Step up in hospital pharmacy

The Structured Training and Experience for Pharmacists (STEP) programme has been running for almost 10 years and is a unique partnership between four major London hospital trusts: King’s College, South London, Guy’s and St Thomas’, and Lewisham. These sites offer a complete range of clinical and technical services necessary to form the cornerstones of all pharmacists’ training. The programme provides competency-based training, education and experience over three years to equip pharmacists with the skills and knowledge to provide the highest quality professional care and progress their careers.

Three pharmacists who have undertaken the STEP programme give their accounts and experiences of it below.

Developing into a competent clinical pharmacist

By Leonie Reid

I had my first taster of being a hospital pharmacist as a preregistration trainee and was made aware of the vast number of specialties I could get involved in. From paediatrics to elderly care and everything in between, there were numerous highly specialised pharmacists and experienced technicians who contributed to my learning.I had heard many things about on-call service, too, such as some resident pharmacists being awake and functioning into the small hours while others stayed at home offering advice over the telephone in emergency situations.

I knew I wanted to pursue a career in hospital pharmacy and I was keen to find a job that would push me to develop myself as a competent clinical pharmacist. The STEP programme was perfect for me.

One of the most challenging and exciting aspects of STEP is that all sites do things a little differently, such as the way the clinical teams are managed, dispensaries are run and the services are provided. Each hospital has a unique set of people and surroundings and provides a different on-call service. When applying for the STEP programme, I made sure I had done some background reading about the base site I was applying to since it was important for me to find a role in a department with the right kind of on-call service. I had the chance to speak to representatives at each site at the STEP open day, which helped me to make the right decision.

Another important aspect for me when looking for a post-registration job was the opportunity to study for a diploma. Throughout the STEP programme, I have been working towards the new Joint Programmes Board (JPB) diploma in general pharmacy practice, which fits well alongside my day-to-day hospital work.

An opportunity to work in different hospitals

By John Minshull

I spent the first 12months of the STEP programme completing foundation training at my base hospital. This comprised rotations through medicines information, technical services and patient services. Each day, I provided cover to a ward, the specialism of which depended on the rotation I was completing at the time. My clinical and time-management skills were developed further through participation in the department’s on-call service.

I then completed six months of core clinical training.I was given a more intensive clinical role to perform on the wards.With this came more responsibility for the provision of the clinical pharmacy service and the expectation that I would provide an enhanced level of pharmaceutical care. I also continued working towards the competency frameworks as part of the JPB diploma.

I took two examinations during these 18 months. The first, after 12 months, tested my knowledge of general principles of pharmacy practice. The second, after a further six months, was designed to test my knowledge of clinical therapeutics (with particular emphasis on pharmacology and pharmacokinetics), which I had built up during the core clinical training.

The main reason I applied to work within the STEP programme was the opportunity to work outside my base hospital in three six-month defined areas of practice (DAPs). In my mind, the DAPs offered by the STEP programme made it stand out from all of the other hospital pharmacy training programmes.

Since the programme is made up of four base hospital trusts and many other associated trusts in south east London, I believed that the chance of finding DAPs to fit my career aspirations were high and I looked forward to experiencing the different ways that trusts provide clinical pharmacy services.

The range of DAPs on offer to STEP pharmacists is expanding all the time. Some colleagues sought out placements working in DAPs involving intensive ward work (eg, critical care, care of the elderly, surgery), whereas others were interested in other challenging roles in primary care organisations or hospital formulary teams.

Being kept on my toes

By Georgina Boon

As a pharmacist working within a DAP, I have been exposed to scenarios traditionally reserved for more senior staff.Most DAPs have an element of management built into them. For me, this has varied from leading the training and development of junior staff to responsibility for drug budgets. My DAPs took me from a local primary care trust to a neurosciences department and onto an acute pain team.

The fact I have had the opportunity to work across three different trusts is a unique benefit of STEP. Even within the London region, different trusts work differently, with procedures and processes varying greatly. This has allowed me to build up a broader base of knowledge and skills.

By frequently adapting to new styles of working, I have been kept on my toes, which has prevented me from feeling like I am stuck in a rut. I have also seen how different clinical specialists work from trust to trust. This has helped me formulate a picture of what type of practitioner I want to be. Proving myself across multiple trusts has also been a great boost to my CV.Just as my early clinical training was highly structured, each DAP provided me with a solid backbone of learning, which was accredited by the JPB. Diploma assessments continued and were managed centrally. I found that DAP assessments were designed to encourage me to develop the skills relevant to the role that I was currently working in whereas, during the clinical training, the emphasis was on ensuring my skills were up to the same level as those of my peers.I was encouraged to work under my own initiative and use my own ideas to provide the best services at my place of work.

Reflecting on my three years of STEP, I am glad to have completed my basic training at such varied sites and have experienced many different ways of working. I would highly recommend STEP as a training programme. Apart from gaining your clinical diploma, you have the benefit of working across different trusts.