Community pharmacy has been hit by wage stagnation and a drain of talent to primary care roles, says Mohammed Hussain…

Some say that if you love what you do, you’ll never work a day in your life. They would be wrong. When you love what you do, you’ll work harder than anyone else: you’ll work evenings and weekends, you’ll forego breaks and lunch, and you’ll think about work at home.

You’ll think about work as you fall asleep, and you’ll think about it as soon as you wake up. You don’t do it for the money: you do it because it is your vocation. But be careful what you love for it can burn you out.

The issue of burnout in the health service, and community pharmacy in particular, has been the subject of much discussion. This is closely linked with the vigorously disputed concerns of a workforce shortage in community. Are there fewer pharmacists and more vacancies in community due to a genuine shortage, or are there deeper structural issues?

My view is that community pharmacy has been impacted by a perfect storm of decades long wage stagnation and a drain of talent to primary care roles. The talent hasn’t gone to primary care necessarily for higher wages - many have taken a pay cut to move. The true drivers for this shift in the workforce are the poor conditions and burnout in community pharmacy.

The burnout is caused by the conditions in community pharmacy, where pharmacists are often working alone or with fewer staff than required, with no planned breaks. Staff turnover, targets and bureaucratic burden from both the NHS and employers add to the strain.

Examples of this include the pointless collecting and rekeying of lateral flow test codes, the dual keying required to dispense some private prescriptions from private providers, the Pharmacy Quality Scheme and more. Add to this that all community pharmacy teams have been playing Covid roulette for the past two years, not knowing which staff member is going to be isolating tomorrow, compounding the pressure on those who remain.

PCN and prescriber roles are brilliant for pharmacists and rightly celebrated, but they have turned into a nightmare for the sustainability of the community pharmacy workforce and, by extension, the community pharmacy network. There is no network without a workforce. Championing primary care roles needs to go hand in hand with supporting the community pharmacy workforce by addressing the root causes of burnout.

There has been a colossal failure of workforce planning. None of the organisations which should be dealing with this appear to have understood what is happening, or even truly care. After all, these are not the ‘clinical pharmacists’ NHSE has long trumpeted in its unnecessarily divisive and dismissive trolling of community pharmacists by making that invidious distinction.

The Royal Pharmaceutical Society has no meaningful answer to this workforce dilemma and burnout epidemic. There is no coherent strategy. There are still calls for more data from the NHS, but no plan to address either issue from the pharmacy leadership body. In the meantime, burnout is at record levels.

What can be done? Here is my simple request of NHS England, its new chief pharmaceutical officer, the RPS and the PSNC: recognise the problem. Invest in community pharmacy with the same focus as primary care. Push for minimum staffing levels (like nurses on hospital wards). Actively seek and enshrine mandatory lunch breaks for pharmacists in community. Finally, design roles in primary care that include community pharmacy practice, so that both sectors can flourish.

Championing pharmacy is not done by soundbites on media outlets, rather it’s done by addressing the root causes, lobbying decision-makers and working with partner organisations to make community pharmacy a healthier choice for a rewarding career.

Until then you may love community pharmacy but it won’t love you back.
 

Mohammed Hussain is an independent contractor and non-executive director of Bradford Teaching Hospitals Foundation Trust.