Digital Capabilities for the Pharmacy Workforce

RPS Position Statement

The pharmacy workforce must be empowered to embrace the opportunities that evolving technologies can provide in order to adapt and thrive in a healthcare system that is increasingly technology-enabled.

General definition of Digital Literacy: At an individual level the phrase digital capabilities refers to those skills which equip someone to live, learn, work and participate and thrive in a digital society.

The British Computer Society defines digital literacy as, “being able to make use of technologies to participate in and contribute to modern social, cultural, political and economic life”.¹

RPS believes that appropriate digital capabilities in the pharmacy practice context must support the personal, intuitive skills of the pharmacist, pharmacy technician or member of the pharmacy team, so that digital systems can add value to pharmacy input. Consequently, digital capabilities need to be embedded into pharmacy professional development and practice in an agile and dynamic way. This, in turn, will enable them to transform practice, and for new models of practice to emerge which can be appropriately supported by technology.

There is a critical need for pharmacy leadership in transformation through digital.

While the term digital capabilities is often used in industry to describe IT hardware and infrastructure alone, in a health professional educational context, it is used to describe both skills and systems, which is why RPS has adopted this term instead of digital skills or digital literacy.

Both appropriately developed skills and high performing systems (and access to them) will be needed to enable health professionals to deliver high quality care in a digitally connected NHS.

Whilst digital capabilities are being used to digitise current services the main aim is to use digital to transform the services that can be delivered. Pharmacists have a key role in leading the digital medicines agenda.

The recommendations below align with the Digital Health development goals published by the International Pharmaceutical Federation² which state that globally we will have:

• Enablers of digital transformation within the pharmacy workforce and effective processes to facilitate the development of a digitally literate pharmaceutical workforce
• Systems and structures in place to develop and deliver quality digital health and pharmaceutical care services through the digital literacy and utilisation of technology and digital enablers, configuration of responsive digital services to widen access and equity
• Application of digital technology in healthcare delivery and development of innovative medical products

Whilst the recommendations only relate to pharmacists, we recommend that all of the pharmacy workforce, including pharmacy technicians, counter assistants and other members of the pharmacy team, are also supported in digital capabilities.

Recommendations

Digital capabilities should be stated explicitly in initial pharmacy education and training standards as well as the supporting curriculum documentation

Schools of pharmacy must ensure that digital capabilities are embedded across the undergraduate pharmacy curriculum

Employers and NHS pharmacy education commissioners must ensure advancement of digital capabilities is embedded into education, training and professional development at all career stages, including the development of clinical informatics roles

NHS England/Scotland/Wales must provide adequate resources, including funding, for the development of digital literacy and associated training for the current pharmacy workforce

Digital capabilities for pharmacy teams should include an understanding of the opportunities, benefits and risks of artificial intelligence applications for pharmacy practice, and how these systems might enhance pharmacy services

Before launching newly commissioned services involving the pharmacy workforce, the necessary digital capabilities must be assessed to ensure that the pharmacy staff are competent to deliver the service

Pharmacists and pharmacy team members must have access to relevant technologies across health and care systems to provide high quality personalised care for patients

More research needs to be undertaken to understand current and future digital needs for the pharmacy workforce.

Education and Training

Digital capabilities should be stated explicitly in pharmacy education and training standards as well as supporting curriculum documentation

MPharm students should be able to demonstrate digital competencies in line with the HEE framework³ to at least level three across the six domains. This should be included in the initial education and training standards for pharmacists set out by the GPhC.⁴

• Whilst the current Standards for the initial education and training of pharmacists does reference remote consultations in domain one, which focuses on patient-centred care, this is not part of the learning outcomes, and we believe it should be explained further in the underlying text
• Learning Outcome 35, Apply relevant legislation and ethical decision-making related to prescribing, including remote prescribing is welcomed as more prescribing is undertaken remotely, following COVID-19
• It is good to see that keeping abreast of new technologies (including digital) and use of data are referenced as learning outcomes in domain two (professional practice)
• Learning Outcome 24, “Keep abreast of new technologies and use data and digital technologies to improve clinical outcomes and patient safety, keeping to information governance principles." needs to be made more granular and detailed. There should be separate headings as suggested below, or this should all be included in supplementary guidance to support this learning outcome
  • System impacts on clinical risk management
  • Use of systems to support consultations and the care process
  • Use of systems to personalise care
  • Use of data to personalise care
  • Knowledge and use of consumer medicines-related apps/technologies
  • Use of data in terms of data governance principles and data breaches
  • Information governance with clear links to professional standards on confidentiality and consent
  • Interdisciplinary learning.

The GPhC standards for the education and training of pharmacist independent prescribers⁵ makes more reference to the digital skills related to remote consultations as well as the use of emerging systems and technologies in safe prescribing. When the standards are reviewed, there needs to be more alignment between the initial education and training standards and those for independent pharmacist prescribers.

Similarly, the Standards for the Initial Education and Training of Pharmacy Technicians⁶ will need to be reviewed with digital capabilities in mind.

Digital technology is rapidly changing so the digital curriculum should be subject to continuous review and updates to ensure it remains aligned with emerging digital technologies, practices, and innovations.

Within the implementation of various software in daily pharmacy practice, pharmacy teams have gained access to a vast amount of data. Despite this advantage, there is often a lack of understanding regarding how to effectively use this information to make more informed clinical decisions.⁷

The integration of data science into pharmacy education is essential for preparing future pharmacists to effectively utilise data in their practice. It is recommended that foundational concepts such as data collection, basic statistics, and data interpretation be explicitly included in pharmacy education and training standards, ensuring that students are equipped with the skills needed to make informed clinical decisions.

The inclusion of data science tools relevant to healthcare at a basic level within the curriculum will further support this understanding, enabling students to grasp the capabilities of these applications in a pharmacy context.

Pharmacy students need to be prepared for the interdisciplinary nature of modern digital healthcare. Digital capabilities should not only be embedded within pharmacy-specific courses but also integrated with courses from related disciplines such as computer science, health informatics, and data science. Encouraging joint modules or collaborative projects with students from these fields can encourage a broader understanding of digital technologies and their applications in healthcare.

The RPS post-registration curricula already includes elements of digital capabilities. We will ensure that digital capabilities continues to be embedded into RPS post-registration curricula where appropriate, which will underpin career development and credentialing pathways across all areas of pharmacy practice.

Schools of pharmacy must ensure that digital capabilities are embedded across the undergraduate pharmacy curriculum

• Clinical informatics skills in the undergraduate pharmacy degree should be embedded in other areas of teaching, such as medicines safety, pharmacy practice (prescribing / dispensing/labelling systems), law and ethics (confidentiality and information governance), medication reviews, etc.
• Digital skills should be embedded in pharmacy training in a format such as service-based pharmacy and prescribing consultation case studies, for example, a flu vaccination consultation, which would illustrate the digital skills that the practitioner would need to carry out the consultation, and to find and record information appropriately.
  Consultation case studies should cover a variety of settings and use cases, and also include patient counselling, and use of and interpretation of data for improvement of both the service and patient outcomes
• As well as digital skills training being embedded in service-based consultation training, such as Pharmacy First and in prescribing skills, there should also be a demonstration of how undergraduate students meet the general digital capabilities framework, to ensure that all pharmacists get a good grounding, even if they are not in a patient-facing role
• Students should be supported to develop basic data science competencies to enhance clinical decision making in pharmacy
• Issues, such as being able to obtain licenses to enable students access to the relevant technology need to be addressed
• Pharmacy Departments should consider collaboration with IT departments. Students should possess fundamental knowledge about aspects such as cybersecurity, data science and artificial intelligence. These departments should encourage students to participate in research and quality improvement projects together. By developing an environment of collaboration, pharmacy departments can ensure that digital tools and systems are not only technically appropriate but also tailored to the unique needs of pharmacy practice.

We are aware that the Schools of Pharmacy have developed a Digital Community of Practice and are working on an indicative curriculum for Digital Health for MPharm, similar to the indicative curricula that have been created for the likes of prescribing and genomics.⁸

Employers and NHS pharmacy education commissioners must ensure advancement of digital capabilities is embedded into education, training and professional development at all career stages, including the development of clinical informatics roles

To date, the use of IT has often been treated as a separate and discrete area in professional competency guidance, whereas, in fact, it should be a cross-cutting skillset which should underpin all areas of practice. This should include strengthening digital capabilities in all post-registration curricula including, for example, digital as a communication medium, using digital technology in delivering pharmaceutical care.

There must be mechanisms in place to formally recognise digital skills as a development area for all staff, and to create time in relevant development planning meetings / appraisals to understand people’s needs in this area. These skills may be acquired through training outside of pharmacy such as NHS Digital Academy, British Computer Society, university informatics courses etc.

The pharmacy workforce requires access to training programmes which address gaps in knowledge and skills in digital capabilities. Pharmacy employers have a responsibility to identify and signpost/provide/fund this and NHS pharmacy education commissioners need to source or create and fund such training programmes.

Continuous professional development in data science should be a priority for pharmacists at all career stages. Employers and educational bodies must ensure that accessible training programs are available, focusing on how to work with healthcare data, utilise data analysis software, and apply insights to improve patient care. These programs should be embedded into professional development pathways and post-registration curricula to ensure that pharmacists remain adept at using data throughout their careers.

Practical application of data science is crucial in reinforcing these skills. Educational programs and CPD activities should incorporate practical examples and case studies that demonstrate the use of data science in pharmacy. For example, pharmacists could be trained to analyse data to enhance service delivery within primary or secondary care settings.

It is also vital that pharmacists understand the limitations of data and how to analyse it safely, in compliance with Information Governance frameworks. Training should include principles of data privacy, patient consent, and legal requirements, ensuring that pharmacists can handle data responsibly while maintaining patient trust.

Post-registration development should include modules on digital leadership, tailored to different career stages and roles within pharmacy. These modules should cover topics such as change management, stakeholder engagement, and risk management in digital projects, ensuring that pharmacists are prepared to lead at every level of the healthcare system.

Consideration also needs to be given to the expansion of specific digital competencies for the pharmacy profession. This would include:

• Data Analytics and Interpretation: Understanding how to analyse healthcare data to inform clinical decisions.
• Digital Health Tools: How to use and evaluating digital health tools, such as electronic health records (EHRs), ePMA, digital platforms, and decision support systems
• AI and Machine Learning: Basic understanding of how AI and machine learning can be applied in pharmacy, including benefits, risks, and ethical implications.

In addition to the general digital capabilities of the workforce, the role of the clinical informatician is key. These emerging roles operate at the interface of clinical and digital professionals, spanning both to optimise the potential of digital in safe and effective clinical service transformation from the scoping and development to the delivery and optimisation of systems. These roles require a broader spectrum of knowledge and skills which can align with advanced and consultant level practice on competency frameworks for these roles.

Implementation

NHS England / Scotland / Wales must provide adequate resources, including funding, for the development of digital literacy and associated training for the current pharmacy workforce.

These additional resources could include appropriate hardware, software, training materials, and funding to access materials, courses and having protected time to learn. There should be consistency in provision across countries and nations.

Some resources can be found at https://digital-transformation.hee.nhs.uk/building-a-digital-workforce/digital-literacy/what-is-digital-literacy

It is also important that pharmacists are equipped with the skills to find and secure innovative funding to lead and deliver impactful digital projects. Pharmacists need to understand where and how to apply for funding streams and should be supported to do this.

Digital capabilities for pharmacy teams should include an understanding of the opportunities, benefits and risks of artificial intelligence applications for pharmacy practice, and how these systems might enhance pharmacy services

Pharmacists should access education on artificial intelligence to stay informed of the latest developments in the field of pharmacy, medicines and healthcare. When considering adoption of artificial intelligence, pharmacy professionals should scope out the opportunity, make an assessment of risk and benefits, mitigate any risks, monitor impact and inform patients of its use. Pharmacists also need to understand the limitations of AI and its use in line with information governance.

Pharmacy professions need to position themselves more than just a supplier of medicines or a provider of medicines and health information, but as a source of practical wisdom and personal advice. Pharmacists and their teams should be aware of the RPS principles on AI, once published.

Systems design

Before launching newly commissioned services involving the pharmacy workforce, the necessary digital capabilities must be assessed to ensure that the pharmacy staff are competent to deliver the service.

This would include a summary of what skills are essential to deliver the service, including staff digital capabilities, as well as pharmacy team members being able to support patients to self-care where appropriate. Consideration of clinical safety needs to be a priority, and pharmacists and their teams need to be provided with a clear understanding of the risks and benefits of digital systems.

This might include the use of apps and ordering prescriptions online, for example, helping people to sign up and navigate the NHS App. Digital Therapeutic apps, essential for service delivery and supporting patient care, need to be understood by pharmacists and their teams so they can explain and support patients in their use. Pharmacists must also be able to use a variety of platforms to support delivery of care such as the platforms used to record immunisations, smoking cessation interventions, Pharmacy First records, electronic medication records etc. They need to be knowledgeable about specific platforms relevant to the sector they are working in.

UK mandatory standards and regulation are in place for organisations that manufacture or implement health IT systems.⁹

The digital systems to support a service should be in place prior to a service being launched, as it is often difficult to introduce technology into an existing service.

Additional clinical safety / risks need to be explored. Human factors such as alert fatigue is one issue with digital clinical decision support, and a clear understanding of the risks / benefits of digital systems needs to be considered and explained to pharmacists.

There is a need to invest in the development of clinical informatics roles, moving through advanced and specialist practice and developing pharmacists as clinical safety officers.

Pharmacists and pharmacy team members must have access to relevant technologies across health and care systems to provide high quality personalised care for patients

In the future, the emergence of new, highly intuitive systems will create new professional opportunities for pharmacy professionals provided they have the capability to use the systems optimally. Pharmacists must be involved in the commissioning, design, evaluation, implementation and improvement of technologies to be used/interacted with for the pharmacy workforce.

Systems should be designed according to the principle of being intuitive and easy to use for both professionals and patients.

The future aim should be for collaboration around co-creation or user research in terms of the designs of systems. There should also be a period of user acceptance testing for any new technologies. Systems should enable the pharmacy workforce to add notes and comments to patient records to ensure ongoing continuity of care.

More research needs to be undertaken to understand current and future digital needs for the pharmacy workforce

There is a recognition that digital capabilities is a complex area and what to include and how it can be measured has not been defined.¹⁰ More research needs to be undertaken to determine current and future digital needs for the pharmacy workforce, both as generalists and in specialist roles.

Further research is also needed to understand how data will be used for the benefit of individual wellbeing and the public collectively, including the development of new and innovative ways of working, improving care, developing new treatments and technologies. This needs to occur at pace, given the rapid adoption of technology and the need to respond.

Other areas that require exploration include looking at the type of hardware, software, and training materials that might be needed for the pharmacy workforce and also to explore how training can be delivered consistently across regions.

The Importance of Digital Capabilities

All members of the pharmacy workforce need to be able to use digital systems competently and in a way that is role-appropriate, so they can:

• Be personally effective
  Pharmacy professionals must efficiently use digital tools to manage their tasks and responsibilities, improving their productivity and reducing errors.
  For example, a pharmacist can use the advanced options of an Electronic Prescribing System to improve the accuracy of safe prescribing and save time compared to manual record checking.
• Provide high quality patient-centred care
  Digital tools enable pharmacy professionals to deliver more personalised care by accessing patient-specific data, improving treatment outcomes.
• Meet the needs of a digitally diverse public
  Pharmacy workforce must support patients with varying levels of digital literacy, ensuring all can benefit from digital health services.
  For example, a pharmacist is able to help a patient unfamiliar with technology set up the NHS App, guiding them through the process of ordering repeat prescriptions and accessing their health records
• Realise professional aspirations for themselves and for their teams
  Digital competence helps pharmacy professionals grow in their careers and lead innovation within their teams.
  For example, a pharmacist trained in project management methodologies successfully leads the implementation of an electronic prescribing system, helping the team enhance efficiency and patient safety.
• Realise aspirations for the services they deliver
  Pharmacists can innovate and enhance service quality by leveraging digital tools to improve patient outcomes and operational efficiency.
  For example, a pharmacist utilises data-driven analytics to monitor the prescribing patterns and usage of a given group of medications in primary care. By analysing this data, the pharmacist identifies trends of over-prescribing or suboptimal use of a specific medication class, such as antibiotics.

This will optimise current practice and ensure that the profession is well-placed to develop future skills such as data-driven care and use of intelligent systems (artificial intelligence).

It is recognised that the skills needed to provide effective integrated care in the NHS will be interpersonal skills, for example, communication, empathy and observation, as well as the technical skills and digital knowledge needed to use the systems effectively.

The Topol Report acknowledged that, as sophisticated digital medicine develops, using artificial intelligence and genomics informatics, the need for “traditional” clinical skills on the part of the practitioner will change.

Correspondingly, the need for interpersonal skills will increase in order that healthcare professionals can make the most of new systems and patients can experience better care in a digitised NHS.¹¹ Skills need to encompass the shared decision-making approach and ensure patient involvement in their own care.

In the future, AI use may affect this balance between information and intuition. AI will support and augment the "intuitive" skills of individuals in "ill structured and uncertain decision environments", rather than challenge them directly.¹² The current medicolegal situation is that an intelligent system that can make decisions where the output is not obvious from input data constitutes a medical device¹³, and the health profession remains liable for the clinical risk of its use.

Current Use of Digital Systems in Pharmacy

Pharmacy teams have been using digital systems in their practice for over thirty years. Pharmacy patient medication record (PMR) systems have been in widespread use since the 1980s.

More recently, community pharmacy teams in England have been using national NHS systems for electronic transmission of prescriptions (eTP) and access to NHS care records. They have also been using NHSMail and web-based pharmacy services management systems to help them deliver patient-focused services.

In Scotland, the ePharmacy programme has created an electronic message to accompany the paper prescription generated by GPs. This prescribe message is then downloaded at the pharmacy where the prescription is presented and electronic dispense/claim messages can be added. The majority of community pharmacies in Scotland do now have access to the Emergency Care Summary Record either via the website or via their local Health Board clinical portal.

In Wales, the Choose Pharmacy platform is integrated with the NHS Wales network, so pharmacists have access to the medication details within the patient’s Welsh GP Record, to help them make informed decisions.¹⁷

In addition, many pharmacies are using systems such as PharmOutcomes and Sonar in England to record information and capture data relevant to service provision.

Many community pharmacies are also benefiting from remote consultation services, especially those in remote areas.

It is recognised that the use of large-scale interoperable digital systems across organisational boundaries, as is happening in community pharmacy in England with ETP, and in Scotland with the Digital Prescribing and Dispensing Programme¹⁷, and transfer of patient information, has the potential to shape fundamental aspects of pharmacy work such as its nature and values, professional roles, the degree of power professionals can exercise, their jurisdictions and professional boundaries.¹⁸

Over the last decade, many hospital pharmacy teams across Great Britain have begun to use electronic prescribing and medicines administration (EPMA/ HEPMA) systems, which improve patient safety, depending on how the system is implemented and optimised for use in practice, and may also improve quality of care through improved access to, and exchange of, clinical data to facilitate team-based care across disciplines and clinical settings.¹⁹

Furthermore, in the care home setting, electronic medicines administration record (eMAR) systems are increasingly being used to record real-time medicines administration data and improve patient safety.²⁰ Pharmacy teams working in general practice are using GP systems and have the ability to use and extract information and reports on prescribing from the GP system which is an important skill for pharmacists.

Additionally, across Great Britain, there are a greater number of pharmacists working within GP practices and across primary care, often as prescribers with access to clinical systems and a greater array of clinical data.

With the inclusion of EPMA systems for hospital discharge, hospital to community pharmacy e-Referral systems and eMAR systems in care homes, there is an increasing potential for interoperable systems to transform the medicines optimisation process across the entire NHS, and for pharmacists working in all sectors to play an enhanced role in medicines optimisation.²¹

Future integration with the Internet of Things (IoT) may provide more relevant data that can be shared across the boundaries too, subject to interoperable capability. Biosensors and health tech wearables capture data which can also feed into patient healthcare.

Across all sectors of healthcare, digital systems are used in the procurement of medicines and consumables, people management, operational performance data, adverse event reporting and other aspect of operations which indirectly impact on the quality and safety of pharmacy services. Systems currently used in pharmacy include robot interface; controlled drug registers; Medicines Homecare systems; EPMA systems; patient management systems; electronic procurement and invoicing; closed loop technology; business monitoring tools; incident management; HR and payroll.

Previous research on digital capabilities in pharmacy suggests that many pharmacists perceive that, although their basic computer skills are adequate for workstation use in pharmacies, they may need to develop their IT skills in order to fully participate in a digital NHS.²² Crucially, it has been observed in digital capabilities studies that technology can change the nature of work faster than people can change their skills.²³

It is also the case that formal training in IT systems is not always effective, as it may not coincide with system installation, but that ongoing support and “learning by doing” are important for effective use of systems.²⁴ There is evidence that development of digital capabilities in pharmacy staff does more than simply give them the skills they need to be personally and professionally effective, but can also can facilitate staff confidence in system use, and willingness to adopt new ways of working.²⁵

As a profession, we need to support individuals and organisations with the change to roles / tasks and skill set required in response to the technology used. We need to be working more collaboratively across transitions of care to share new technologies, approaches to digital learning and innovations in practice. There are real differences in how the same systems are set up (configured) and the rights assigned to users across transitions of care, which means that digital skills developed in one organisation are not transferable across organisations.²⁶

Whilst we look to a digitally enabled future, we also need to consider the current state of affairs. Much of the pharmacy workforce are still unable to access information in a timely manner, have issues signing in to systems, systems take a long time to load up and are clunky to use and do not integrate with other software being used throughout the NHS.

In the future, pharmacists and the wider pharmacy workforce must have easy access to individual’s relevant health and care data and have the confidence and ability to use and share data to improve services and patient outcomes.

What will the RPS do?

We will support pharmacists to develop digital capabilities in the following ways:

• We will work to ensure that pharmacists and pharmacy teams are prepared for the future, integrated NHS, by collaborating with national training providers to provide relevant digital skills training across all three countries. We will signpost to relevant training across the three countries
• We will campaign for the development and adoption of digital systems for pharmacy teams that are clinically safe, use modern technology, easily accessible and appropriately structured to support pharmacy practice and optimal patient care. We will work with national digital health agencies, other pharmacy bodies (especially the educational bodies), other healthcare professions and, where possible, with local employers and system suppliers to meet these objectives
• We will work with academic partners to get the evidence base behind implementation and supporting development / transformation and clinical safety of systems. Where appropriate, we will adopt a "digital first" approach with interoperability, so there are reduced silos of information, and information follows the patient, using systems that meet the criteria for medicines interoperability
• We will advocate for enhanced inclusion of digital capabilities in undergraduate pharmacy courses related to national digital capabilities frameworks and encourage advancing digital capabilities education for the whole pharmacy workforce. This needs to include the new capabilities needed for areas such as pharmacogenomics and personalised medicines
• We will continue to support the development of national information standards and advocate for their use across systems
• We will continue to advocate for pharmacy teams to have access to, and the skills to utilise, the appropriate data for the delivery of care to patients
• We will ensure that digital capabilities continues to be embedded into RPS post-registration curricula where appropriate, which will underpin career development and credentialing pathways across all areas of pharmacy practice
• We will explore the development of guidance and resources for pharmacists on all digital issues in pharmacy, but especially those are new to the pharmacy profession, for example data interpretation, artificial intelligence and data-driven care
• We will support the development and embedding of digital careers in pharmacy. We will explore how we can support the specialist pharmacy digital workforce in terms of advanced and consultant practice. There needs to be a recognition of the requirement for advanced digital skills in pharmacy / medicines and recognition of this as a speciality where people can choose to specialise
• We will continue to advocate for the further development of community pharmacies as “health hubs” for treatment and prevention of common conditions, public health, health literacy, self-management and management of long-term conditions in the future NHS. This will be enabled by appropriate use of various digital systems, and integration into other parts of the health system and appropriate data standards
• We will coordinate with global pharmacy organisations to showcase best practice in the use of technologies to support pharmacy practice and pharmacy professional enablement with technology, and to demonstrate how the use of digital systems by pharmacy teams contributes to patient outcomes.

Resources

Digital skills – health informatics competency standards, frameworks and tools for healthcare professionals

https://www.england.nhs.uk/long-read/digital-skills-health-informatics-competency-standards-frameworks-and-tools-for-healthcare-professionals/

Faculty of Clinical Informatics Core Competency Framework

https://www.bcs.org/media/tfblc4ny/fcicorecompetencyframeworkreport.pdf

Core competencies for clinical informaticians: A systematic review

https://www.bcs.org/media/t5toahcy/ijmi-publication-core-competencies-systematic-review.pdf

See also our pages on Artificial Intelligence, Copyright and Intellectual Property, Artificial Intelligence (AI) in Pharmacy and Digital Skills and Capabilities.