The GPhC is planning to introduce “peer discussion” as part of its consultation on revalidation, so what will this new activity mean for pharmacy professionals?

Safe and effective care delivered through ‘person-centred professionalism’ – that’s how the GPhC describes the new standards for all pharmacy professionals that came into effect on 12 May.

The nine standards – reduced from 57 – replace the standards of conduct, ethics and performance and, instead, emphasise key themes of person-centred care, demonstrating leadership and greater accountability on the part of pharmacy professionals.

Alongside this, the GPhC is also consulting on proposals to introduce revalidation for pharmacists and pharmacy technicians. Revalidation is something that many health professionals already have to do, but pharmacy is distinct from other professions, so just what will this involve?

As well as making declarations that they continue to meet GPhC standards and remain fit to practise; undertaking, recording and submitting four CPD activities; and undertaking, recording and submitting a reflective account against one of the GPhC’s standards for pharmacy professionals, pharmacists and technicians are also expected to undertake, record and submit a peer discussion. The peer discussion element will not begin to be reviewed by the GPhC until 2020.

According to the regulator, evidence shows that peer discussion is a valuable exercise for bringing about improvement and reflection, as well as a way to reduce the sense of “professional isolation that many pharmacy professionals have reported to us”.

What is peer discussion?

Peer discussion is a learning and development activity that encourages engagement with others in your profession to reflect on learning and practice. To be most effective, these discussions should be formative (that is, designed to aid development), open and honest and should be held with someone trusted and respected. They can take place in any format: face to face, over the phone, via web chat, via a video call or any other means of real-time communication.

Peer discussion is already embedded into the RPS professional development programmes (both foundation and faculty), so members who are engaged in these programmes have this element covered. The RPS also provides peer discussion opportunities to everyone as part of its CPD offer, even if you are not taking part in its professional development programmes.

Find the right peer for you

Your peer should be someone who understands aspects of the work you do and whom you respect and can trust. The GPhC suggests the person could be:

• an individual you work with
• a group of people with similar roles to you
• someone with the same or similar professional background, or
• a colleague from a multidisciplinary team.

Beth Ward, RPS foundation programme manager, says finding a peer, or becoming a peer yourself, does not need to be a difficult or daunting task. “The RPS has developed guidance on ‘what good looks like’ for peers, whether that be from within or outside the profession, and can help you to find the right person for you,” she says.

The relative status of the peer does not matter in terms of prompting discussion and you can choose a peer who has a different level of authority from you. However, it’s better not to choose a peer with whom you have too close a relationship, such as a family member or close friend.

Marc Donovan, chief pharmacist at Boots UK, says the focus should be on choosing a peer whom you trust, who can provide open and honest feedback and who will seek to share ideas and comments that will encourage change. “This may not be possible if the peers don’t have a strong relationship and rapport,” he says. “It’s these latter points that should be emphasised, more than whether the individuals both work in the same organisation.”

You might find your peer through your employer, an education and training provider,
a professional body or association, or via local or national networks.

What you should discuss

Before your peer discussion, it will be useful to share information to make sure the conversation is effective. You should consider discussing your CPD activities and your reflective account (especially if you have yet to decide what they might be), as well as other information about your practice. There might even be things you decide not to talk about.

In order for the discussion to be fruitful, Gary Choo, head of information services at Numark, says it needs to be relatively formal.

“One would think that community pharmacists attending training workshops and seminars with other community pharmacists could, in theory, fulfil the peer discussion requirement of the revalidation process,” he says. “Such a discussion will inevitably require insight into current issues that affect all parties, but according to the GPhC, these discussions need to be planned and not spontaneous in order for them to be successful.

This makes the having-a-few-beers-with-my-mates-at-the-local-pub scenario less likely to happen.”

Mr Donovan adds that limits should be clearly agreed beforehand, and it should be clear what these limits are, such as the sharing of business and patient-sensitive information. “We would reinforce that one of the key elements of the peer discussion should be the emphasis on complete confidentiality,” he says.

Make the discussion formative

The point of the discussion is that it should be formative, in order to positively influence your development, rather than for your peer to make an assessment of you.

Mr Donovan thinks this “might need further guidance” as those who are new to peer discussions may find this element more challenging at first. In the first instance, he suggests, “Each individual should be encouraged to identify some objectives that they’d like to meet during the discussion, and we would encourage the use of feedback. A positive outcome is that individuals in the peer discussion should come away from this with goals or actions – What am I going to do next? What could I do differently? How can I repeat that success?”

Ms Ward says it’s also important to document your peer discussion, and the RPS has developed a range of template forms that can be used. However, the GPhC stresses that if and when peer reviews are implemented, you will not have to submit information on the subjects discussed, and if you are selected for review, while they will contact your peer to confirm the discussion has taken place, they will not ask for any information about the discussion other than to confirm that it has happened.

Preparation for peers

If you are asked to be a peer for someone else, the RPS has guidance available to help you prepare for the discussion, and the GPhC will also publish separate guidance to help with becoming a peer.

Mr Donovan says a good place to start is by setting clear expectations and ground rules. “It’s important to clarify that this isn’t a mentoring or coaching relationship,” he says. “This can also be important for clarity of time commitments. If a peer continually fails to attend meetings, it should be agreed that the peer relationship can be terminated. Preparation should also include consideration of the topic being discussed. Are you familiar with the individual’s situation, or is it necessary to find out a little more?”

Raising concerns

Another issue to bear in mind is how you might raise any issues that appear to highlight significant danger to patients or the public if these are identified during a peer discussion.

The GPhC has guidance for raising concerns (pharmacyregulation.org) and cites examples of things you might want to report as serious unprofessional or inappropriate behaviour, dispensing errors, criminal conduct, dishonesty or fraud, working under the influence of drink or drugs, having a health condition that affects the ability to practise safely and practising while unregistered. The RPS also offers access to confidential support if anyone has concerns about the discussion once it has taken place.

Mr Donovan says in all circumstances it’s important to attempt to find out more about the situation and to discuss the concerns with the individual, providing feedback and highlighting issues in a clear way.

“If it becomes apparent that there is a significant risk to patient or public health, there needs to be an appropriate mechanism for raising this, and the individual should be informed unless doing so would increase risk to either party’s health or wellbeing,” he says. “It should be clear to the individual what action will be taken (or needs to be taken by the individual) following the discussion in relation to the concern(s) highlighted.”

Mr Choo says that, as they stand, there is also the chance that peer discussions may prove to be “a challenge”, especially in an open-forum environment. “Community pharmacists may not be comfortable baring their souls in front of their competitors and might not feel confident enough to share their views or business practices in an open forum. It could create a privacy issue.”

Nonetheless, he says Numark will be “encouraging the consultation process [on revalidation] as we believe that it is an important milestone in the development of our profession”.

Ms Ward adds: “The RPS is here to support you to be revalidation ready, regardless of your stage or area of practice.” She suggests that a good way to find out more about what is involved is to go along to the RPS Conference (taking place on 3–4 September) to hear the latest from both the RPS and the GPhC in keynote sessions.