Step 2 Accreditation 2010/11 - General Pharmaceutical Council

Step 2 Accreditation of an Overseas Pharmacists’
Assessment Programme (OSPAP), Kingston University
Report of an accreditation event, 4 May 2011
Introduction and background
The General Pharmaceutical Council (GPhC) is the statutory regulator for pharmacists and pharmacy technicians and is the accrediting body for pharmacy education in
Great Britain. The GPhC assumed responsibility for pharmacy regulation from the Royal Pharmaceutical Society of Great Britain (RPSGB) on 27 September 2010.
An Overseas Pharmacists' Assessment Programme (OSPAP) is a postgraduate diploma which is undertaken as the first part of the route to registration required by those
who have qualified as a pharmacist from outside of the EEA. An OSPAP is a one‐year course designed to ensure that those who have qualified overseas receive the
appropriate education and training to prepare them for UK Practice and entry to pre‐registration training.
Kingston University signalled to the Royal Pharmaceutical Society of Great Britain (RPSGB) its intention to apply to provide such a programme with a view to recruiting
overseas pharmacists to commence the programme in September 2010. As a result, an accreditation team from the Society visited the University on Tuesday 9 February
2010. The then accreditation team recommended to the regulator that Kingston University was not ready to proceed from Step 1 to Step 2 of the process for accrediting
new OSPAPs and must make a reapplication for accreditation to be considered. The then accreditation team’s reasons were that 1) the course team was unable to
answer with any certainty a substantial number of questions about the logic and structure of the course. In particular, the then accreditation team was not given
adequate reasons for the inclusion or exclusion of areas of science in the course and the particular suitability of existing MPharm modules for the OSPAP. This related to
criterion 25, 2) the then accreditation team questioned the course team about accreditation criteria and received insufficient evidence to agree that some had been fully
met. The relevant criteria were: 5, 9, 11, 15, 25 and 27. The record of this event gives full reasons for the team’s position on these criteria., 3) linked to the previous two
reasons was the inaccuracy and brevity of responses to some indicative syllabus items. The then accreditation team’s principal reason was that a substantial number of
the responses in the documentation were single sentences giving the team no sense of the rationale behind coverage in particular areas. Members of the course team
agreed that there was a mismatch between some syllabus items and their commentaries on them. As this was the case, the documentation as submitted represented an
inadequate evidence base for accreditation purposes.
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The University resubmitted documentation in May 2010 and a re‐visit by a Society accreditation team took place on 16 June 2010. At this visit, the accreditation team
agreed to recommend to the Society’s Education Committee that the Kingston University OSPAP be recognised in the first instance for a period of one year, subject to
two conditions. Thus, the University was allowed to enrol students in September 2010. The conditions were 1) that module descriptors be rewritten to accurately reflect
the curriculum content. Whilst the individual elements of the indicative syllabus had been satisfied as evidenced by the School’s oral submission, neither the written
submission nor the current module descriptors supported this. This related to criterion 25. The rewritten module descriptors must be submitted to the Society’s
Accreditation Department for approval by 16 July 2010, and 2) that the advertising booklet for students be rewritten and submitted to the Society’s accreditation team
for review prior to dissemination. During the visit the accreditation team was reassured to hear from the Associate Dean of the University’s commitment to supporting
the Kingston OSPAP.
The Step 2 visit detailed within this accreditation record followed the General Pharmaceutical Council’s September 2010 accredited processes and reaccreditation was to
the GPhC’s interim standards for accreditation ofOverseas Pharmacy Assessment Programme.
Documentation
Following receipt of the provider’s submission documentation, a pre‐visit meeting was held on 28 March 2011, at which the meetings’ schedule and any additional
documentation requirements were agreed. The pre‐visit meeting was attended by the accreditation team leader, the GPhC Accreditation and Recognition Manager and
the provider’s representatives.
The following documents were submitted by the provider in advance of the step 2 accreditation visit:
1. Document for Accreditation of the Postgraduate diploma in Pharmacy practice (OSPAP) Step 2
The following documents were submitted by the provider during the step 2 accreditation visit:
2. Compendium of module guides
3. Variances in module guides from module descriptors document
4. Placements and feedback document
5. SSCC minutes 27/10/10
6. SSCC minutes 10/03/11
7. PYM010‐PYM080 module boxes
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The visit
The step 2 accreditation visit took place on the 4 th May 2011 at the Department of Pharmacy, Kingston University. A private meeting of the accreditation team was held
on the 3rd May 2011.
The visit comprised a series of meetings at the University. The meetings were with senior School staff to discuss strategic issues, course staff to discuss the syllabus,
student representatives, and senior University officers. The accreditation team also had the opportunity to meet with 10 students representing the entirety of the
current cohort.
The Accreditation Team:
The GPhC accreditation team (‘the team’) comprised:
Name Designation at the time of accreditation event
Mrs Linda Stone *
Accreditation team leader, pharmacy consultant, past President of RPSGB, community
pharmacy background
Professor Larry Gifford Accreditation team member (academic), Professor of Pharmacy Education and Deputy Head of
School, Keele University School of Pharmacy
Dr Brian Curwain Accreditation team member (International Panel), Freelance pharmacist consultant to NHS and
industry, Past Chair, English Pharmacy Board, member of International Panel of GPhC, former
PCT head of medicines management
Mr Surinder Bassan Accreditation team member (pharmacist, hospital), Chief Pharmacist, Southampton Universities
Hospital and member of International Panel of GPhC
along with:
Name Designation at the time of visit
Ms Joanne Martin* Accreditation and Recognition Manager, General Pharmaceutical Council
Ms Martha Pawluczyk** Registration Manager, General Pharmaceutical Council
Ian Marshall Rapporteur
*attended pre‐visit meeting
**attended the Day 1 private meeting of the accreditation team only
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There were no conflicts of interest expressed by members of the accreditation team. The Vice Chancellor declared that he is a member of the GMC accreditation team at
Keele University School of Medicine. This was not regarded as a conflict of interest.
The accreditation criteria
Criteria (See Appendix 1)
Outcomes: the graduate…
(criteria 1‐17)
Processes: the student…
(criteria 18‐‐24)
Processes: the OSPAP…
(criteria 25‐32)
Accreditation team’s commentary
The accreditation team agreed that all 17 criteria in this section had been met. The team noted that the OSPAP students were
enthusiastic adult learners who were enjoying a worthwhile course. Students were comfortable with the UK requirements in
law and professional matters and were conversant with the area of ethical dilemmas and decision‐making. The team found the
students somewhat vague on the subjects of medicines management and pharmaceutical care. The team noted that the
Department conducted diagnostic testing of prior knowledge during the induction week and provided remedial support where
required. Students expressed themselves as wishing to become pharmacists and queried the inclusion of so much science and
critical analysis in the OSPAP; the Department indicated that it wished to dispel this view of modern pharmacy provision.
The accreditation team agreed that all 7 criteria in this section had been met. The team noted that students were comfortable
with the concept of continued professional development and with the UK standards of conduct, ethics and performance.
Students arrange their own placement in community pharmacy in Semester 1, often in the pharmacy where they regularly
work. Staff opined that this system had both positive (familiarity with the environment) and negative (possibility of bias)
aspects. It was stressed that some students lived long distances from the University and hence a placement close to their
home was advantageous. It was also stressed that students were required to complete workbooks relating to the placement to
differentiate it from a normal working day. The accreditation team was of the view that the students selecting their own
placement represented poor academic practice and would have preferred to have seen students working on neutral territory.
The accreditation team agreed that all 8 criteria in this section had been met. The course director and module leaders indicated
that the course had gone well and that there had been no problems with the delivery. It was reported that the attitude of the
students had been very professional and that they had been a pleasure to teach. The accreditation team was told that the
practice of co‐teaching parts of the OSPAP with the MPharm had both advantages and disadvantages. In this respect, students
interviewed expressed the view that they were often confused as to whether they were being treated as undergraduate or
postgraduate students. The team was told that the Department planned to introduce more separate teaching for the two
cohorts in the next teaching year. Students commented that they found very confusing the departmental practice of referring
to modules by code rather than by title, a view with which the accreditation team concurred.
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The teaching fellows are pharmacists working in practice and hence are aware of the latest developments in the practice area.
Teachers in pharmacy practice keep up‐to‐date with developments in the profession and on the science side, students
undertake critical evaluations of research papers. The team was surprised to learn that the Department did not have as part of
its quality approach an agreed method of providing lecture information to students, rather it being left to individual teachers to
decide on their own method. The team did not regard this as good practice. The accreditation team also noted some
indications of student dissatisfaction with the feedback on assignments. The teaching team indicated that because of the small
cohort size it was possible to give individual feedback, but it was also stated that group feedback is given at the end of some
modules. The accreditation team was told that the Department had made little progress in developing interprofessional
learning since the Step 1 visit. The team was told that no other healthcare professions were on the site and that the timetable
issues with St George’s Hospital Medical School continued to be insoluble. The accreditation team accepted this explanation
and, noting that this criterion is currently not mandatory, agreed that the criterion was met. However, it was pointed out to the
Department that the new GPhC standards for both MPharm and OSPAP degrees demand an element of interprofessional
learning. Accordingly, it will be a recommendation of this record that that the University should use its best endeavours to
explore teaching and learning opportunities with students of other healthcare professions.
Structures
(criteria 33‐42)
The accreditation team agreed that all 10 criteria in this section had been met. The accreditation team noted comments in the
minutes of the Staff Student Consultative Committee concerning the shortage of books in the library. Students interviewed
described the library as always being crowded. The documentation stated that the library purchases recommended textbooks
in the ratio of one book per ten students. The team was satisfied by a statement from the Information Specialist (Science) that
he maintained a watching brief on usage of books and both he and the Acting Dean indicated that the library was prepared to
purchase extra copies if the need arose. The accreditation team was cognisant of the fact that since the Step 1 visit the
University, through an error that was no fault of the Department of Pharmacy, had admitted 50 additional students to Year 1 of
the MPharm programme in September 2010. The team was told that the University had acknowledged that the Department of
Pharmacy required extra resource to cope with this temporary increased student load and that extra fixed‐term appointments
had been made for the next 2 years. The team leader indicated that the GPhC would expect this extra support to be maintained
throughout the period that the extra students would be on course in order that neither the MPharm nor OSPAP provisions
would be compromised. The Acting Dean indicated that there was uncertainty about the figures quoted in the original business
plan in the current financial climate for universities but he was comfortable that the funding level to the OSPAP programme
would be preserved. Likewise, the Vice Chancellor, although unable to promise the precise sums that would be available,
indicated that the University would continue to support pharmacy at appropriate levels to maintain the student:staff ratio.
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Summary and conclusions
This conclusion concerns the first part of the two‐part step 2 accreditation event. The second part of the event is a return visit to the University by the team leader and
the Head of Education and Quality Assurance to confirm the appropriate conduct of the assessment process for the 2010/2011 academic year in July 2011.
In reaching its conclusion based on this Step 2 visit, the accreditation team made two separate judgements:
1. whether or not the University met the criteria for a new provider delivering a new OSPAP; and
2. whether or not the University met the criteria for an established provider delivering an existing OSPAP
The accreditation team agreed that both sets of criteria had been met, subject to conditions and recommendations.
Consequently, the accreditation team agreed to recommend to the Registrar of the GPhC that Kingston University be permitted to progress from the process for the
accreditation of a new OSPAP to the process for the accreditation of an existing OSPAP. The result of this is that Kingston University now delivers a fully accredited
OSPAP, subject to the confirmatory visit later in July.
The accreditation team also agreed to recommend to the Registrar that Kingston University be accredited as an OSPAP provider for a period of three years .
There are no conditions.
There is one recommendation:
1) that the University should use its best endeavours to explore teaching and learning opportunities with students of other healthcare professions. This is to meet
criterion 31.
The accreditation team was pleased to hear the Vice Chancellor’s assurance of the University’s continued support for the pharmacy provision and his view on the
standard of the student experience at Kingston University.
The team leader and the Head of education and Quality Assurance will return to the University on 5 July 2011 for the second part of the Step 2 accreditation to check
that the assessment process has been conducted appropriately. At this meeting, the views of external examiners will be sought. They will be asked the following:
- whether all graduating students have met all the learning outcomes of the course;
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- whether the course is securely at Master’s level;
- whether the assessment process has been conducted fully in accordance with relevant academic regulations;
- whether there are any issues which would or could have the potential to affect academic standards in the future.
Satisfactory answers to all of these questions must be obtained. Accordingly, the Head of education and Quality Assurance will inform the Registrar of this outcome, so
that he can confirm full accreditation on behalf of the General Pharmaceutical Council.
The Head of Education and Quality Assurance will also inform the Preregistration Department of the General Pharmaceutical Council that the OSPAP is now fully
accredited so that any signed pass list submitted by Kingston University to the Preregistration Department of the General Pharmaceutical Council can be used to confirm
that the students on the list can be permitted to begin preregistration training. The visiting team will direct the School to inform the OSPAP students of this process.
The team leader reminded the University of the following:
- The General Pharmaceutical Council has assumed responsibility for the regulation of pharmacy education. The Pharmacy Order, the legislation establishing the
General Pharmaceutical Council as regulator, states that the General Pharmaceutical Council accept previous decisions of the Society. In this context, that means
previous accreditation decisions of the Society will stand.
- The recommendations of the accreditation team are not binding on the Registrar and the Registrar may add, remove or modify points on reflection and in light of the
accreditation panel views.
- The General Pharmaceutical Council’s record and report will be sent to the University shortly to comment on factual accuracy. The providers must respond to the
definitive version of the record and report within three months of receipt.
- Thereafter the summary report, along with the University’s response, will be published on the General Pharmaceutical Council’s website and remain for the duration
of the accreditation period. The record remains confidential to the institution and the General Pharmaceutical Council.
- All accredited providers are required to inform the General Pharmaceutical Council annually of changes to the curriculum and/or resources.
The accreditation team’s feedback is confidential until it has been ratified by the Registrar of the General Pharmaceutical Council.
Following the above event, a Step 2 part 2 confirmatory visit was conducted on 5 July 2011. Following positive responses from the External Examiners
at this visit the accreditation team’s recommendation for accreditation remained.
The Registrar of the General Pharmaceutical Council subsequently agreed with the accreditation team’s recommendations and approved the Kingston
University OSPAP for accreditation for a period of three years.
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Appendix 1
Prerequisite with regard to entry to the OSPAP
All OSPAP entrants must have satisfied all relevant requirements of the GPhC’s International Panel
at the successful conclusion of the OSPAP, the graduate…
1. takes personal responsibility for his/her learning, developing a foundation for subsequent continuing professional development,
2. can communicate effectively, orally and in writing, with his/her teachers and peers, as a sound basis for future interaction with patients, carers and other healthcare
professionals,
3. can undertake structured problem‐solving,
4. is able to recognise ethical dilemmas in healthcare and science, and understands ways in which these might be managed by healthcare professionals, whilst taking
account of relevant law,
5. appreciates and has an understanding of main sources of drugs; ways in which drugs are purified, characterised and analysed; their physico‐chemical properties; and
properties drugs display as biologically active molecules in living systems,
6. has an understanding of the design, manufacture and performance of drug dosage forms and is able critically to appreciate the inter‐relationship between
formulation, drug delivery and therapeutic effectiveness,
7. understands how medicines are developed, manufactured and brought to the market place,
8. has proved him/herself capable of performing pharmaceutical calculations accurately,
9. has the capability to prepare extemporaneously any medicine for which this would be regarded as the normal means of provision, including by aseptic technique,
10. is able to interpret and evaluate, for safety, quality, efficacy and economy, prescriptions and other orders for medicines, and to advise patients and other healthcare
professionals about medicines and their usage,
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11. is aware of and understands systems for the quality assurance of products and pharmaceutical services. This includes the management of risk,
12. is able to design, improve, and operate within standard operating procedures, including Patient Group Directions,
13. is able to supply medicines in accordance with legal and professional requirements,
14. can undertake critical appraisal of information or conjecture in all forms of presentation,
15. can apply appropriate approaches and methods to manage scientific and practice problems,
16. has a foundation of knowledge, understanding and skills for promoting good health; diagnosing disease; and prescribing medicines,
17. understands and can explain concepts of medicines management and pharmaceutical care.
Processes
the student…
18. is inculcated with a concern for the patient, normally above other considerations,
19. gains first‐hand structured experience of practice, including contact with patients and practitioners of other healthcare professions,
20. is required to communicate with individuals and audiences,
21. is required to apply, library and other information resources,
22. is required to apply routinely, word‐processing, spreadsheet, database, e‐mail and information retrieval computer applications,
23. has brought to his/her attention the continuing professional development opportunities open to practising pharmacists,
24. Is encouraged to seek networking opportunities in professional pharmacy organisations
the OSPAP…
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25. is planned with reference to the indicative syllabus appended and students’ prior learning.
26. seeks to develop students' skills of self‐management, teamworking and peer assessment,
27. has the features of positioning knowledge, understanding and skills in a pharmaceutical context and with reference to pharmacy practice,
28. in the processes of curriculum review and development, benefits from the academic staff properly taking account of major advances and developments potentially
impacting on pharmacy,
29. features a variety of approaches to achieving and assessing learning appropriate to its stated objectives, including lectures, practical classes, seminars, workshops,
tutorials, computer‐based/aided learning, clinical visits, problem‐solving exercises, essays and other assignments, and examinations,
30. includes significant staff‐led or supervised time devoted to the topics of British pharmacy law and professional requirements, and their applications in practice, this
being in addition to the assimilation of legal and professional requirements into a substantial proportion of a dispensing practical course,
31. where appropriate and possible, has the student taught and learning alongside and together with students of other healthcare professions,
32. has pharmacy teaching taking place alongside and with reference to research and other postgraduate activities.
Structures
33. For its proper ethos, quality assurance, and scientific and professional leadership, the OSPAP is within the control of, and predominantly delivered by, an
autonomous school or department of pharmacy,
34. accommodation, human, equipment, and other resources available to the school or department of pharmacy are sufficient for the effective delivery of the OSPAP to
planned numbers of students, properly taking account of the full teaching, research and other commitments of the unit,
35. the school or department of pharmacy applies an appropriately expert academic staff, including such in the practice of pharmacy, to the delivery of the OSPAP
36. teacher‐practitioners and visiting lecturers from community and hospital pharmacy practice, and appropriate persons from other healthcare professions are involved
in teaching/support for learning and assessment,
37. the student has access to a personal tutor or tutors for academic guidance and pastoral care,
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38. there is an active staff‐student consultative committee,
39. pharmacy law, professional requirements and practice are taught ‐ predominantly by pharmacists ‐ from within the identifiable organisational unit which provides
the bulk of teaching and other support for learning for the OSPAP,
40. there is assessment of competence in dispensing by either one examination at the end of the dispensing course, taken under full examination conditions with an
external examiner present; or a series of tests taken under examination conditions, with an external examiner having the right to attend any of the practical tests
and attending some part of the assessment every year. The external examiner is associated with the overall assessment,
41. there is a requirement for achievement of a satisfactorily high standard in assessments of both dispensing practice, and pharmacy law and professional
requirements, irrespective of the student's performance in other subjects. Compensation of marks for these subjects is not allowed and success in these subjects is a
condition for successful completion of the OSPAP,
42. regulations governing the OSPAP are based on those applying to the MPharm degree course of the school or department.
Indicative syllabus
The patient
The patient is the main or ultimate focus of everything in the OSPAP course. The items grouped under this heading address the biological, environmental, psychological
and some of the social foundations of treatment with medicines.
1. The unique role of the pharmacist in ensuring that the patient benefits from pharmaceutical intervention.
2. Principles and methodologies of the social and behavioural sciences relevant to pharmacy.
3. Health and illness: definitions and perceptions.
4. Theory and practice of personal and inter‐personal skills, including written and verbal communication skills, and study skills.
5. The ideas and approaches of compliance or concordance in health care provision, particularly as they apply to medicines‐taking.
6. The pharmacist’s contribution to the promotion of good health and disease prevention.
7. Normal and abnormal bodily function: biochemistry, genetics, microbiology, nutrition, immunology, physiology, pathology, pathophysiology and infective processes.
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8. Aetiology and epidemiology of major diseases and the principles of their drug treatment.
9. Symptoms recognition and management, the principles of differential diagnosis, important diagnostic methods and tests, and medical terminology.
10. Disease management and care planning, including application of clinical guidelines, prescribing and medication review.
11. Complementary therapies.
12. Drug and substance misuse, and physiological and psychological dependence. Clinical toxicology associated with drug over‐dosage, drug or substance misuse or
accidental exposure.
Medicines : drug action
The focus here is on drugs in use, particularly in the patient. The first three items in this short list are large in scale and high in importance.
13. Molecular basis of drug action and the actions of drugs within living systems; molecular, cellular, biological, and physical aspects.
14. Clinical therapeutic uses of drugs and medicines in man, including contraindications for, adverse reactions to, and interactions of drugs, and their relevance to
treatment.
15. Drug absorption, distribution, metabolism and excretion and influences thereon, including formulation, route of administration, dosage regimen, ageing and disease.
16. Clinical evaluation of new and existing drugs and medicines, and post‐marketing surveillance. Good Clinical Practice.
17. Prospects for new approaches in therapeutics.
Medicines : the drug substance
For patient safety and often for the quality and efficacy of treatment, it is important that the pharmacist, uniquely among the team of health professionals, has an
appreciation and understanding of the sources and properties of the drugs which form the biologically‐active and therapeutic components of medicines.
18. Sources and purification of substances used in medicine of biotechnological, chemical synthetic, immunological, mineral and plant origin.
19. Physico‐chemical aspects of drugs and biological systems, including thermodynamics and chemical kinetics.
20. Specifications of substances used in medicine, including physical and chemical tests.
21. Analytical methods: principles, design, development, validation and application.
22. Prediction of drug properties, including chemical compatibilities, from molecular structure.
23. Drug design and discovery: principles, approaches and future prospects.
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24. Cell and molecular biology, including genomics, proteomics and gene therapy, relevant to pharmacy.
25. Biological methods of measuring drug activity and biological standards.
26. Biotechnology and biotechnological processes.
Medicines : the medicinal product
The formulation and compounding of medicines, taking the pure drug substance and producing a dosage form for administration to the patient, are at the heart of
pharmaceutical science. This is established as the main area of contribution of pharmacy to the pharmaceutical sciences. More importantly, for the safety, quality,
efficacy and economy of treatment with medicines, all pharmacists need knowledge, understanding and capability in this area.
27. Sale and supply of medicines, including evaluation and management of risk and provision of advice.
28. Medicines: licensing of medicines; consumer protection, including product liability and unlicensed medicines; legal classifications of medicines, including controlled
drugs and their sub‐classes.
29. Materials used in formulations and devices for the delivery of drugs, their biological, chemical and physical properties, and the development and application of
standards.
30. Biopharmaceutics, developmental pharmaceutics, pre‐formulation and formulation studies; design and standardisation of medicines for administration to the body
by different routes and for delivery to specific target sites.
31. The influence of manufacture and distribution on product quality with respect to biological safety, bioavailability (including bio‐equivalence), dosage uniformity and
stability.
32. Packaging and labelling; purpose, design and evaluation.
33. Quality assurance of pharmaceutical products and processes, including Good Laboratory Practice, Good Pharmaceutical Manufacturing Practice and the role of the
Qualified Person.
34. Microbiological contamination: sources, determination, consequences and control.
35. Sterilisation processes and aseptic procedures in the preparation of pharmaceutical products and medical devices; monitoring of sterilisation processes.
36. Environmental control in manufacturing facilities and in the supply chain.
37. Degradation of medicines; evaluation and control of biological, chemical and physical degradation.
38. Immunological, biotechnological and radiopharmaceutical products.
39. Dressings and other wound management products.
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40. Medical devices: their types, regulation and, particularly, their usage for the measurement and maintenance of physiological function or medicine delivery.
41. Statutes and main regulations related to medicines and poisons.
Healthcare systems and the roles of professionals
For pharmacists to be able to practise effectively, efficiently and confidently they need to know about, understand and have some of the skills to operate within
healthcare systems, alongside and together with other health professionals and other scientists.
42. Health care systems: NHS community, primary, secondary and tertiary care; private health care; the pharmaceutical industry; scientific and medical publishing; all
including the roles of pharmacists, and other healthcare professionals and other scientists. (To include coverage of concepts of medicines management and
pharmaceutical care.)
43. Public health and the role of the pharmacist.
44. The duty of care to the patient and the wider public: concept, scope and application of the Standards of conduct, ethics and performance.
45. Codes, standards and systems of governance and practice; risk management; and personal accountability, to include the need for, and means of, continuing
professional development.
46. Professional and multi‐professional audit. Managing and learning from errors.
47. Present and potential use of information technology in pharmacy and more widely in healthcare.
The wider context
The pharmacist needs a realistic and well‐informed view of how healthcare, and pharmacy within it, fits and operates within the wider world.
48. The political and legal framework, requirements and processes relevant to pharmacy.
49. Health policy and economics, including particularly pharmacoeconomics.
50. Scientific, clinical, health services and social services research; methods and results relevant to pharmacy.
51. Laboratory, other workplace and environmental safety and protection, including health and safety at work, the Control of Substances Hazardous to Health, Chemicals
Hazard Information and Packaging for Supply, and waste disposal.
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