WORKFORCE


> We therefore owe it to them, and to the people of northern Ireland, to address the workforce issues that need to be fixed. and we need to ensure that we aren’t just fixing the problems from 2006 or 2016. We need to look forward to 2026.’


Eh, no, we need to look at the situation noW and address it as a matter of urgency, not produce lovely documents with extremely professional images – not to mention ‘stating the bleeding obvious’.


‘In addition to the existing vacancies in the nI training programmes,’ states the report, the hSc has been experiencing a growing number of medical vacancies at consultant and specialty doctor/associate specialist level. Whilst a small number of specialties feature on the UK shortage occupation list, a growing number of grades and specialities not on this list are being reported as ‘hard to fill’. this not only has an impact on waiting lists, but also on the overall cost of elective care.’


Yes, there is a shortage in this sector but every pharmacist in nI - and his dog – knows that there is a serious workforce problem in the province. the advent of practice-based pharmacists has seen the locum market decimated and many contractors – and their staff – all working on an all-out, hell-for-leather basis – a level which cannot be sustained for much longer. and yet, a quick look at the Workforce Strategy clearly shows that community pharmacy is, once again, the ‘poor relation’ in nI healthcare.


nI’s 2300 pharmacists must be shaking their heads in disbelief. time and time again the profession has shown that it can step up to provide an enhanced level.


gPs complain of ‘overload’. Pharmacists have shown they can use their clinical skills to take some of the burden off gPs. Problem? no funding.


Current problems in the system When you look at the profile of the current nI hSc workforce, it’s not difficult to see why problems are arising.


• overall, the hSc workforce is predominantly female, although some


22 - PharmacY In focUS


staff groups have a majority of male employees. as such, issues such as maternity leave have to be taken into consideration.


• the average age of directly- employed hSc staff has increased slightly in the last ten years from 40 to 43 years.


• there are also hSc staff groups with older age profiles, who therefore experience higher leaving rates.


• around 40 per cent of the hSc workforce are part-time workers. Profile apart, other problems are becoming increasingly prevalent throughout the hSc workforce. the level of sickness absence, for example, remains a concern, with mental health and musculo-skeletal issues being the largest contributing factors.


hSc’s increasing use of agency workers and locums is also a major concern. Expenditure on agency workers in this sector has doubled in the last five years: the largest proportion of expenditure going on doctors.


the vacancy rate (as of march 2017) was around five per cent for posts currently in the system. Drilling down this figure highlights key areas of concern, primarily within nursing, midwifery and medical staffing. on the positive side, the Workforce Strategy certainly acknowledges that pharmacy can play its part in the future of hSc.


‘the pharmacy workforce is expanding, with a range of careers for pharmacists, pharmacy technicians and other pharmacy staff,’ it notes.


‘this reflects the increasing need for pharmaceutical expertise within multi- professional teams in all settings, helping to optimise the benefits of medicines and transform services.’


With the current cost of medicines within hSc around £600 million and taking into consideration the fact that medicines are over used, under used and misused to the extent that outcomes can be sub-optimal, it is obvious that pharmacists need to be better utilised within hSc as a whole. the sticking point is, once again, funding and, let’s be honest, recognition of the abilities and skill mix of the pharmacist.


Leanne Carey and Sally Arnison


If any more proof was needed of pharmacists’ ability to carry out such work, we need only look to Scotland, where many pharmacists are now running common clinical condition clinics on a daily basis, looking after patients’ hypertension, diabetes, etc


this is obvious when you look at the report’s aims.


‘By 2026,’ it says, ‘we need to deal with the following workforce challenges:


‘….the professional development of the clinical prescribing role of pharmacists in general practice. While all general practice pharmacists train as prescribers, it is important that they are supported in their ongoing professional development. for example, they should have the opportunity to develop in line with the advanced practice framework.’


two issues arise out of this point. firstly, Pif is already aware that many PBPs are not working in line with the proposed objectives of their roles and are being used by gPs in a less clinical, more perfunctory role, simply filling scripts. Secondly, most community pharmacists could fulfil this role in their own pharmacies noW - (given funding). So, we ask, why wait until 2026?


If any more proof was needed of pharmacists’ ability to carry out such work, we need only look to Scotland, where many pharmacists are now running common clinical condition clinics on a daily basis, looking after patients’ hypertension, diabetes, etc, etc.


also, by 2021, every community pharmacist in Scotland is required to be an independent prescriber so that they can utilise their clinical skills and


thereby relieve pressure on gP practices across the region. one brilliant example of this work in practice is at Barnton Pharmacy in Edinburgh, where contractors Leanne carey and Sally arnison are both independent prescribers, who have been actively prescribing in gP practices since 2005.


the two currently work as gP practice pharmacists one day a week, tackling long-term conditions in dedicated clinics, and carrying out medicines reconciliation and polypharmacy reviews in the practices in which they work.


the rest of the working week is spent running their own community pharmacy in north-west Edinburgh, in which they also run ‘Pharmacy Surgery’, to which patients can self refer. at this clinic, a wide range of common clinical conditions are treated and, if necessary, the patient is then referred on to the gP.


northern Ireland’s community pharmacists are equally capable of carrying out this wide and diverse range of clinical practices. While the report’s authors refer to the Workforce Strategy 2026 as ‘ambitious’, and consider that the ‘significant challenges facing health and social care in nI’ will combine to ‘create a complex environment in which to transform’, it might be a better idea to look at what patients have access to now, rather than what needs to be brought in – or rather bought in – in the future!


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