Introduction
The quality of care that NHS patients receive depends largely on the skills and knowledge of its healthcare professionals. In addition, a clear framework of practice standards should be defined for practitioners¹. Our challenge is to clarify what is expected from pharmacy practitioners at both General Level (post registration) and the Advanced Specialist and new Consultant levels². We believe an evidence-led competency-based assessment is required to ensure fitness for practice and professional development from registration to Consultant.

Aim
To assess the validity for self-assessed competence in the experienced specialist and advanced practitioner workforce, using the Advanced Competency Framework.

Method
The Advanced Level Framework (ALF) has been developed and previously described³. Using this framework, we collected data on the self-assessed competence and level of practice among practitioners in selected specialist interest groups. The ALF comprises 34 competencies clustered into 6 key competency domains: "Expert Professional Practice", "Building working relationships", "Leadership", "Management", "Education, Training & Development" and "Research & Evaluation"³. The target population comprised the membership lists of 7 UK based interest groups for specialist practitioners (e.g., the British Oncology Pharmacy Association; the UKCPA Critical Care group; etc). Each practitioner was contacted by mail, and asked to ascribe their current level of practice into one of three categories: "Specialist in training", "Experienced practitioner" and "Leading edge practitioner". Each respondent self-assessed their competence, in line with the validated ALF, at "Foundation", "Excellence" or "Mastery" level. In addition, practitioners were asked to support their self-assessment by listing evidence-based categories. Data were coded and analysed using descriptive and homogeneity analysis (HOMALS) (SPSS version 12.0).

Results
Data were obtained for 390 pharmacists. There were 66.9% females. The mean number of years qualified was 18. 22.8% were represented by Specialists in Training, 39.7% were Experienced Practitioners and 34% were Leading Edge Practitioners. HOMALS analysis (fig.1) showed that Specialists in Training tended towards "Foundation" (lowest) level, while Experienced Practitioners clustered around "Excellence" and Leading Edge Practitioners clustered around "Mastery". Used with a frequencies analysis, we estimate that of the advanced practitioner workforce sampled, 14% would fit the description for "Consultant" .

Conclusion
Using this type of analysis, we are able to describe levels of practice and associated levels of competence for these practitioners, and hence provide a map that will identify Advanced Practice and Consultant level practice for pharmacist practitioners.

References

1. Department of Health. The Report of the Public Inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984-1995: Learning from Bristol. (Cm 5207) The Stationary Office. July 2001.

2. Davies JG., Webb DG., McRobbie D., Bates I.  Fitness for practice: a competency-based approach.  Pharmaceutical Journal, 2002, 268: 104-06.

3. Meadows N., Webb D., McRobbie D., Antoniou S., Bates I., Davies G.  Developing and validating a competency framework for advanced pharmacy practice.  Pharmaceutical Journal, 2004, 273: 789-9.