Pharmacy education and training

Pharmacists in the EU are one of the [six] professions granted automatic recognition of qualifications under the Directive on the Recognition of Professional Qualifications [Directive 2013/55/EU]

No other health professionals have so much of their education devoted to medicinal products. Citizens of all EU Member States can therefore be confident that before a pharmacist is permitted to practice in in their country, the necessary studies have been successfully completed and their community pharmacist is a true expert on medicines.

For the benefit of the public, all pharmacists practice within strict Codes of Ethics and Professional Standards and have a personal commitment to maintaining professional competence throughout their working lives, through continuing professional development. EU citizens can be confident that professional regulatory controls in all Member States are designed to ensure their protection, through action being taken to ensure that all pharmacists authorised to practice and maintain the required high quality in the professional services they provide.

PGEU welcomed the last revision of the Directive on the Recognition of Professional Qualifications [Directive 2013/55/EU]. PGEU is particularly pleased with the revision of the article regulating pharmacists’ activities [Art. 45§ 2]. The current provision properly reflects harmonised pharmacy practices in the Union.

Another significant development arising from the revised Directive is introduction of the European professional card (EPC). It is not a plastic card as such, but rather an e-certificate available from 18 January 2016 for five professions namely general care nurses, physiotherapists, pharmacists, real estate agents and mountain guides. The EPC does not replace the 'traditional' recognition procedures under the Professional Qualifications Directive, but it does offer an advantageous option for professionals who wish to work either temporarily or permanently in another EU country.

PGEU understands that the Commission is currently looking into updating other sections of the Directive with an impact on the pharmacy profession. Therefore, PGEU together with the European Association of Faculties of Pharmacy (EAFP), the European Pharmaceutical Students’ Association (EPSA) and the European Industrial Pharmacists Group makes some proposals on those provisions (please see downloads section for detailed statement). In particular they suggest some modifications on:
•    Annex 5.6.1 describing the list of courses of training for pharmacists
•    Article 44. 3 describing the knowledge and skills that need to be acquired during the training of pharmacists.

Those provisions have not been changed since 1985. Pharmacy stakeholders suggest building up on the spirit of modernisation that based the last revision of the Directive. In addition, they will add consistency to the text following the last modification on the provision on pharmacists’ activities as well reflects scientific progress and innovation in practice.

Continuing Professional Development (CPD)
There is widespread recognition of the importance of continuous professional development (CPD) for health professions. CPD ensures that professional practice is up-to-date, contribute to improving patient outcomes and increase public confidence in the professions.
PGEU together with other health professions representing organisations undertook an EU funded study to map and describe Continuous Professional Development (CPD) programmes for health professions in Member States.

More information and downloads:
•    New European Professional Card helps professionals work throughout the EU
•    Video
•    How to apply from the Your Europe website
•    CPD study Final Report
•    PGEU/EAFP/EPSA/EIPG Statement on the pharmacy training

Pharmacy workforce

Pharmacists represent the third largest health professional group globally after nurses and physicians. Until very recent there has been a lack of data and nominated research in relation to pharmacy, which has lead to a degree of oversight of pharmacy in health workforce planning.

The shortage of health professionals is of varying severity depending on particular health profession and country of origin. However, due to the increasing overlap of professional roles, and modern health systems that require health professionals to work in a team, so called ‘skill mix’, when creating workforce forecasting models and developing workforce plans national authorities and well as scientists need to consider all health professionals.

The shortage of pharmacy workforce and the impact on pharmacy services depends largely on the role of pharmacists in the relevant country. In many European countries pharmacists are developing more patient-centered roles and the number of primary care services available via community pharmacies is expanding. Furthermore such issues as increasing volume of prescriptions; overall ageing of European population; rising polypharmacy; innovations in chronic disease management; advancement of technology and personalized medicine; greater administrative requirements for handling third-party payments; increasing feminization of pharmacy workforce, when women are more likely to work full-time or take career breaks; and the global economical climate all point to an increasing need to ensure an adequate pharmacy workforce.

The greater part of healthcare budgets is allocated to reimbursement of medicines; consequently those resources will be at risk of waste and misuse if not managed by adequately trained and motivated health professionals.

EU Joint Action on Health Workforce Planning
According to an estimate, Europe expects a shortage of 1.000.000 health workers by 2020 (190.000 of those pharmacists and physiotherapists).  Healthcare workforce planning is crucial as countries that are self-sufficient today could face challenge due to mobility of their workforce.There is a great variety of healthcare workforce planning methods across member states. Sharing and exchanging practices has a great potential to support member state capacity and respond to challenges of tomorrow. EU Joint Action on Health Workforce Planning is a collaboration between Member States, European Commission and stakeholders mainly representing different healthcare professional groups. The general objective of this action is to create a platform for collaboration and exchange between Member States to prepare the future of the healthcare workforce.

The PGEU participated in a WP6 teleconference on the drafting of ‘user guidelines on how to use qualitative methodologies to estimate future health workforce needs’, which is now in its second draft, the final version being due in June 2014.

The PGEU has been approached by one of the UK Horizon Scanning Team to be interviewed for a report on the future skills and competences needed in the health workforce over the next 20 years. The interviews will be with key experts from a range of professional backgrounds to develop a greater understanding of the driving forces which may affect skills and competencies in the future.

From the 7th – 9th of May 2014, the PGEU attended the Joint Action on EU Health Workforce and Planning meeting in Florence where the WP5 (Pilot Study) plans for Portugal and Italy were discussed. A steering committee (of which the PGEU belongs) also took place in Florence where stakeholders were encouraged to contribute to the development of the pilot study.

Additionally, feedback from stakeholders was sought on the suitability of the recently prepared ‘matrices’ for Belgium, Denmark, England, Finland, The Netherlands and Spain for the design of a handbook to aid the pilot studies and future workforce planning. These matrices are the country specific guidelines from the national experts in workforce development and planning and it is anticipated that these documents will be used to produce a handbook for use both in the upcoming pilot studies in Italy and Portugal, and also for other Member States to utilise.

Proportionality of professional regulation
The main goal of health professional regulation is to ensure the highest quality of healthcare and the protection of patients and public health in general.European health systems are consistently ranked among the top performing in the world and are recognised for providing high quality and accessible healthcare services to citizens.

Article 168 of the Treaty of functioning of the EU establishes the need for a high level of human health protection to be ensured in the definition and implementation of all Union policies and activities. In addition, this provision states that the organisation and delivery of health services to citizens is a responsibility of Member States. In general, and unless explicitly defined otherwise, Union action is therefore restricted to a complementary and coordinating function where added value can be achieved.

European health systems as well as the access to and the practice of health professions are highly regulated at national level. These provisions are characterised by a high number of obligations and restrictions on healthcare professionals. The main goal of such provisions is to ensure the highest quality of healthcare and the protection of patients and public health in general.

For instance, in the pharmacy profession, the opening of pharmacies is subject to authorisation and/or registration requirements in all Member States. In addition, all EU countries have reserved certain activities for pharmacists (such as providing advice on use of medicines, dispensing, compounding, etc.). Many countries link the establishment of new pharmacies to the number of inhabitants in a given area or to the geographical or demographic characteristics of the territory with the aim of safeguarding a sufficient access to medicines. Pharmacists are subject to continuous professional development requirements and professional ethics and supervision, among other obligations. The application of such criteria has proven to be key in the organisation of national healthcare systems and guarantees high quality, safe and accessible pharmacy services throughout the national territory.

Furthermore, cost-containment for public health expenditure (either by the state budget or by Statutory Health Insurance) is an important goal of national regulation in the health sector. These economically specific circumstances of the health sector constitute an outstanding distinction from other economic sectors and call for a different approach.

We believe that Member States should remain fully responsible to define the conditions for access to and practice of healthcare professions, such as pharmacists, as well as to choose the most appropriate method to assess the proportionality and necessity of such requirements. When implementing new regulation for healthcare professions Member States are best placed to consider the country-specific issues and take into account the interest of patient safety and quality of healthcare. In addition, given that health and life of humans rank foremost among the assets and interests protected by the TFEU, PGEU would like to stress that the objectives of healthcare systems and the regulation of health professions (namely ensuring accessibility and quality) should always take priority.