BTEC Level 3 Diploma - enrolment form

IMPORTANT: Please ensure you have all necessary information to hand as you are unable to save the form. You may wish to review this form before completion and come back to complete it later. Please also ensure you have read the enrolment criteria document on the 'Background information on the diploma and study guidance' page before completing this form.

Date*

Are you a supervising pharmacist/technician?*

Yes
No

Please ensure you have seen the course information videos to understand all parties' roles and responsibilities (those who do not meet the entry criteria will not be permitted to enrol on the course):*

I have seen the course information videos.

My student has seen the course information videos.

I confirm that the applicant has completed a self-declaration for health, and if they have any conditions that may affect the applicant’s fitness to practice as a trainee, and there are concerns about how these conditions could be managed, I have raised this to the Member Services team at the NPA prior to enrolment.

I have seen evidence to confirm that the applicant has a good character reference from a school or employer, or has a Disclosure Barring Service/Disclosure Scotland check.

My applicant has secured a placement as a pre-registration trainee pharmacy technician, and works for a minimum of 14 hours in a pharmacy environment.

The applicant will be directly supervised by a pharmacy professional registered with the General Pharmaceutical Council.

I have seen evidence to confirm that the applicant has GCSE pass grades (C, 4 or above) or equivalent qualifications in English, mathematics and science (For more details please see the FAQs. Please contact the NPA on 01727 800402 if you are unsure whether your student’s qualifications are equivalent, or if you would like to find out more about what your student can do if they do not have the required qualifications)

Qualification 1 - English

Qualification achieved*

Grade achieved*

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Date achieved*

Copy of your certificate*

Max. file size: 128 MB.

Please upload a scanned image of your certificate (PDF/JPEG/PNG files)

Qualification 2 - Maths

Qualification achieved*

Grade achieved*

Hidden

Date achieved*

Copy of your certificate*

Max. file size: 128 MB.

Please upload a scanned image of your certificate (PDF/JPEG/PNG files)

Qualification 3 - Science

Qualification achieved*

Grade achieved*

Hidden

Date achieved*

Copy of your certificate*

Max. file size: 128 MB.

Please upload a scanned image of your certificate (PDF/JPEG/PNG files)

Qualification 4

Qualification achieved

Grade achieved

Hidden

Date achieved

Copy of your certificate

Max. file size: 128 MB.

Please upload a scanned image of your certificate (PDF/JPEG/PNG files)

Qualification 5

Qualification achieved

Grade achieved

Hidden

Date achieved

Copy of your certificate

Max. file size: 128 MB.

Please upload a scanned image of your certificate (PDF/JPEG/PNG files)

Student details

Title*

Full name*

Please ensure that your name matches the name on your passport for GPhC registration purposes.

Date of Birth*

Personal contact telephone number*

Email Address*

Please ensure this email address is unique to the candidate, we will use this for the purpose of contacting the student.

Supervisor details

NPA membership number

Pharmacy name*

Pharmacy Address*

Street Address Address Line 2 City ZIP / Postal Code

Title*

Full name*

Personal contact telephone number*

GPhC number*

Email address*

Please ensure this email address is not shared and is unique to the supervisor, we will use this for the purpose of emailing login details

Hidden

Email Address*

Please ensure this email address is not shared and is unique to the supervisor, we will use this for the purpose of emailing login details

I confirm that once enrolled, it is my responsibility as a supervisor/ employer to ensure:*

This course should be completed within 27 months. If a candidate falls behind with their timetable, you are required to contact the NPA.

Any candidate, who does not complete the full course within the 27 months allocated time, will automatically be discontinued from the course.

The student undergoes a monthly review to discuss and document their progress. This will be logged in their portfolio.

The student is allocated a mentor in the workplace to assist them in the day-to-day working environment and to act as contact for the assessor.

The student is rotated in their roles to ensure that they are exposed to sufficient experiences and can dispense a range of prescriptions. The opportunity to work with, or have interactions with, multidisciplinary teams must be provided.

Sufficient and relevant work is given to the student in order to allow them to gain wider employment experience and to enable them to develop, within their contracted working hours, the competencies and the related knowledge, skills and behaviours required for this qualification. This includes having regular patient-facing experience and an involvement in stock management.

The student’s workload is monitored to ensure that it is appropriate and realistic, and reflective of their experience. Time to learn must be sufficient and provide effective opportunity to complete work and collect or produce satisfactory evidence.

The student can access personal and academic support and I must signpost this support clearly to them at induction and throughout the course. They should have access to pharmacy professionals who are able to act as role models and give professional support and guidance.

The student has sufficient access to resources in order to support their learning and make effective progress. Resources will include (though they are not limited to) appropriate information technology hardware and software including a PC/laptop/tablet/phone with access to video calling via WhatsApp, relevant and current textbooks.

Standard operating procedures (SOPs) are put in place for patient-facing roles in the pharmacy, as well as SOPs that govern: all areas of medicines reconciliation and supply; all areas of assembling and checking dispensed items; receiving, validating and issuing prescriptions; and all areas relating to the preparation and manufacture of medicines.

I complete the expert witness training pack on receipt of Pack B and scan/fax a copy of the self-declaration of competency to the NPA.

As supervisor/employer, I confirm that:*

I agree to the Terms & Conditions of the course registration as set out above.

I am aware that the course is non-refundable and non-transferable to another student.

I am the permanent supervisor of this student and have discussed the implications and limitations of this training with the student and consider them to be a suitable candidate.

I am willing to support the student throughout the training.

I have carried out a personal assessment of the student's capabilities and consider them to be suitable to enrol onto the course.

I certify that the information given on this form is correct.

Important Information

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