Proposals to introduce an apprenticeship qualification for pharmacists were first drawn up in 2019, but then went quiet. With NHS England’s Long Term Workforce Plan considering “the potential” of a pharmacist degree apprenticeship, where are we now with this means of entry to the profession? By Saša Janković

Pharmacy apprenticeships were first proposed during a 10-day consultation in April 2019. However, plans were swiftly put on hold after arms-length government organisation the Institute for Apprenticeships and Technical Education said the ‘trailblazer group’ – made up of large employers and other organisations – needed to better represent the wider pharmacy industry.

In October 2019, the group put out an updated proposal, agreeing to “more transparency in the process” and “a longer consultation period”. Then the Covid-19 pandemic happened and – as with so many initiatives at the time – the trailblazer group went quiet.

But with NHS England’s Long Term Workforce Plan explicitly stating that consideration is being given to pharmacist apprenticeships, and the launch of a medical doctor apprenticeship scheme this September, could pharmacist apprenticeships be back on the agenda?

Meeting demand

NHS England published its Long Term Workforce Plan in June 2023, setting out an ambition to increase training places for pharmacists by nearly 50 per cent to around 5,000 places by 2031/32. The Plan also mentions the “potential to continue expanding training via the apprenticeship route for pharmacy technicians”.

While it appears to assume that there will be no pharmacist apprenticeships in place at least before 2031, it says that “consideration is being given to the potential of a pharmacist degree apprenticeship”.

Revisiting the idea of a pharmacist degree apprenticeship last year, the Pharmacists’ Defence Association (PDA) union remained cautious, saying that “many of the original misconceptions [about apprenticeships] remain unaddressed” and it was “unclear how the new trailblazer group of employers propose a degree apprenticeship to sit alongside the new IETP [initial education and training of pharmacists] course”, especially since this now involves independent prescribing as part of the curriculum and far more varied workplace learning.

Now, PDA director Paul Day says that since “the previous flawed proposal” was withdrawn, no alternative proposal has been submitted. “If any group of employers are considering doing so,” he said, “they should not repeat earlier mistakes and should engage with the wider profession, including the PDA, before progressing such a proposal.”

According to Day, the PDA is not involved in active discussions about apprenticeships, and while he says that “apprenticeships can have a role to play in the appropriate circumstances for some roles”, he stresses that “in particular, we do not believe the reality of a community pharmacy setting is appropriate for someone to be able to be developed as a pharmacist”. 

In its response to the NHS Long Term Workforce Plan, the Pharmacy Schools Council (PhSC) – which represents the collective interests of 30 UK schools of pharmacy – said that, in principle, it “welcomes the introduction of pharmacist apprenticeships as a means of widening access and providing innovative routes into the pharmacy profession”, but that “apprenticeships must be properly funded”.

“Far more detail about how pharmacist apprenticeships would operate in practice is required,” says PhSC. “Those becoming pharmacists through any apprenticeship route must meet the same learning outcomes (as defined by the pharmacy regulator, the General Pharmaceutical Council) as those following a traditional university route to an MPharm degree followed by a foundation year”. 

“We all want the workforce to get the support it needs to deliver excellent patient care amid the changing health needs of the population – and implementing the plan will not be without its challenges,” says professor Katie Maddock, chair of the PhSC and head of School of Pharmacy and Bioengineering at Keele University. “Placement capacity, particularly at undergraduate level and around prescribing, for instance, will be an important issue as well as long-term funding. We strongly encourage the Government to consult heads of pharmacy schools and the Pharmacy Schools Council on delivering its plan, and we look forward to working productively together to address the challenges that emerge.”

NHS England has said it is working with NHS England Workforce, Training and Education (WTE) (formerly Health Education England) to further clinical education and development for pharmacists and pharmacy technicians, with investment from the Pharmacy Integration Fund. However, a WTE spokesperson confirmed to P3pharmacy that with regard to pharmacy apprenticeships and how they might be rolled out: “At this stage, we don’t have anything further to add to the detail in the Long Term Workforce Plan.”

Skills for Health – the not-for-profit organisation working on the development of an improved and sustainable healthcare workforce across the UK, and also part of the trailblazer group, said it too is “not aware of anything other than the text in the NHS Long Term Workforce Plan” in relation to next steps for pharmacy apprenticeships. Confirming that it was “not aware of any plans at this time”, it added: “If the decision of the employers and other stakeholders is to proceed with the development of the apprenticeship standard, we would provide the facilitation support as part of our NHS England Trailblazer Support contract.”

With NHS England’s Community Pharmacy Workforce Survey showing a 15 per cent decline in the number of full-time equivalent employed pharmacists in community pharmacy, and a doubling of the rate of vacancies for community pharmacists to 16 per cent in the survey year (which ran from 6 October to 30 November 2022), there’s a pressing need to encourage and support more people to study pharmacy and pursue a career in the pharmacy professions.

Despite the survey – published on 3 August this year – showing that the total number of all pharmacists (not FTE equivalent) employed in community pharmacies increased by 1 per cent to 27,711 from 27,406 in 2021, in 39 out of 42 Integrated Care Board regions, 50 per cent or more of contractors said it was very difficult to recruit employed or locum pharmacists.

Educational reforms 

NHSE said the data is “intended to support decisions about where the community pharmacy workforce can contribute to supporting NHS clinical service expansion” and to inform education reforms for pharmacists and pharmacy technicians, as well as the ongoing review of the Additional Roles Reimbursement Scheme (ARRS), which funds primary care networks to recruit pharmacy staff for non-community pharmacy positions. So could this be the push needed to bring forward pharmacy apprenticeships reforms?

Matthew Taylor, chief executive of the NHS Confederation, has said the ambitions around apprenticeships and degree apprenticeships are “critical if we are to increase the size of the NHS workforce and attract more people into the service from diverse backgrounds”. 

He says the Confederation “believes apprenticeships will provide a particular boost in areas where it’s harder to recruit staff”. Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), says that the significant workforce challenges in the sector at the moment, highlighted by the workforce survey, make it “important that all avenues to alleviate workforce pressures are discussed and judged on their merits”.

“Pharmacist apprenticeships offer one of many possible solutions”, says Harrison, “and the CCA is seeking to understand the detail of proposals. Other sectors have reported great success with the introduction of degree apprenticeships, including acting as valuable catalysts to breaking down barriers to entering the profession [and] apprenticeships may play a role in building a more diverse and inclusive profession.”

The NPA, too, offers a cautious welcome to the idea. Gareth Jones, head of External and Corporate Affairs at the NPA, says: “Properly conceived and constructed degree level apprenticeships for pharmacists could increase access, enabling new talent to enter the profession [but] any new approach to education and training must maintain or enhance the professional standing of pharmacists, the skills of pharmacists and the scope of pharmacist practice.”

When it comes to pharmacist apprenticeships, it seems there is a will, but who will lead the way?

How different is a degree apprenticeship to other forms of entry to a pharmacy degree course?

Like other models of academic and workplace learning for pharmacists, degree apprenticeships will need to meet the General Pharmaceutical Council’s learning outcomes and standards in order to be fully accredited.

Skills for Health’s list of organisations involved in developing the pharmacist apprenticeship standard as of June 2021

Employers: Asda • Blackwell Medical Services • Boots UK • LloydsPharmacy • Lincolnshire Co-operative • Ministry of Defence • Norfolk and Suffolk NHS Foundation Trust • Paydens • Rowlands • Somerset Partnership NHS Foundation Trust • Superdrug • University Hospitals of North Midlands NHS Trust • United Lincolnshire Hospitals NHS Trust • Well.

With input and advice from: De Montfort University • General Pharmaceutical Council • Health Education England • Institute for Apprenticeships & Technical Education • Liverpool John Moores University • National Pharmacy Association • Pharmacy Schools Council • Royal Pharmaceutical Society • Skills for Health • The Company Chemists Association • University of Nottingham.