Pharmacy Apprenticeship: One Profession, Two Tiers?

The idea of training a pharmacist via an apprenticeship route is as reckless as training a surgeon via NVQ qualifications.  Pharmacists spend four years learning the intricacies of how drugs impact the human body. Comparatively, doctors don’t spend more than a couple of hour long sessions learning about it early in their undergraduate studies.  Nobody else in the entire healthcare team knows about medicines as well as pharmacists, and the modern method of treating conditions favours treatment via medication rather than surgery or lifestyle interventions. Yet some companies (and apparently NHS trusts) argue that pharmacists don’t diagnose or manage care which, at best, is a blatant disregard for the master’s degree we all hold.  

I honestly don’t care how long the apprenticeship is, or what the study involved is – it’s not a masters degree.  This isn’t arrogance, it’s the humility to know that the human body is an extremely complex system which deserves due study and attention.  Nobel laureates attest to this fact. To expect an apprentice to make decisions with limited knowledge is reckless and endangers the lives of the very people we care for.

The truth of the matter is that a masters degree isn’t something you can just pick up through years of experience. It takes years of hard work, dedication and effort to attain.  It’s hours spent reading books and literature, hours spent learning about cells, microorganisms, human biology, pharmacology, the list goes on. Put simply, a masters degree teaches you thinking skills, that no employer will ever teach you.  Pharmacists work for multinational corporations with only profits on their mind – can we really afford to lose our ability to think independently?

Other healthcare professions

Similar professions, such and doctors and dentists, hold elite positions in society, almost revered for their knowledge and skills, despite degree courses becoming more accessible.  This is because they know there are limits to accessibility. A career in healthcare isn’t like free Wi-fi – it’s not for everyone. Of course accessibility is essential, it ensures circumstances don’t hold competent candidates back, but as medics and dentists recognise, there are limits.  As Anton Ego says in the 2007 Disney production Ratatouille “Not anyone can become a great artist; but a great artist can come from anywhere”.

A (very) brief history

The title of “Pharmacist” has been protected since the 1930’s. It is a criminal offence for anyone who is not on the register to call themselves a pharmacist.  Even back then the state recognised that anyone using a protected title should be appropriately trained and up to date so that quality can be assured. To further ensure competence, the route to becoming a pharmacist became a graduate only pathway in 1967; it’s needless to say that the world was a very different place before then. Prior to 1967, becoming a Pharmacist via an apprenticeship was par for the course.  This served the profession well at the time, and produced some excellent pharmacists who served the public well and passed on their knowledge. This was at a time when the majority of pharmacies were owned by individuals and they needed apprentices to carry on the business.

In 1890 there were four pharmacy chains that had more than 10 pharmacies, all owned by Pharmacists. This soon changed and by 1906 Boots had 329 branches in total. Fast forwarding to today, in 113 years, a single chain controls almost as much market share as all of the independent Pharmacies combined – that’s a lot of power concentrated in very few hands. It’s little wonder that Pharmacists have lost control of their own profession to government lobbying multinational corporations. This comes at a hefty cost for Pharmacists and the public they serve.

So the recent proposition to consult on re-opening the apprenticeship route for becoming a Pharmacist must be looked upon critically to say the very least. Since the short ten day consultation, Superdrug, Lloydspharmacy, Well and Boots have all admitted they were involved in developing the proposal for a pharmacy apprenticeship.  They’ve also said they’re looking for “the right solution that is best for both our business and the profession as a whole”. Reading the proposals alongside these comments, it’s clear their biggest problem is expensive pharmacists who don’t “diagnose or manage care”. These faceless multiples don’t have a clue about pharmacy or the value pharmacists bring to their business.   

Accessibility

Making something accessible means empowering those who are disadvantaged, to achieve, whilst not reducing the level of achievement needed to enter the pathway. Over the last few years entry requirements needed to access the MPharm degree have dropped across the board, further accelerated by the need for universities to fill places on their courses. Furthermore, we already have foundation courses which students can complete if they need to undertake some extra learning prior to starting the MPharm degree.

How much more accessible does the profession need to be?

Reverting back to the apprenticeship route will not improve our profession. It will only benefit the companies who can price condition students into low salaries i.e. start paying them £3.50 per hour apprentice wage, then offer £10 per hour after five years, to work as the responsible pharmacist.

The future

If our profession is to be forward thinking, in a world where we will need to be increasingly trained to a higher level, training pharmacists by apprenticeship will be dragging the profession back, and with this will go the safety of patients, our good public standing, respect of our colleagues and quality pharmaceutical input in patient care.

Just one final thought

In 2008 the Nursing and Midwifery Council ratified proposals to make nursing an all graduate profession.  They said that nursing roles are demanding and involve increasingly advanced levels of practice and clinical knowledge, and a degree-level education would provide new nurses with the decision making skills they need to make high-level judgements in the modern NHS.  If the NMC came to this conclusion in 2008, why then, 10 years later, are pharmacists being subjected to the threat of apprentice level training and regressing our profession to endanger patients, at the hands of faceless multiples who only have profit driven business models?

I’ll say it again, the idea of training a pharmacist via an apprenticeship route is as reckless as training a surgeon via NVQ qualifications.

Written by guest blogger, The Responsible Pharmacist aka @TheResPharm on Twitter