As THe LONG-AWAITeD PHARMACy WORkFORCe RevIeW Is FINALLy PuBLIsHeD, PIF TAkes A LOOk AT THe ReCOMMeNDATIONs MADe FOR THe DeveLOPMeNT OF THe PROvINCe’s PHARMACy WORkFORCe…
‘Ambitious and transformational’ recommendations for future of pharmacy in Northern Ireland
A
t a time when community pharmacy stepped up to the plate and became the public- facing sector of primary care, the Health Minister, Robin swann, has released the Pharmacy Workforce Review, which provides
recommendations for all sectors of the profession.
The Review contains an analysis of the current pharmacy workforce in Northern Ireland (NI) and recommendations, which are designed to inform the development of the pharmacy workforce over the next ten years.
The Review was initially finalised in late 2019, but plans to formally publish it in March of this year were postponed due to the COvID-19 pandemic. There was, however, extensive engagement with pharmacy stakeholders from across the profession and an action plan developed that will implement the recommendations contained within the Review.
Aims of the Review The ten-year vision for healthcare in NI describes a model of healthcare based on multidisciplinary teams working across the primary-secondary care interface. Importantly, pharmacists and pharmacy technicians were seen to play a central role in this model, highlighting the need for a skilled pharmacy workforce across all settings.
As has been proven by the recent pandemic, community pharmacists are the most accessible healthcare professional to patients. There are
34 - PHARMACy IN FOCus
currently 528 community pharmacies in NI and it has been reported that, on average, 45 per cent of the population used a pharmacy ten times or more within a year. Over the last decade, the average monthly dispensing volume per pharmacy has increased by 22 per cent.
Issues facing community and GP pharmacy
Over the last 30 years, the profession of pharmacy has been taking on a more central, patient facing clinical role. This has, however, led to various issues arising in areas such as recruitment, retention, career progression etc.
Shortage of pharmacists Currently, 1522 pharmacists are employed in the community pharmacy sector, equating to around 900 WTes. It has been reported that almost 400 pharmacists have left community pharmacy since 2016 to take up posts in hospital trusts (18 per cent), general practice (44 per cent), the Republic of Ireland or GB (17 per cent).
In addition, only 69 pharmacists on the pharmaceutical register are designated as locum and a high proportion of pharmacy contractors reported difficulty in sourcing locum cover. These staff movements, together with a reduction in new pharmacy graduates, have resulted in community pharmacies reporting difficulty in filling vacant posts. Naturally, these recruitment challenges are putting increased demands on an already pressurised workforce.
Professional isolation Professional isolation has been a long-standing issue within community pharmacy. Following analysis of data collected for the Review, almost 60 per cent of community pharmacists stated that they felt professionally isolated, compared to just 21 per cent and fourteen per cent of hospital and general practice pharmacists, respectively.
Work-related stress in Northern Ireland
‘Professional isolation’ in community pharmacy was cited by many pharmacists and there are various reasons for this.
Firstly, in many cases, a single pharmacist bears sole responsibility for all daily dispensary activities, staff management and answering medicines-related queries. Without adequate skilled support staff, this can be particularly challenging for young, inexperienced staff.
secondly, poor communication and collaboration between community pharmacy and GPs further augments community pharmacists’ perceived isolation.
Thirdly, pharmacists in this sector do not have the level of career development opportunities of counterparts in hospital and general practice.
Fourthly, lack of access to patient information systems, such as the electronic care record (eCR), isolates community pharmacists from other healthcare professionals.
Career development and succession planning unlike the hospital sector, a defined career pathway for community pharmacy is lacking and 66 per cent of community pharmacists reported they have no opportunities for advancement in their career. There is a need to expand the scope of practice for both lead and general practice pharmacists, yet the absence of a career development pathway does not reflect this. Foundation training for general practice pharmacists was introduced in 2019, after which pharmacists may train as independent prescribers. Whilst most pharmacists in this sector reported that they enjoyed their role, opportunities for grade progression and advanced clinical practice, central to a career in hospital pharmacy, were, they felt, absent in general practice pharmacy.
Registration and regulation Pharmacy technicians in NI are not regulated healthcare professionals, unlike their counterparts in GB, who have been a regulated profession since 2011. One consequence of this is that pharmacists are still professionally accountable for all regulated activity in the pharmacy, including that which they may not ordinarily be directly involved in. Therefore, they tend to be reluctant to delegate some of their dispensing and management responsibilities in the absence of another registered professional, which limits the potential for service development. Full benefit of any alternative regulatory model designed to support maximum utilisation of skill mix may only be
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