By Neil Trainis

A report published today by the Royal Pharmaceutical Society and Pharmacist Support calls for a raft of measures to be implemented to ensure pharmacy teams do not suffer from burnout and patients’ safety is not jeopardised as a result, including supporting employers to “actively look at managing workload” through technology and skill mix.

The report, the result of a roundtable discussion in May that was hosted by the two organisations and involved a range of other pharmacy bodies who examined the impact of pharmacy workforce pressures on patient safety, comes as concerns about pharmacies’ workload intensifies.

The report said pharmacies in England dispensed 1.075 billion prescription items in 2022-23, over 60 million more than 2017-18. The number of interactions between pharmacists and patients over that period through nationally commissioned services increased by 80 per cent, reaching more than 10 million in 2022-23.

The report lists a number of risk factors that are associated with poor wellbeing of staff.

Those include longer hours worked by pharmacy teams which, according to a National Pharmacy Association report last year, was a contributory factor in the overall working environment factors that accounted for 41 per cent of errors by staff.

The report said increased workload was a result of the community pharmacy contractual framework “demanding more of the pharmacy workforce with little additional support provided by the NHS.” It noted that since 2019, six new clinical services have been commissioned nationally.

The report also said increasing numbers of prescriptions, leading to more patients turning to pharmacies for their medicines, has ratcheted up the pressure on pharmacies, compounded by a lack of appreciation of the efforts of staff by some of their colleagues and the public. Around 44 per cent of respondents to a workforce wellbeing survey by the RPS and Pharmacist Support said they had experienced physical or verbal abuse in the last six months, mostly from members of the public.

Other risk factors, the report found, included a lack of senior support for younger pharmacists and those with less professional experience, inadequate administrative or teaching time, with many respondents saying they were not offered any protected learning time, as well as staff suffering a poor work-life balance as they were regularly asked to do more because of a lack of staff in the pharmacy.

Pharmacy staff undertaking too many non-clinical or administrative duties, the report said, added “additional mental burden to staff,” while a lack of “burnout management resources” at some employers and support that, although on offer, was not easy for staff to access “at a convenient time,” were cited as other risk factors.

The report was also critical of the government for failing to plan to help pharmacy’s workforce cope with increasing workload and “sky-high vacancy rates” while it had failed to address “pay issues” as a workforce pressure factor.

The report’s solutions

The report produced what it describes as “practical longer-term solutions,” including supporting employers to use “digital solutions” to help them manage workload and make alterations in their business through changes in supervision and hub and spoke regulations “to maximise potential efficiencies.”

Pharmacists, the report added, should be encouraged to have “wellbeing conversations” with managers and teams, which in turn would “reduce stigma” and encourage conversations about mental health and wellbeing.

Commissioners were encouraged to support employers to introduce “more radical changes” by, for example, facilitating their use of technology and creating “professionally fulfilling roles for pharmacy professionals, aligned to supporting collaboration across professions.”

The report’s other recommendations include developing interprofessional learning so other professions understand the pressures pharmacists face, giving pharmacy students the chance to develop their management and leadership skills and increasing research to understand how factors such as medicines shortages and prescription volumes – described by the report as examples of “system stressors” – increase workload.

More needed to be done, the report added, to understand what conversations about wellbeing are taking place within integrated care boards and what impact those have on ICB workforce plans.

It said the “additional burden of discrimination” suffered by students and learners “from some backgrounds” needed to be researched more, better understood and more effectively addressed because “the additional burden of discrimination can negatively impact on wellbeing.”

The report also called for public-facing campaigns and collaboration with patient groups to raise awareness of the abuse suffered by pharmacists and their teams and the fact that, at times, the public is too quick to judge staff by how long it takes them to get their medicine ready rather than how safely and effectively they do so.

The bodies who attended the roundtable discussion, including the NPA, Community Pharmacy England, Association of Pharmacy Technicians UK, British Pharmaceutical Students’ Association, Company Chemists’ Association, General Pharmaceutical Council, Pharmacists’ Defence Association, Guild of Healthcare Pharmacists, Pharmacy Schools’ Council, Care Quality Commission and NHS England, promised to meet again in six months’ time to discuss what progress has been made.