chosen discussion topic. The question words ‘what’, ‘where’ and ‘who’ may help with focusing the discussion. These should help you reflect on decisions you have made and how they have affected your practice and the users of your service. The discussion should aim to influence your development positively, rather than your peer making an assessment of you[3].

The discussion should provide an opportunity to revisit an event or situation in detail, providing an opportunity to explore your practice. You may wish to take some notes during the discussion to help you when writing up your experience. In your record, you will need to describe the suggestions and changes implemented in practice as a result of the discussion and the results, with real examples (see later). However, please note that you do not need to provide a written account of the discussion as this remains confidential.

At the end of the discussion, you should set aside some time to reflect on your discussion overall, focus on what you have learnt and what you will do afterwards.

A dedicated page on the journal’s website has been developed to help support subscribers and members of the Royal Pharmaceutical Society (RPS) complete their peer discussion. Relevant learning and career articles that meet the requirements for the application of each of the standards have been collated on this page, which will be available from the end of May 2019. This content can be used to support your discussions.

For more information on what to do if you are a peer for someone else, see Box 2.

If the discussion does not go well, you may choose a different peer and repeat the process[3].

What should the record from the discussion include?

You must provide a written explanation of how your peer discussion has changed your practice for the benefit of your service users[2].

Explain why you chose your peer

This should be a simple statement explaining your rationale. This could be because they have more experience than you or they understand your role well (e.g. they are your line manager). For example:

  • I chose my line manager at the commissioning support unit that I work for. I chose them because they understand my work well and also because we have a strong working relationship[5].
  • I chose an established pharmacist prescriber working in a community setting within the trust with their own caseload of patients as my peer because they have significant experience of working as an independent clinician; they also work within the management team for the specialty[5].

Describe how the peer discussion process has helped you to reflect on your practice

Provide an overview of the main area of discussion and why you chose to discuss it. For example:

  • We used my discussion to think about each piece of work I was doing at the time. My role is split between both primary and secondary care customers. I work as one of the pharmacists that enter overspent practices in the clinical commissioning group. I provide support to practices by identifying medications that can be switched so that quality, innovation, productivity and prevention savings can be made[5].
  • I chose to discuss an area of practice that is new to me: the supply of medical equipment and the processing of prescriptions for spectacles. The discussion helped me understand from the perspective of someone with more experience what I need to do to work effectively in this area[5].
  • My peer discussion helped me to think about how to write up research[5].

Describe how the peer discussion has helped you make improvements in your practice

This should explain what changes you have made as a result of the discussion. For example:

  • This discussion gave me the opportunity to reflect on the impact of incidents on the pharmacists involved, and made me realise that there was a gap in our knowledge and resources as a professional team. It provided me with the opportunity to put measures in place, should another of our pharmacists find themselves in a similar position[5].
  • I used the feedback provided to identify what further learning I needed to undertake to complete the writing of this journal article and to reflect on where I had made good progress. We developed an action plan and produced a final draft that has been published[5].

Include a real example of any beneficial outcomes for the people using your services as a result of this

This might also include any feedback about your practice that you have received from other people. Although real-life examples are required by the GPhC, it is important to remember that patient confidentiality must still be maintained. As such, you need to anonymise anything that could be used to identify a patient (e.g. the patient’s name, the date of the event, the location where the event occurred). For example:

  • I have also shared how I put my learning into practice with colleagues and ensured that everyone in the team is up to date. We already collate service user feedback — the evidence of an enhanced service will be provided in the form of improved quality of documented medicines information (MI) query answers, and improved responses from the MI Users Survey[5].
  • Already, I have had time to talk to one of my patients about their inhaler technique through the new asthma local enhanced service (LES) and have documented several chronic medication service (CMS) new medication interventions[5].

Can this process be made easier?

The RPS MyCPD app has a facility to keep a record of peer discussions, alongside ongoing learning. The app is available for iOS devices via the App Store and Android devices via Google Play.

The RPS provides members with a dedicated Revalidation Support Service, which can be contacted by phone or email (0845 257 2570; support@rpharms.com); a dedicated revalidation support hub, which provides specific information relating to the peer discussion, such as prompt sheets, videos and tutorials; and resources to support revalidation on its website.

The GPhC also has a number of resources on its website to help guide pharmacy professionals (see Useful resources).

For information on how to complete your reflective account entry, see the accompanying learning article here.

Useful resources

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206477

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