Prescribing Safety Assessment (PSA)

The Prescribing Safety Assessment (PSA) has been developed jointly by the British Pharmacological Society (BPS) and MSC Assessment. It is intended to be a valid and reliable tool allowing medical graduates and foundation doctors to demonstrate that they have achieved the core prescribing competencies outlined in Outcomes for graduates (originally published in Tomorrow’s Doctors).

All F1 doctors are required to pass the PSA to be awarded a Foundation Year 1 Certificate of Completion (F1CC) at the end of the first year of the foundation programme.

It is also considered best practice for all F2 stand-alone doctors to undertake and pass the PSA. Any F2 doctor who has not passed the PSA before starting work is encouraged to undertake the exam during their F2 year.

F2 doctors who have previously completed a recognised F1 training programme since August 2016 (when this requirement was first introduced for F1) will have been required to pass the PSA in order to achieve F1 sign-off and will therefore not be required to undertake the exam again during F2.

National requirement for completion of Foundation Year 1

Prescribing is a fundamental part of the Foundation Programme as doctors will write and review many prescriptions on a daily basis. The British Pharmacological Society and MSC Assessment have worked together to develop the PSA which allows all final year students and postgraduate doctors to demonstrate their competences in relation to the safe and effective use of medicines.

The PSA is an essential component of demonstrating the necessary competences for successful completion of the Foundation Year 1. It is a national requirement for all F1 doctors to demonstrate a pass by the end of the year. All foundation doctors will be required to pass the PSA before being signed off as having successfully completed the F1 year and being awarded the F1CC. If the PSA was passed more than two years before starting foundation training, it will need to be successfully retaken before completion of the F1 year.

Foundation doctors who have not passed the PSA before commencing the programme will be offered a support package and will be required to sit or re-sit the assessment.

Preparing to take the PSA during the Foundation Programme

Your foundation school will register you for an account at https://prescribingsafetyassessment.ac.uk. You will receive an email requesting that you activate your account. This will give you access to further information about the PSA, how the assessment is constructed and FAQs.

All registered candidates will also have access to at least three practice PSA assessment ‘papers’ prior to the main assessment event for which they are registered. These practice papers will give you an opportunity to familiarise yourself with the online assessment environment and provide individualised scoring and feedback after each one has been completed. Online support will be available from 1 month in advance of the first assessment events until the release of the results.

PSA sittings

There are three opportunities for doctors in the Foundation Programme to sit the PSA during each training year (one sitting in each four-month placement). For the training year starting in August 2021 the sitting dates are:

– Tuesday 7 September 2021 at 1pm

– Monday 14 March 2022 at 1pm

– Friday 29 March 2022 at 1pm

The assessment

The PSA is an online assessment of knowledge, skills and judgement related to prescribing medicines in the NHS and will give you an opportunity to gain familiarity with prescribing duties expected of F1 doctors and to receive feedback on your performance.

The PSA is based on the competencies identified in the General Medical Council’s Outcomes for graduates (originally published in Tomorrow’s Doctors), such as writing new prescriptions, reviewing existing prescriptions, calculating drug doses, identifying and avoiding both adverse drug reactions and medication errors and amending prescribing to suit individual patient circumstances. The eight distinct prescribing areas: prescribing, prescription review, planning management, providing information about medicines, calculation, adverse drug reactions, drug monitoring and data interpretation, are delivered over two hours. The content of each question refers to ailments and drugs you are likely to encounter in year one of the Foundation Programme.

The PSA is designed to be taken in two hours. Extra time of up to 30 minutes can be accommodated for those eligible for reasonable adjustments. The paper will consist of 60 items.

Access to the content of the BNF (British National Formulary) will be available as part of the assessment interface. Paper copies of the BNF and BNFc can be allowed, however, candidates need to be aware that they may not contain the most up-to-date prescribing advice. Please note that PSA scoring is based on information on the BNF and BNFc websites that is most up-to-date at the time of the assessment. Candidates are not allowed to make any notes in the BNF during the assessment.

Results

Individual candidates will have access to their performance results by logging into the PSA interface.

It is important to note that failure to pass the assessment prior to the commencement of the Foundation Programme will not impact employment. Individuals will commence their allocated programme as scheduled and will be required to undertake the appropriate remediation package.

Candidates are not permitted to appeal against their PSA score. The test is marked automatically. Appeals against locally managed elements of the PSA delivery will be addressed by foundation schools in accordance with local procedures.

Evaluation

Feedback from candidates will be sought through an online evaluation form, which is automatically presented after candidates complete the assessment.

Original publications

This information was originally published as the following pdfs in July 2021:

UKFP 2021 PSA Guidance for F1 Trainees

UKFP 2021 PSA Guidance for F2 Applicants and Trainees