Background: Inconsistency in the practice of clinical pharmacy at a junior level encouraged our group to develop a general level competency framework (GLF) to facilitate practitioner development and assessment. The framework consists of patientrelated, personal and problem-solving clusters of competencies assessed on a four-point frequency scale. This study describes a large, controlled study to determine whether the framework could improve the clinical practice of junior hospital pharmacists.Method: One hundred and two junior grade pharmacists in 22 acute NHS trusts in the south of England were recruited. The hospitals were enrolled as either intervention (n ¼ 13; 72 pharmacists) or non-intervention sites (n ¼ 9; 30 pharmacists). The pharmacists ("tutees") and senior supervisors ("tutors") in the active sites used the competency framework for practice development. Tutees and tutors in the control sites did not have access to the competency framework, and measures were taken to ensure these trusts remained isolated from the assessment outcomes. All pharmacists were assessed at baseline, 3, 6 and 12 months. Non-intervention pharmacists were assessed by external evaluators.Results: A repeat measures analysis (month-6 compared to baseline, month-12 compared to baseline) revealed that the intervention group showed an improvement in 24 of the 25 competencies at month-6, which was sustained at month-12. In contrast, the non-intervention pharmacists demonstrated an improvement in just 7 of the competencies at month-6 increasing to 12 competencies by month-12 (Table III). Using an aggregated competency score for each recruit, intervention and nonintervention pharmacists were compared using an application of Kaplan-Meier analysis. Event status was defined as the achievement of competence, detected by the attainment of a predefined threshold score. A significant difference existed between the groups at all time points (log rank ¼ 7.97, p ¼ 0.0048).Discussion: This controlled study demonstrates that tutees in the intervention sites improved significantly in 24 of the 25 patient-related competencies at 6 months and that this was sustained at 12 months. By contrast, non-intervention candidates showed progression in only 12 of the 25 competencies.

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A pharmacist could manage an estimated 8% of adult attendances at this A&E department. Efforts should be made to increase the awareness of the general public of the role of a community pharmacist to reduce demand on A&E and GP services.

DRPs account for 4% of attendances at a central London A & E Department.

Introduction: This paper describes data collected over a period of 4 years in the former South Thames Region, UK, where objective structured clinical examination (OSCEs) have been used to assess pre-registration pharmacists in a secondary care setting. The study aims to describe a quantitative measure of competence using OSCE style assessments of graduate, preregistration pharmacists.Method: All pre-registration pharmacists within the South Thames Region undertook a series of OSCEs; data were collected over a period of 4 years. Competence was assessed in each OSCE workstation using a pre-defined checklist.Results: In total, 223 pre-registration graduates participated; two thirds (67.9%) were female and the majority (62.7%) were trained in district general hospitals. Overall, 17.2% of graduates were deemed competent at the beginning of their preregistration year compared to 68.3% at the end. This represents a significant improvement in clinical skills performance over the year (Wilcoxon signed rank test, Z ¼ 2 12.024; p ¼ 0.005).Discussion: The training program undertaken by pre-registration pharmacists significantly improved the clinical competence of these graduates in the areas measured, with two thirds considered competent overall at the end of the year. Of particular concern is the apparent inability of graduates to monitor prescriptions appropriately. The findings of this study have significant implications for workforce training and career planning. New graduates should not be working in isolation but should be considered as training grades and given support within the clinical team to develop their skills. Newly registered pharmacists should not be expected to undertake the range of tasks currently allocated to them, without appropriate supervision and further competency assessment.

Pharmacists consistently carried out interventions to patient care over a 4 year period and provide the Trust with a service that focuses on ensuring safety and efficacy of the medications administered. Impact of findings on practice Daily clinical pharmacy services in a UK teaching hospital allow pharmacists to contribute to protecting patients from the adverse effects of medications. Pharmacists most frequently intervene to patient care for the reasons of medication efficacy and safety and to prevent adverse drug reactions.