The rising number of temporary pharmacy closures has led to a dispute in the sector as to the cause. Large multiples blame a workforce crisis but locum pharmacist Tohidul Islam takes a different view. Interview by Arthur Walsh

Temporary pharmacy closures are the topic of much fierce debate, causing the mistrust between some employers and elements of the workforce to become more deeply entrenched than ever.

Representatives for the large pharmacy multiples – which appear to be struggling to keep their doors open to a greater extent than independents – attribute the problem to a deepening workforce crisis.

They cite Health Education England data indicating that the number of full-time vacancies for pharmacists may have doubled between 2017 and 2021, as well as wider issues in the health sector with recent reports indicating there are over 100,000 vacancies in the NHS as a whole.

One of the most outspoken critics of this narrative has been Tohidul Islam, a locum pharmacist and founder of the networking platform The Pharmacist Cooperative. He claims it is a mistake to confuse the effects of years of underfunding with personnel shortages, and highlights the rising number of pharmacists on the GPhC register each year.

Shortages are solvable

“Yes, there are local shortages,” he says. “If you go to Cumbria, for example, there aren’t that many pharmacists – but it’s been that way for decades. It is just the way it works; people tend to live in the larger cities.”

Nonetheless, he is adamant that even these local shortages are solvable. “If you have a vacancy anywhere in the country, I will find you a pharmacist in under an hour – that’s how confident I am that there isn’t a shortage.

“I understand what [the multiples] are trying to do. They want to put pressure on the NHS and Government to get better funding so they can cope with rising inflation and demand for higher wages. We’ve had a funding cut year-on-year for the last four or five years so I can completely understand the financial pressures pharmacy owners are feeling – but frame it better.

“When you say there is a shortage of pharmacists, what [the Government] will do is open the tap to bring in more pharmacists, open up more schools of pharmacy, create apprenticeships and flood the market, thereby dropping rates. That doesn’t solve the problem of poor funding.”

Short-sighted

“I think it is a very short-sighted policy,” he continues. “It will drive more of the experienced and talented pharmacists away from community pharmacy and into other sectors. You’ve seen people take a pay cut just to go into primary care networks because they are so burned out by community pharmacy.”

Disputes between employers and locums over hourly rates are a contributing factor to the closures crisis, he says. “I’m getting more and more reports of pharmacists saying, ‘I’ve offered to cover this shift, but the business didn’t even respond and now they’ve closed for the day.’”

Unlike other businesses, pharmacies are at the mercy of public funding decisions and cannot mitigate rising expenses by charging higher prices to patients. At what point do locum rates become so high that they are simply unsustainable for an employer?

“That’s a question for businesses to answer – I’ve seen some very wide-ranging figures in terms of what businesses say they can afford,” says Islam.

He refers to reports of some locums charging as much as £100 an hour as a “red herring... that’s a very small minority of people focusing on that just to make the sector look better and saying ‘that’s where our problem is: locums ripping us off ’.”

Look further afield

Employers should cast a wider net when searching for locums, he says, claiming that some have been over-reliant on the same pool of pharmacists and run into difficulties when they are all engaged.

What about reports of locums agreeing to shifts and then cancelling shortly before the booking to try and secure higher rates? “I can’t comment on individual instances, but locums are independent businesses and can negotiate as hard or soft as they like. As long as they remain within professional boundaries and GPhC standards, it is just an arrangement between two businesses.

“Pharmacists’ wages are the most expensive element for a business, but that is because without pharmacists you don’t have a pharmacy.”

“When I first qualified as a pharmacist the rate was around £25 an hour. If this had kept in line with inflation it would be around £40-45 now – but because contractual funding hasn’t gone up, it is very difficult to pay that sort of money.

“I can fully sympathise with independent pharmacy owners; it is very difficult for them – they are being squeezed by wholesalers, inflation, and demands from their employed staff as well as increasing locum rates. I’ve asked pharmacists to support independents as much as they can because we need them to survive.”

Islam suggests that pharmacies struggling financially should focus more on private services, potentially looking to European business models as an example.

Staunch the flow

A greater emphasis on clinical services will also boost job satisfaction and staunch the flow of pharmacists to NHS roles, he argues – a point that has also been made by the Community Pharmacy Workforce Development Group, consisting of employers’ bodies such as the Company Chemists’ Association and National Pharmacy Association.

“We need pharmacies to be more like health centres, not just dispensing as many packs of medicine as they can,” he says. “To me, that is where the future is.”

The rise in temporary closures, which is attracting increasing attention in local and national media, risks causing permanent damage to the sector’s reputation after it played such a vital role in the pandemic, Islam argues.

So how does the sector move beyond this impasse? “I think honesty would go a long way,” he answers.

“It is time for businesses to come out and say finances are the problem – ‘we can’t operate like this and are going to have to start closing branches because we just can’t afford to run them’.

“Then you’d have the whole sector behind you. But the minute you start trying to make pharmacists the enemy, that is where you have an issue.”

Backstory: Tohidul Islam joined the register in 2005 and began working for a multiple but didn’t enjoy the life of an employee pharmacist partly due to what he felt was an excessive focus on targets. He has worked as a locum pharmacist since then and is a founder of the networking platform, The Pharmacist Cooperative.