Pharmacists in Advanced Clinical Practice Roles in Emergency Departments (PARED)

Background Following evidence published in the Pharmacists in Emergency Departments (PIED 2016) study Health Education England funded novel advanced clinical practitioner training for pharmacists (ACP-p), to support service delivery. Objective To explore experiences and clinical activity of trainee ACP-p, and opinions and recommendations of both trainees and clinical supervisors. Setting and participants Five Urgent/Emergency Care Departments in London UK. Registered UK pharmacists appointed as trainee ACP-p. Method Longitudinal mixed-methods study in three phases. Phase 1 – early semi-structured interviews and focus group using an experiences, opinions and recommendations (EOR) framework, Phase 2 – recording of trainee clinical activity using bespoke spreadsheet, Phase 3 – as Phase 1 but at conclusion of training. Main outcome measure Experiences, clinical activity, opinions and recommendations of study participants. Results Twelve (92%) eligible trainee ACP-p and five supervisors were recruited. Identified themes include: trainee personality, educational components, length of programme, support/supervision, career transition, university and placement training alignment, recommendations. Success was dependent on effective support and supervision. Clinical supervisors should be allocated supervision time. Trainees, their supervisors and emergency department staff should be given a clear brief. Study participants agreed that the programme could be successful. Trainee ACP-p reported that they could manage 82% of 713 reported cases. Additional training needs include: ECGs, Xrays and CT scans. Conclusion Pharmacists can successfully train as ACP-p in this setting over a two-year period. This career transition needs careful management and clear structures. Training ACP-p is a useful way of enhancing skills and supporting clinical services to large numbers of patients.