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Burnt out and quitting

The latest Workforce Wellbeing Survey from the RPS and Pharmacist Support makes sobering reading – for those pharmacists who have the time to pick it up.

Respondents to the latest annual Royal Pharmaceutical Society (RPS) and Pharmacist Support Workforce Wellbeing Survey for 2022 report negative impacts on their mental health and wellbeing.

The fourth annual survey received a total of 1,496 replies – the highest number to date – and revealed top factors causing poor mental health and wellbeing include inadequate staffing (70 per cent), lack of work-life balance (53 per cent), lack of protected learning time (48 per cent) and lack of colleague/senior support (47 per cent). 

Mental health

Respondents working in community pharmacy were more likely to report that their mental health was poor compared to other sectors, with findings broadly consistent across England, Scotland and Wales. 

Forty-five per cent of community pharmacy respondents rated their mental health as poor compared to the average (37 per cent) and only 28 per cent of female respondents rated their mental health and wellbeing as good or very good compared to 39 per cent of male respondents.

However, 37 per cent of female respondents rated their mental health and wellbeing as poor or very poor, which was similar to the response received from male respondents (38 per cent).

Burnout

The majority of respondents (88 per cent) were at high risk of burnout – as measured by the Oldenburg Burnout Inventory (Demerouti, 2010), a standardised tool for measuring burnout in healthcare professionals. This figure is consistent with figures from previous years, where the risk of burnout was 89 per cent (both in 2021 and 2020).

In community pharmacy an alarming 96 per cent said they were at risk of burnout, with the score for women slightly higher compared to men (91 and 85 per cent respectively).

Worryingly, 17 per cent of respondents had taken time off work (or study) in the past year due to the impact of their work on their mental health and wellbeing; 27 per cent had wanted to take time off but had not felt able to do so. Women appeared to have taken more time off work compared to men (18 and 13 per cent respectively).

Figure 1: Overall mental health and wellbeing of respondents in the last year, compared year-on-year (2020 to 2022)

Taking breaks

The majority of respondents (81 per cent) reported being offered regular rest breaks during working hours and of these, 39 per cent usually took a break. However, 34 per cent said they were frequently unable to take a break and 14 per cent of respondents said they were not offered rest breaks, with a higher number of respondents working in community pharmacy (20 per cent) reporting not being offered breaks compared to all other sectors (8 per cent).

Protected learning time

The majority of respondents (65 per cent) also did not believe they were given any, or sufficient, protected learning time, and 42 per cent said they were not given any protected learning time to address their professional development and learning needs. A higher number of respondents working in community pharmacy were less likely to be offered protected learning time (5 per cent vs an average 22 per cent). 

Verbal and physical abuse 

When it came to verbal and physical abuse, nearly half of respondents (44 per cent) had experienced abuse (verbal or physical) in their workplace or place of study within the last six months, the majority of which from a member of the public
or a patient.

Again, this was more prominent in community pharmacy where 69 per cent of respondents said they had experienced abuse, compared to 22 per cent working in other sectors.

Figure 2: Rating of respondents' work enjoyment on a day-to-day basis, compared year-on-year (2020 to 2022)

Quitting pharmacy

Almost three-quarters of respondents (73 per cent) had considered leaving their job or the pharmacy profession (including pharmacy studies) in the past year due to the impact of their work (or study) on their mental health and wellbeing. Of these, 12 per cent had moved roles or left the profession. 

Low awareness

Although the RPS and Pharmacist Support both have long-established wellbeing offerings, 38 per cent of respondents said they had not heard about Pharmacist Support and almost three-quarters (72 per cent) were not aware of the RPS Wellbeing Hub.

“For the fourth year running, this report exposes some disturbing statistics,” says Danielle Hunt, chief executive of Pharmacist Support. “The state of mental health and wellbeing in pharmacy is a huge concern, with the risk of burnout of those working within the profession remaining worryingly high. 

“As well as the strategic plans needed to address the root cause of some of the workplace issues highlighted, we believe that there is an immediate need for employers to consider what they can do to support positive wellbeing. 

“We plan to support this during 2023 by providing tools, training and support for pharmacy leaders that we hope will assist in embedding positive wellbeing practices into the workplace.” 

Given the expansion and promotion of its workforce wellbeing programme, the RPS said it was “disappointing to see that the findings do not show an increase in awareness of the RPS Wellbeing Hub” and added that “clearly, more work is required to explore awareness of, and access to [it]”.

In a bid to address the mental and physical wellbeing of all pharmacy staff across England, Scotland and Wales, the RPS has pledged to continue to advocate for the following:

  • Pharmacy working environments must have a culture of belonging that is inclusive, celebrates diversity and supports wellbeing
  • All pharmacists must be given access to, and be enabled to take, appropriate rest breaks, both for the welfare of pharmacists and for patient safety
  • Pharmacists must have dedicated protected learning time within working hours
  • Pharmacists and their staff must have continued access to national wellbeing and occupational health support
  • Investment is needed in the pharmacy workforce to train more pharmacy staff and upskill existing staff to work at the top of their competence.

“With pharmacy teams at risk of burnout, governments urgently need to improve workforce planning for pharmacy that addresses head-on the issues of skill mix and adequate staffing which are at the heart of overload in pharmacy,” says Royal Pharmaceutical Society president Professor Claire Anderson. 

“The recruitment and retention of pharmacists and their teams is crucial if the ambitions for pharmacy to play a key role in the future NHS are to be delivered. Planning must be backed by long-term investment and training from both employers and governments to make work more rewarding and improve career pathways.”

Figure 3: Burnout in pharmacy professionals, year-on-year (2020 to 2022), measured by the Oldenburg Burnout Inventory (Demerouti, 2010)

Resources

Case study: A personal perspective from a pharmacist in Wales

“The amount of pressure we are all under is phenomenal. Our sore throat test and treat service went through the roof at Christmas because of Strep A, and since we have a minor ailments service in Wales the surgeries used that to their advantage by telling people to go to the pharmacy first. The money we get from the minor ailments service is very poor so even though we are busy we can’t hire more staff and are burning out. 

“Nearly everyone on our group chat is really depressed and down, can’t see a way out, and we can’t seem to plan for the future either as cuts are ongoing. Some of us are not getting home until 8pm because we are struggling to do all the paperwork. While offering more services is great, all it is doing is taking pressure from one part of the NHS and moving it to us. We are also feeling forced to become independent prescribers, as from 2026 everyone qualifying will be IPs so will be better equipped than you are.

Legal challenge?

“We are glad that the RPS, PSNC and NPA are trying to fight for pharmacy but we think the focus should be looking at whether working 12 hours without a break falls under the remit of the Human Rights Act, and whether we should be mounting a legal challenge against Government for that. Lorry drivers are only allowed to drive for six hours but they are happy for us to check medicines for 12 hours without a break. 

“I used to do sport but since buying the pharmacy I’ve hardly been able to do any exercise. My fitness levels have gone down and other pharmacists say the same – we are all grabbing food on the go so our physical health is deteriorating as well. I won’t be surprised if we see lots of pharmacists having heart attacks and suicide rates going up. In another six months there will be a lot of pharmacists leaving the profession. 

“I worry about paying staff and if I can cover my loans. I was worrying about people ringing in sick before Christmas, plus trying to get antibiotics for all the sick children coming to us. Now I’m worrying if we are going to have to cut staff because of the cuts. I simply don’t know. The pressure is immense and it will break down.”

  • PSNC recently ran its latest Pharmacy Pressures Survey to help it make the case to Government for more funding. Acknowledging that “the sector is on its knees” with “a serious risk of collapse”, chief executive Janet Morrison said the aim of the survey was to show Government and the NHS how difficult things now are for pharmacies and to persuade them to take action.
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