Derek Evans
Background: The history of pharmacy based travel medicine services was originally published in 2018. This article reviews the current training and education standards against the regulators and professional standards.
Professional standards: The provision of travel health services standards were assessed by different regulators for the professions giving rise to variances in the inspection processes and a dependence on self-assessment. The principal of self-assessment had been criticised due to practitioner’s inaccuracy in the determination of competency.
International and National Training Standards: The International Society of Travel Medicine (ISTM) offers an education course with guidance on the proportioned time for study in the key areas. This was compared to the provision by the UK agency responsible for of PGDs and the NHS providers of travel health advice to identify the areas of variation from an international standard. A review of PGD providers showed a wide variation in the length of time for self-determination and assessment when compared to the specialist providers.
Discussion: The training time for a single study was suggested as a 50 hours modular course and the key areas needed to include pretravel risk consultation and immunology/vaccinology. When considering the travel consultation process in the UK, the immunisation technique was the only identified area with formal assessment; however this was only 5% of the suggested international standard and was not mandatory. This was unlike other high income countries which have defined mandatory training and licensing before a travel health service can be supplied by a pharmacists. The potential for increased patient risk continues to rise without any formal education or assessed pharmacy standards. To provide uniform consistent standards the same standardised education and inspection should be provided by all the regulatory agencies. These standards should follow a similar pathway to the national immunisation standards involving education and have a mandatory standard of competence assessed externally before independent practice is allowed. The pharmacy regulator is introducing new inspection standards but it is unknown if these will involve mandatory assessment before practice in the future.
Conclusion: The current pharmacy system is not fit for purpose for use of PGDs without additional training. This assessment/inspection should involve all the areas of the service provision including vaccination technique, education and training and an external level of assessed competence. Both the PGD regulating authority and the pharmacist regulator have the authority to commit to uniform practice across all professions.