The ongoing pharmacist workforce crisis has posed a significant risk to patients' access to care, medicines and advice - particularly affecting the elderly and vulnerable living in areas with health inequalities.
Many from the sector have raised concerns about this issue with the Company Chemists' Association (CCA) recently acknowledging the shortage of pharmacists or pharmacy technicians in the country to meet the needs of patients and the NHS.
The trade body representing almost 50 per cent of the community pharmacy sector said that pharmacy teams are exhausted after working tirelessly during the pandemic,
adding that Covid, Brexit and NHS reforms have exacerbated the shortage.
Covid and winter-related sickness absences are adding to the strain and with Brexit it has become difficult to attract overseas pharmacists to the UK.
Those of us who work in community pharmacy know there is a workforce crisis created in large measure by PCNs actively recruiting pharmacists and pharmacy
technicians from our sector. It is welcome, if long overdue, that this has now been officially acknowledged in a report commissioned by the English Health Secretary.
PCN hiring 'exacerbates pharmacist shortage' says DH-commissioned report, which states such recruitment has "on occasion exacerbated the problem of a general
shortage of pharmacists" which has compounded "the problem of community pharmacy closures."
We have been telling the government this for years only to be told "problem? What problem?"- but now that Steve Barclay has his own official report sitting on his
desk, he and NHSE cannot continue in denial mode. The facts are there for all to see. Time to act. No more dithering, delay or indifference. You asked if there was
a problem and you have been told there is.
In the absence of a holistic workforce strategy and cross-sector career pathways, PCNs poaching from community pharmacy is a zero sum game adding nothing to
improving patient care.
Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching.
More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice.
Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit.
The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists.
Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.
The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England
after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce.
The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to
quit.
Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited
to general practice: community pharmacies are also suffering the consequences of it."
"Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to
make ends meet, not least given the rising staffing costs which are being driven up by workforce issues.
Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt
unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.
What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services
Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies.
Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope
the government listens and work with them to find resolutions.
"We are bullied into a corner," said Salim Jetha Chairman, Avicenna.
"Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost
cutting would be detrimental to patient care. Urgent holistic review is required."
Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the
ongoings pressures and squeeze on Community pharmacies."
"If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very
stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must
beg the question; what will it take to get help before the sector and individuals break?" he questioned.
The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm
burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to
find resolutions."
The Royal Pharmaceutical Society (RPS) has informed the Welsh Parliament about the workforce crisis in the pharmacy sector and the need to prioritise staff well-being and training requirements to help Covid recovery plans.
Providing evidence to the Senedd's Health and Social Care Committee's inquiry into waiting times, the RPS director in Wales Elen Jones emphasised that the pandemic
brought the pharmacy workforce under immense pressure.
She emphasised on "the need for workforce planning that allows pharmacists enough time to learn, teach and embed new skills," which would help in maintaining a motivated and sustainable workforce.
Jones presented the evidence alongside colleagues from the Royal College of General Practitioners, Community Pharmacy Wales and the Royal College of Nursing.
The Community Pharmacy Workforce Development Group (CPWDG) has called upon policymakers to take action in response to the 2022 Community Pharmacy Workforce
survey for England, which revealed a significant workforce reduction.
The survey found a steady decrease in the number of full-time equivalent (FTE) pharmacists, pharmacy technicians, and pharmacy support staff from 2017 to 2022,
with no signs of a slowdown. In response, it presented four recommendations to the Government and the NHS, aimed at ensuring that the sector can effectively adapt
to the evolving needs of patients.
CPWDG's findings indicate that vacancy rates are on the rise, reaching nearly 25 per cent, or 1 in 4 roles, in certain regions, accompanied by a noticeable shift
in working patterns.
The Company Chemists' Association (CCA) has published a 'pharmacy paradox paper' which outlines how community pharmacy can match the ambition amidst the
workforce crisis.
The sector is experiencing a workforce crisis, exacerbated by NHS recruitment of community pharmacists into primary care networks. Pharmacies are also facing a
significant increase in demand on services.
CCA said, "A stretched and reduced pharmacy workforce is having to deliver more and more. This is unsustainable."
"Unless the tension between ambition and capacity is addressed, there is a risk that community pharmacies will not only not meet their potential, but the existing
offer could be compromised."
Therefore, the association has set out solutions to resolve the current paradox between ambition and reality.
The National Pharmacy Association (NPA) has called on the NHS England to uplift funding for pharmacy contractors to enable them to cover higher staffing costs
along with a range of other cost-inflating factors.
This follows latest data released by the recruitment platform Locate a Locum, which showed a huge increase in locum rates for pharmacists in 2021 and predicted the
trend to continue.
The report noted a 71 per cent surge in the cost of employing locum pharmacists in England, from the 2020 average to the second half of 2021.
NPA chief executive Mark Lyonette said: "There is a heavy reliance on locums in community pharmacy to maintain continuity of services with the average pharmacy
operating 50 hours per week. Consequently, increases in locum rates have a big effect on the cost base.
"Pharmacies face a range of general cost pressures beyond locum rates, including much higher energy costs. We hear a lot about the cost of living crisis; our
members are facing a cost of doing business crisis and it's every bit as real.
"The underlying underfunding, significant general inflationary pressures and specific cost increases relating to the locum workforce together make a powerful and
urgent case for new funding."
The Royal Pharmaceutical Society (RPS) Director for Scotland Clare Morrison participated in the panel discussion alongside representatives from other health
professional organisations on tackling the workforce crisis at the SNP conference in Aberdeen on 8 October.
At the conference, the Cabinet Secretary for Health and Social Care committed to achieving protected learning time for health professionals. Morrison welcomed the
Cabinet Secretary's statement as fantastic news for pharmacists across Scotland.
"RPS Scotland will follow up the discussion by writing to the Cabinet Secretary to request a meeting to discuss achieving protected learning time, the forthcoming
results of our workforce wellbeing survey, and positive examples of how pharmacy teams have improved the well-being of their teams," said the society.
Shortage of pharmacists remains a big challenge for community pharmacies as the chief executives of the national community pharmacy bodies met with senior NHS England and NHS Improvement officials to discuss the precarious situation in October-end.
In the last few months, several pharmacy contractors have reported increased staff shortages that caused difficulties in maintaining services, leading to temporary closures in some instances.
The sector is also facing chronic shortage of other staff including van drivers and pharmacy technicians.
During the meeting, NHS England's director for primary care, Ed Waller, and chief pharmaceutical officer Keith Ridge held talks with leaders from across the pharmacy sector on a variety of topics.
National Pharmacy Association (NPA) urged the NHS England to make local impact assessment a key requirement prior to any recruitment into Primary Care Networks (PCNs) and Clinical Commissioning Groups (CCGs), to help tackle workforce crisis.
With inputs from LPCs, PCNs and CCGs should consider the impact of the creation of new roles on all health care providers in the area and on their ability to deliver their objectives on behalf of the NHS, it said.
The NPA believes that creation of the Additional Roles Reimbursement Scheme (ARRS) programme is impacting community pharmacy services in some areas and contributing to the ongoing workforce shortage.
In a letter addressed to Ed Waller, director of Primary Care for NHS England, NPA chief executive Mark Lyonette highlighted the challenges emerged following a shortage of pharmacists and other members of staff.
Pharmacy bodies and MPs discussed on support needed to unlock the "full potential" of community pharmacy at the All Pharmacy Party Group (APPG)'s general
meeting held in Westminster on Tuesday (01 November).
The attendees of the meeting were Janet Morrison OBE, Chief Executive of Pharmaceutical Services Negotiating Committee; Malcolm Harrison, Chief Executive of The
Company Chemists' Association; Thorrun Govind, Chair of the Royal Pharmaceutical Society; Sanjeev Panesar, National Pharmacy Association Board Member, and Pharmacist
Superintendent and Owner of the Pan Pharmacy Group; and Sandeep Dhami, Association of Independent Multiple Pharmacies member and superintendent at MW Phillips Chemist
At the session, 18 parliamentarians were briefed on the myriad of ways pharmacies contribute to the health of the nation.
The panel of experts also highlighted that pharmacists are 'running out of fuel' with the growing challenges such as flat funding, workforce shortages and the
cost-of-living crisis impacting pharmacies' ability to deliver vital services.
National pharmacy bodies have welcomed two VAT changes related to community pharmacy services announced in the Spring budget on Wednesday (15 March) but were
disappointed that the budget brought no further relief for the sector in a crippling funding crisis.
It was announced that from 1 May 2023, VAT exemption on healthcare would be extended to include medical services carried out by staff directly supervised by
registered pharmacists.
The government will also extend zero rate on prescriptions to medicines supplied through Patient Group Directions. This measure will be introduced in autumn 2023.
HM Treasury said these measures were being introduced to ensure that the VAT system keeps up with changes to how the NHS operates and how healthcare is delivered
across the country.
More widely, Chancellor Jeremy Hunt promised to halve inflation and said that the NHS would soon publish its long-term workforce plan.
In an oral parliamentary debate on community pharmacy held on Monday (20 March), the government was asked for an indication of 'how much it would cost to
make the best use of community pharmacies'.
A number of Peers at the House of Lords spoke out in support of pharmacies, while others asked when would the government address the current crisis in the sector.
Kicking off the session, Baroness Hodgson asked the responding minister, Lord Evans, about recent pharmacy closures as well as underfunding. She asked whether the
government would 'enter into discussions with PSNC to look at introducing a fairly funded pharmacy first service as soon as possible which will help relieve the
work load on GPs'.
The minister responded: "We have already introduced and funded a range of service in community pharmacy that make use of the clinical skills of pharmacy teams… we
continue to discuss with PSNC how the government can best support the sector to provide support to patients."
The House of Lords oral questions session was opened by Baroness Hodgson on behalf of Baroness Cumberlege as follows: "To ask His Majesty's Government what plans
they have for making the best use of community pharmacies".
The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday
(15 November).
The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on
the front-line and were briefed on the urgent need for action to address the pressures on the sector.
Outline of the four-point plan:
Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to
get through this winter.
Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free
up capacity and freed from red tape that does not enhance patient care.
Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services
for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of
long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.
The country as a whole is facing uncertain and challenging times, and for our profession emerging from the second year of the pandemic, the pressures and
stresses don't look to be easing up. It is undeniable that the wellbeing of those in our pharmacy family has suffered and many face emotional and psychological
challenges in addition to immense workplace pressure.
What do we know about the state of wellbeing within the profession? As the profession's independent charity, it is crucial that Pharmacist Support keeps abreast of
the changing needs of the profession to enable us to meet the needs of those we are here to help. To do this, each year we collaborate with the Royal Pharmaceutical
Society (RPS) to carry out an annual Workforce Wellbeing Survey.
The last survey carried out was in the latter part of 2021 but nothing has changed since. And the results provided stark reading. Of the 1,014 responses received,
many reported living with 'poor' or 'very poor' mental health and wellbeing.
The survey results highlight a continued clear need for mental health and wellbeing support. Within the survey, it was identified that there is a very clear need for
independent assistance, with many saying they feel unable to talk to their employers about their mental health issues. The need for our charity has never been clearer.