Section 2 - Core Concepts & Skills

Question 1

A Profession can be described as an occupation that:

2.1 Professionalism

Answer 1

• Is recognised by the public as a profession.
• Has a recognised representative professional body
• Benefits from professional standards and codes of conduct
• Is regulated to ensure the maintenance of standards and codes of conduct.

Question 2

2.1 Professionalism

Answer 2

A member of a profession

A member of a professional body

An individual who:
- Behaves & acts professionally
- Exercises professionalism & professional judgement
- Undertakes continuing professional development.
- Has professional values, attitudes & behaviours.

Question 3

Pharmacy Professionalism
- Definition

2.1.1 Professionalism

Answer 3

• Can be defined as a set of values, behaviours & relationships that underpin the trust the public has in pharmacists.

Question 4

Pharmacy Professionalism
- Examples

2.1.1 Professionalism

Answer 4

• Altruism
• Appropriate Accountability
• Compassion
• Duty
• Excellence & Continuous Improvement
• Honour & Integrity
• Professional Judgement
• Respect for other patients, colleagues & other healthcare professionals (including listening to & acting on feedback when needed)
• Working within competence
• Ensure patient is placed at the centre of all decision making
• Being Honest about scope of practice
• Knowing when to seek support

[Many of these values/attitudes/behaviours are also reflected in the mandatory GPhC standards and are relevant to all pharmacy professionals]

[Pharmacists in industry should also adhere to the association of the british pharmaceutical industry (ABPI) code of practice for the pharmaceutical industry]

Question 5

Professional Judgement
- Definition

2.1.2 Professional Judgement

Answer 5

The use of accumulated knowledge & experience.as well as Critical Reasoning to make an informed professional decision.
- often to help solve a problem or in relation to a patient or policies/procedures affecting patients.
- Takes into account the law, ethical considerations, relevant standards & all other relevant factors related to the surrounding circumstances.
- Will resonate with the core values, attitudes & behavioural indicators of professionalism.

Question 6

Excercising Professional Judgement
- Example flow diagram

The process of a professional judgement is under pinned by knoweldge

2.1.2 Professional Judgement

Answer 6

1. Identifying the ethical dilemma or professional issue. e.g. deciding whether to supply a medicine or not.
2. Gather all the relevant information & research the problem. Obtain following: Facts, Knowledge, Laws, Standards, Good practice guidance, advice from support services/head office/ line managers/colleagues
3. Identify all the possible solutions.
   - Consider & act in the best interests of the patient. - Consider & manage appropriately any personal interests or organisational goals, incentives or targets.
4. Weigh up the benefits & risks of each option
   Consider the advantages & disadvantages of each of the possible optuons identified.
5. Choose an option - Ensuring you can justify the decision
   Its important you can justify the decision you have made becuase often the ethical dilemma or professional issue means you are weighing up conflicting obligations which could be genuine patienrt interest, legal obligations, professional standards, public interest, contractial terms of service & company procedures.
6. Record The Deccision-Making Process
   Include your reasons leading to a particular course of action where approprate
   This may be in pts PMR, pt medical record, intervention record book, back of prescription register.
   This is important as evidence of the though processes leading to the decision.

Question 7

Role of Professional Judgement in Ethics

2.1.2 Professional Judgement

Answer 7

Professional judgement is key to handling ethical dilemmas.
- Ethical dilemmas often arise in situations where acting in the patients best interest may be outside the legal constrains of normal practice.
- Two different pharmacists faced with the same situation may choose two different courses of action due to the nature of a finely balaced ethical dilemma. Both courses could still be justafiable & legitimate choices.

Question 8

Do’s/Don’ts when using Professional Judgement

2.1.2 Professional Judgement

Answer 8

• Professional judgement is not a blanket defence or blanket reason to take the most convenient choice.
• It must be excercised properly, logically and for valid reasons.
• ## If there are mechanisms to acheive the required goal, it would be risky to choose an illegal alternative, e.g. lending medication would be difficult to justify if an emergency supply/CPUS could be used.

Question 9

What is Professional Empowerment?

2.1.3 Professional Empowerment

Answer 9

• Professional empowerment is about enabling professionalism and professional judgement.

Question 10

What is Professional Empowerment at an individual level: for pharmacists/future pharmacists.

2.1.3 Professional Empowerment

Answer 10

At an Individual Level for pharmacists & future pharmacists it is about:
- The development of knowledge
- Development of skills, experience & confidence;
- The cultivation of professional values & behaviours which collectively imbue the pharmacist with authority, empowering & enabling professionalism & the ability to manage ethical dilemmas.

Question 11

What is Professional Empowerment at wider level.

2.1.3 Professional Empowerment

Answer 11

• At a wider level it is about creating an environment around an individual which enables all the same as that at an individual level
• the development of knoweldge
• the development of skills, experience & confidence.
• The cultivation of professional values & behaviours collectively imbuing the pharmacist with authority, empowering. & enabling professionalsim & the ability to manage ethical dilemmas.

Question 12

Professional Training for pharmacists/students

2.1.3 Professional Empowerment

Answer 12

-Starts at univeristy
- Enhanced by foundation training year learning, designated supervisors & training programmes.
- In professional practice it is self cultivated through revalidation & continuing professional development (CPD), continuing edication, and supported by the RPS though foundation & advanced practice programmes.

Question 13

GPhC Standards for Registered Pharmacies

2.1.3 Professional Empowerment

Answer 13

• Require that staff are empowered & competent to safe guard the health, saftey & wellbeing of patients & the public.

Question 14

How does RPS Contribute to Creating Empowerment?

2.1.3 Professional Empowerment

Answer 14

• Through guidance, standards, news & alerts.
• Through webinars and mentoring programme, leadership development framework
• Through influencing policy
• Embedding and nurturing the right culture.

Question 15

What is the role of the RPS resource - Reducing workplace pressure through professional empowerment:

2.1.3 Professional Empowerment

Answer 15

Document is designed to help by empowering pharmacists, as individuals, to take action if they are adversely affected by workplace pressures and includes:
- Mechanisms for raising concerns
- Promoting management skills
- Ensuring pharmacists take breaks
- Professionalism & managing commercial pressures
- Job satisfaction.

Question 16

How do Employers play a key role for enabling reducing workplace pressure through professional empowerment?

2.1.3 Professional Empowerment

Answer 16

• Provide structured trainign resources & events
• Conferences
• Opportunity & time for CPD
• Support from superintendents office
• Company alerts & updates
• Developing & implementing the right organisation culture which enables professional empowerment

Question 17

Other Pharmacy Organisations, Stakeholders & training providers role in enabling professionalism

2.1.3 Professional Empowerment

Answer 17

• Through training
• Enabling the right enviornment for professionalism to flourish, including though getting the culture right.

Question 18

Purpose of Regulatory & Professional Standards & Guidance

2.1.4 Standards & Guidance

Answer 18

• Provide framework which helps ensure good care focussed on patients.

Question 19

What being a Pharmacy Professional is about?

2.1.4 Standards & Guidance

Answer 19

Having the right:
- Skills
- Knowledge
- Attitudes
- Behaviour
- Judgement

All to help ensure good quality outcomes for patients and make sure patient-centred care is at the heart of everything done.

Question 20

To inform the care you provide & your decision making you should:

2.1.4 Standards & Guidance

Answer 20

• Consider what is in the best interest of the patient.
• Be guided by your education & training & ongoing CPD
• Consider the standards & guidance (both regulatory & professional) that are relevant to your situation
• Understand the legal framework in which you are operating.

Question 21

What GPhC & RPS expect pharmacists & pharmacy owners are aware of and use

In relation to Standards/Guidance

2.1.4 Standards & Guidance

Answer 21

• Are aware of and use all relevant standards & guidance as part of ensuring safe, effective & high-quality professional practice & care for patients.

Question 22

How Regulatory & Professional Standards, together with guidance, policies & procedures support positive patient outcomes.

2.1.4 Standards & Guidance

Answer 22

2.1.4 diagram 2

Question 23

What are the GPHC Regulatory Standards & Guidance for pharmacy professionals & pharmacies?

2.4.1 Standards & Guidance

Answer 23

• Statements of what people have the right to expect when they use pharmacy services
• Must be met buy all pharmacy professionals & owners of registered pharmacies.

Question 24

What are the RPS Professional Standards & Guidance?

2.4.1 Standards & Guidance

Answer 24

• Provide framework to support pharmacies & their teams, working in a variety of settings & roles, to develop their professional practice, improve services, shape future services & deliver high quality patient care.

Question 25

Are Professional Standards Mandatory?

2.4.1 Standards & Guidance

Answer 25

• While professional standards are not mandatory, they are developed & owned by the profession.
• They set out what constitutes good in terms of practice, systems of care and working practices.
• Pharmacy professionals that are following professional standards set by the RPS can have confidence that they are meeting the regulatory standards set by the GPhC.

Question 26

What are Professional Standards & Guidance

2.4.1 Standards & Guidance

Answer 26

• Supportive & enabling whilst professionally challenging, describing & building on good practice to support pharmacies with achieveing excellence in professional practice.
• Provide broad framework to support pharmacists & their teams to develop their professional practice, improve services, shape future services & deliver high quality patient care across all settings & sectors.

Question 27

Do you need to declare conflicts of interest?

2.1.5 Conflicts of Interest

Answer 27

Yes, it is important to declare conflicts of interest appropriately whether they are actual or potential.

Question 28

What is an Actual Conflict of Interest?

2.1.5 Conflicts of Interest

Answer 28

• When one or more interests materially conflict.

Question 29

What is a Potential Conflict of Interest

2.1.5 Conflicts of Interest

Answer 29

• Where there is a possibility of a conflict between one or more interests in the future.

Question 30

Examples of Conflicts of Interest

2.1.5 Conflicts of Interest

Answer 30

• Having another job or receiving consultancy fees (i.e. having an outside employment) which impacts upon another role.
• Receving or being offered gifts from patients or suppliers to the NHS or your employer
• Receiving or being offered hospitality such as travel, accommodation, meals or refreshments e.g. in relation to attending a meeting, conference or training event.
• Receiving or being offered sponsoship for events, research grants or posts.
• Owning shares in a company whoes value could be influences by your role.
• Having an indirect interest or non-financial interest e.g. if a spouse, close relative, business partnet or close friend has an interest.
• Receiving any other payments or transfers of value

Question 31

Does a Conflict of Interest Prevent an Individual from Carrying out a Role?

2.1.5 Conflicts of Interest

Answer 31

• Not necessarily, but it ensures that there can be no perception that they are seeking to infulence decisions improperly

Question 32

Who are Conflicts of Interest commonly made to?

2.1.5 Conflicts of Interest

Answer 32

• Employer through a line manager, governance or conflic lead.
• Someone commissioning your services
• A chairperson at the meeting which you attend.

Question 33

What is the interface between personal & professional life in pharmacy -

2.1.6 Interface Between Personal & Professional Lives

Answer 33

• One of the most common causes of conflicts of interest or ethical dilemmas likely to come across.
• One of most likley to come across in early career.
• Non-healtcare professionals may not always understand your duty of confidentiality does not only apply at work, but also to people who may not be officially your patients. This could be information reguarding their own health or people they know.

Question 34

Pro’s/Con’s

Providing Pharmacy Services/Advice to family/friends.

-*Pharmacy services: prescription dispensing, providing advanced & locally comissioned/enhanced professional pharmacy services & providing advice.

2.1.6 Interface Between Personal & Professional Lives

Answer 34

• Nature of pharmacy means likely at some stage will be asked to provide pharmacy services or advice for family or close friends.
• This is not necessarily a bad thing, many prefer to ask/accept advice from someone they already know & trust (and who knows them).
• There are likely times however when instincts & duties as a healthcare professional conflict with your instincts & duties as a friend/family member.
• Providing pharmacy services/advice to family/friends relies upon you being able to apply your professional judgement & remain objective within the situation. This is notoriously difficult, especially if the situation is complex
• It is important to stop and think about whether it is appropriate for you to be involved and if so what you should do.

Question 35

Things to consider before doing so:

Providing Pharmacy Services/Advice to family/friends

-*Pharmacy services: prescription dispensing, providing advanced & locally comissioned/enhanced professional pharmacy services & providing advice.

2.1.6 Interface Between Personal & Professional Lives

Answer 35

• Is the situation an emergency: where not advising or dispensing a prescription could put the person at risk of serious harm?
• Could the person be easily signposted to an alternative appropriate healthcare provider?, Would it be more appropriate to do so?
• Are you able to maintain objectivity & exercise professional judgement?
• Is maintaining confidentiality an issue? Dose the person who is asking the question have a right to know the answer?
• Are you fully aware of all the care currently being provided?
• Do you have all of the necessary information to professionally and confidentially provide the pharmacy service/information - can you advise accurately and appropriately with the information that you have?
• Is what you are being asked for within the bounds of your professional competence?
• Can you demonstrate transparency: personal and professional boundaries should be maintained to prevent any conflicts of interest arising?
• Do you have access to summary care records (where required?)
• Are you able to make appropriate records (where required)?
• Will providing the service/advice affect the person’s relationship with their usual healthcare provider(s), and if so how?
• Do you need to inform anyone else of what you ahave done/advised?
• What is in the best interests if the patient, all factors considered?
• Ensure know employers policies reguarding providing services to friends/families.

[Remember if provide pharmacy srrvices (e.g. advice) outside work environment still expected to provide it to the same standard as would at work & you are likely still liable if anything goes wrong]

Question 36

Using Social Media as a Pharmacist

2.1.6 Interface Between Personal & professional Lives

Answer 36

• If using social media should do so responsibly and with the same high standards which would apply in face to face interactions.
• It is important to maintain proper professional boundaries in relationships and interactions with patients, and at all times to respect the confidentially of patients/colleagues
• Be aware of the potential audiance of your online activity, that it may be publically accessible, circulated and shared beyond your control. This activity could impact upon your professional image and the reputation of the profession as a whole.

[organisations may use social media to communicate with healthcare professionasl in other departments, its important pharmacists understand and follow their company or NHS trust policies on this practice]

Question 37

What it is/Requirements

Professional Indemnity

2.1.7 Professional Indemnity

Answer 37

• It is required if your registered with GPhC that you have professional indemnity insurance in place before you start working in your role.

GPhC advisment:
“ that the professional indemnity arrangement you have in place provides appropriate cover. This means that the cover needs to be appropriate to the nature and extent of the risks involved in your practice”

Question 38

What is Professional Development?

2.2 Professional Development

Answer 38

• Described the manner by which pharmacy professionals maintain and enhance their knowledge, skills and personal qualities throughout their professional careers.