Flu Vaccination – training requirements and resources

Flu Vaccination – training requirements and resources

All pharmacy staff involved in the provision of the Flu Vaccination Service should receive appropriate training relevant to the role they will undertake. Community pharmacy contractors are required to demonstrate that all pharmacists providing the service in their pharmacy have the skills needed to do so.

Flu vaccination services have been widely commissioned from community pharmacies over the last few years and as a consequence many pharmacists have already received regular training on the provision of a vaccination service. There are a number of organisations offering training and support for provision of flu vaccination services and contact details can be found below.

The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners document sets the standards and lists the essential topics which should be incorporated into immunisation training for registered healthcare practitioners.. Pharmacists who will provide the Flu Vaccination Service must have completed practical training in vaccination that meets these requirements.

NHS England has determined that pharmacists providing the Flu Vaccination Service need to attend face-to-face training for both injection technique and basic life support training every two years. This requirement means that a pharmacist who undertook face-to-face training for both injection technique and basic life support in 2016 would not need to undertake face-to-face training in 2017. The pharmacist would then need to undertake face-to-face training in 2018 in order to continue to provide the service in 2018/19. Pharmacists who last undertook face-to-face training in 2015 would need to undertake face-to-face training in 2017, prior to providing the Flu Vaccination Service 2017/18.


Click on a heading below for more information. 

Declaration of Competence (DoC)

The Declaration of Competence (DoC) approach (developed by the Community Pharmacy Competence Group) has been agreed by NHS England, NHS Employers and PSNC as being the way by which pharmacists providing the Flu Vaccination Service can demonstrate their competence to the contractor who is contracted to provide the service and to NHS England. An existing DoC for vaccination services (available on the CPPE website) has been amended for use in the Advanced Service. This amended DoC – the NHS Seasonal Influenza Vaccination Advanced Service DoC must be used for the national Flu Vaccination Advanced Service.

To fully complete the DoC, pharmacists must be familiar with the Patient Group Direction (PGD) and the service specification for the service.

Pharmacists should note that completion of the original vaccination services DoC does not provide acceptable evidence of their competence to provide the Advanced Service.

CPPE has produced A guide to using the Declaration of Competence (DoC) system and a factsheet to help pharmacists complete the DoC process.

PSNC resources

Training resources

National flu programme training slide set for healthcare professionals (PHE)

e-Learning for Healthcare Flu Immunisation online course
This interactive flu immunisation e-learning programme, written by Public Health England and produced by Health Education England’s eLearning for Healthcare, is available for anyone involved in delivering the flu immunisation programme.

Training providers

Some LPCs are arranging local training for their pharmacy contractors; contact your LPC to see if they are organising any training.

Vaccination training

There are a number of organisations that provide vaccination training for pharmacists and those that PSNC has been made aware of are listed below for information (listing on this website does not constitute endorsement of the course or provider by PSNC):

AAH Pharmaceuticals

Alliance Healthcare

Avicenna

Buttercups Training Ltd

Cambrian Alliance

Clockwork private health centre

ECG Training

Global Health Medical

National Pharmacy Association

Numark

PharmaDoctor

RxAdvisor

Sonar Informatics

Voyager Medical

Flu Champion course

Pharmacy Complete has launched a distance-learning course which aims to equip pharmacy team members with the knowledge and skills required to support the effective delivery of the Flu Vaccination Service. The course includes a workbook, online assessment, certificate and Flu Champion badge.

Please note: completion of this course is not a requirement of the Flu Vaccination Service; this is an optional course for pharmacy team members.

FAQs

Training and competency FAQs

Q. What are the knowledge and skills required in order to provide a vaccination service?
The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners set out the knowledge and skills that healthcare professionals undertaking vaccination services need to have. NHS England has determined that pharmacists providing the Flu Vaccination Service need to attend face-to-face training for both injection technique and basic life support training every two years.This requirement means that a pharmacist who undertook face-to-face training for both injection technique and basic life support in 2016 would not need to undertake face-to-face training in 2017. Assuming the service continues to be commissioned in 2018, the pharmacist would then need to undertake face-to-face training in 2018 in order to continue to provide the service. Pharmacists who last undertook face-to-face training in 2015 would need to undertake face-to-face training in 2017, prior to providing the Flu Vaccination Service.

Q. Do the 2018 National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners contain lots of changes compared to the previous 2005 versions? (new)
No. The revised document contains several updates to the 2005 version, but most of the revisions reflect the expansion of the immuniser workforce beyond doctors and nurses, and the approach that has been taken in recent years to the training of pharmacists and other “new” vaccinators. For example:

  • e-learning courses may provide an effective mechanism through which immunisers can access training. A blended learning approach can be utilised with an e-learning course used alongside face-to-face sessions;
  • foundation training and updates should be tailored to suit the requirements of the immunisers to their specific area of practice and the vaccine(s) that they administer. So, the training of a new immuniser who will only administer one type of vaccine should cover all the topics in the core curriculum, but these should be made context and vaccine specific. With only one vaccine to cover, length of training will be shorter than for those who give a range of different vaccines; and
  • annual update training – face to face updates are likely to be of particular value to those who give or advise on a diverse range of immunisations, e.g. practice nurses. However, it is recognised that for some immunisers in some areas of practice, face-to-face updates may not be feasible, and updating may be best undertaken through self-directed learning. Methods for this may include undertaking the assessment modules of an immunisation e-learning programme and doing/re-doing the necessary modules to refresh knowledge. Practitioners could also read through the “Information for healthcare practitioner” documents on the PHE website, listen to any available webcasts and read recently published articles on immunisation relevant to their area of practice.

Q. I have heard that the 2018 National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners include a new requirement for supervised clinical practice following training. Is that correct? (new)
A period of supervised clinical practice is recommended, but this is not a new requirement – this was also recommended in the 2005 documents.

Q. Who does the recommendation for a period of supervised clinical practice apply to? (new)
The document states that those new to immunisation should receive comprehensive foundation immunisation training, either through a face to face taught course or a blended approach of both e-learning and a face to face taught course. New immunisers should also have a period of supervised practice and support with a registered healthcare practitioner who is experienced, up to date and competent in immunisation.

Q. Does the recommendation for a period of supervised clinical practice apply to pharmacists who have previously been trained to vaccinate? (new)
If you have vaccinated patients in the past and consider yourself to be an experienced vaccinator, supervised practice would only be required if you feel it would benefit your professional practice, e.g. if a long duration of time has passed since you last vaccinated patients.

Q. I am a pharmacist who is commencing immunisation training for the first time so I can provide the Flu Vaccination Advanced Service. What are the steps I need to take? (new)
If you are a new vaccinator we recommend the following steps:

  1. Complete your core training (face to face and any other learning directed by your training provider);
  2. Complete the Vaccination Services Declaration of Competence (DoC) on the CPPE website;
  3. Undertake a period of supervised practice with a registered healthcare practitioner who is experienced, up to date and competent in immunisation; then
  4. Should any additional training need be identified during your supervised practice, undertake the further training and then review your DoC.

Q. What is the idea behind undertaking a period of supervised practice? (new)
In addition to acquiring knowledge through a theoretical taught course, practitioners need to develop clinical skills in immunisation and apply their knowledge in practice. A period of supervised practice will allow acquisition and observation of clinical skills and application of knowledge to practice when the practitioner is new to immunisation.

Q. What happens during a period of supervised practice? (new)
Before starting to give immunisations, it is recommended that all new immunisers should spend time with an experienced registered practitioner, such as an experienced pharmacist immuniser, who has undertaken training that meets the national minimum standards and is experienced in advising about immunisation and giving vaccines. The new immuniser should have the opportunity in these sessions to observe and discuss relevant issues with the experienced practitioner.

Those new to their role in immunisation should also demonstrate an appropriate standard of practice to their supervisor. This supervised practice should be structured and robust and follow a clear, comprehensive checklist so each step of the consultation is considered. A competency checklist such as that written by PHE and the Royal College or Nursing (see Appendix A of the National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners) should be used for formal assessment and sign-off of the practitioner’s clinical competency in immunisation. A copy of the completed checklist should be retained in the practitioner’s personnel file.

Q. How long should a period of supervised clinical practice be? (new)
PHE advise that there is no agreement or evidence as to how many times supervised practice should occur, but both the supervisor and new practitioner need to feel confident that the practitioner has the necessary skills and knowledge to advise on and/or administer vaccines. If the practitioner administers a range of different vaccines to patients of different ages, their supervisor should ensure this is taken into account and they should be given the opportunity to observe and also be assessed on this range.

Q. Are there any qualifications which apply to the experienced healthcare practitioner? (new)
The supervisor does not require a formal teaching and assessing qualification but should be competent in immunisation and have the ability to make an assessment of a new immuniser’s knowledge and skills. One of the supervisor’s key roles is to go through the assessment document with the new immuniser and assure themselves that the new immuniser has the appropriate level of knowledge and skill to undertake their role in immunisation.

Q. Can another pharmacist act as the experienced healthcare practitioner within a period of supervised clinical practice? (new)
Yes, as long as the pharmacist is competent in immunisation and has the ability to make an assessment of a new immuniser’s knowledge and skills.

Q. How can a period of supervised clinical practice be arranged? (new)
There are several ways a supervision session could be arranged, for example:

  • At the point of arranging face-to-face immunisation training, trainees could enquire whether the training provider could arrange such a session;
  • New immunisers could speak to the pharmacy contractor they work for to enquire whether they could arrange a supervised session with an experienced immuniser, within the same organisation; or
  • New immunisers could contact local pharmacist colleagues, who are experienced immunisers, and ask them whether they would be willing to supervise a session within their pharmacy.

Q. Where can I undertake training to provide vaccination services?
A range of organisations provide training for pharmacists on vaccination. Some LPCs have arranged training for local pharmacists, so you may want to check with your LPC about the availability of local training. A list of training providers is also available on the PSNC website.

Q. I completed face-to-face training covering injection technique and basic life support last year, but I have been told that unless I vaccinated over a specific number of patients last year I will need to re-do the training again this year. Does this apply to the NHS Advanced Flu Vaccination Service?
No, this does not apply to the NHS Advanced Flu Vaccination Service. NHS England has determined that pharmacists providing the Flu Vaccination Service need to attend face-to-face training for both injection technique and basic life support training every two years, irrespective of how many vaccines are administered each year.

If you are providing private flu vaccinations (not as part of the NHS Advanced Flu Vaccination Service) there may be minimum activity requirements in order for your training to be valid; this should be verified with the private PGD provider.

Q. I completed face-to-face injection technique and basic life support training last year. Do I need to complete online refresher training this year?
No, there is no requirement to complete online refresher training for the national Flu Vaccination Service. Pharmacists may choose to do this, or undertake other types of CPD relating to the service, but this is not a mandatory service requirement.

If you are providing private flu vaccinations (not as part of the NHS Advanced Flu Vaccination Service) there may be a requirement to complete online refresher training; this should be verified with the private PGD provider.

Q. Is there any other training I should consider?
As well as training specifically on vaccination provision, contractors and pharmacists should consider training for themselves or their team on topics such as consultation skills or first aid, or even marketing or time management, as these may better equip them to provide the service. The core vaccination training will cover matters such as management of allergic reactions and patient consultation.

Declaration of Competence FAQs

Q. How will contractors determine that their pharmacists have the necessary knowledge and skills to provide the service?
The Declaration of Competence (DoC)approach (developed by the Community Pharmacy Competence Group) is being used to assure contractors that pharmacists have the necessary knowledge and skills to provide the service. An existing DoC for vaccination services has been edited for use in the Advanced Service; it is available on the CPPE website.

Q. Which vaccination DoC should I use for the Advanced Service?
You must use the NHS seasonal influenza vaccination ADVANCED DoC, not the Immunisation (NOT ADVANCED Flu service) DoC.

Q. Once a pharmacist has completed the DoC self-assessment framework and has printed and signed the statement of declaration, is the DoC process complete?
Once both of these documents have been completed and signed, the pharmacist will be able to demonstrate to the contractor that they are working for that they have the necessary knowledge and skills to provide the service. However, it is important to complete step 5 of the DoC process ‘Update your CPPE learning record’. This step confirms that the statement of declaration for the NHS seasonal influenza vaccination ADVANCED has been signed.

Q. If I am a pharmacist with a registered address in Wales or Scotland, but I will be working in an English community pharmacy providing the service, how can I access the DoC on the CPPE website?
Pharmacy professionals on the borders who work in England but live in Scotland or Wales can make a request to CPPE for their practice location to be changed on their database (telephone 0161 778 4000 or email info@cppe.ac.uk). This will allow the pharmacist access to learning and assessments plus the DoC. Every six months CPPE will automatically check if they still practise in England.

Q. I completed the DoC process last year and will be completing face-to-face injection technique and basic life support training this year. Do I need to complete the DoC process again?
The DoC process needs to be completed every two years so it would not need to be completed again this year. However, we would suggest that pharmacists consider completing the DoC process again as by doing this it will mean a pharmacist’s face-to-face training and completion of the DoC process can then be completed together every two years, rather than having to do training one year and completion of the DoC process the next.

Q. The NHS seasonal influenza vaccination ADVANCED DoC provides a list of recommended learning and assessments; should all of these be completed?
This is a decision that needs to be made by the individual pharmacist. A pharmacist is personally responsible for keeping their knowledge and skills up to date and relevant to their roles and responsibilities. Working through the DoC system provides a pharmacist with the opportunity to reflect on their current competencies, and identify and meet their learning and assessment needs.

The list of recommended learning and assessments will help pharmacists to fill any gaps in their knowledge or competence in order to provide the Flu Vaccination Service.

Q. If a pharmacist has completed an independent prescribing course, does this mean they meet the Consultation Skills for Pharmacy Practice: Practice Standards for England, and can complete the core competency section in the NHS seasonal influenza vaccination ADVANCED DoC?
The wording in the core competency within DoC states that pharmacy professionals should be working towards the Practice Standards. This is because developing consultation skills is an ongoing process throughout the career of every pharmacy professional. The independent prescribing course will have provided a pharmacist with an element of training on consultation skills to support them in working towards the Practice Standards; however, it would be down to the individual pharmacist to download the Consultation Skills for Pharmacy Practice: Practice Standards for England to see whether they feel the training they have undertaken has sufficiently supported them or whether further learning would be beneficial. If a pharmacist feels they meet the standards and have a good understanding of consultation skills due to the learning they have undertaken, they should attempt the consultation skills e-assessment, which will help assess their skills in this area and provide reassurance of competency.

Q.Is it a requirement to have accessed, but not necessarily completed the Consultation Skills for Pharmacy Practice: e-assessment to be able to provide the Advanced Flu Vaccination Service?
Pharmacists are not required to have completed the Consultation Skills for Pharmacy Practice: e-assessment before completing the NHS seasonal influenza vaccination ADVANCED DoC system; they are required to meet or be actively working towards the Consultation Skills for Pharmacy Practice Standards for England.

If you confirm that you are actively working towards the standards, you are declaring that you are undertaking the relevant learning and CPD to meet the standards. It is expected that you will have accessed the standards and associated learning to meet this requirement and that you will complete the assessment within 12 months of signing the Declaration of Competence statement.

As a pharmacy professional, you should continuously seek to develop your consultation skills throughout your career and, therefore, this topic should regularly feature in your CPD plan. To access the assessment, go to the CPPE website. If you have not yet completed the assessment, you should be able to provide evidence of the consultation skills learning you have undertaken.

Q.I signed the statement of declaration for the NHS seasonal influenza vaccination ADVANCED DoC last year, do I need to sign it again this year as it has been updated?
No. The statement of declaration will remain valid from the date it was signed for two years. It is however good practice to align the statement of declaration with practical training and also review the documentation each year i.e. Patient Group Direction and service specification.

Q. Do pharmacists need to complete the safeguarding and consultation skills e-assessment every two years when reviewing their DoC?
This is a decision that needs to be made by the individual pharmacist. A pharmacist is personally responsible for keeping their knowledge and skills up to date and relevant to their roles and responsibilities.  There are regular developments in practice in particular with regard to Safeguarding which require pharmacists to ensure they are aware of new developments in this area.

The pharmacist should reflect on their current competencies, and make a decision on whether further learning is required.

It is also important to note, that Consultation Skills for Pharmacy Practice is not a ‘tick box’ exercise. As a pharmacy professional, you should continuously seek to develop your consultation skills throughout your career and, therefore, this topic should regularly feature in your CPD plan. To access the assessment, go to the CPPE website.

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