Tips for building an inclusive pharmacy workforce

Introduction

The UK pharmacy workforce is highly diverse, drawing from a wide range of ethnic, cultural and socioeconomic backgrounds. In March 2022, results of the NHS ‘Pharmacy Workforce Race Equality Standard’ (PWRES) report found that, of the 51,440 pharmacists and 20,768 pharmacy technicians in England, 11,396 pharmacists and 8,443 pharmacy technicians were employed by NHS trusts^​1​. Notably, at the time of the report, 4,934 (43.3%) of pharmacists and 1,625 (19.2%) of pharmacy technicians in NHS trusts in England were from a black, Asian and minority ethnic background, which is significantly higher than the 18% of the general population of England identifying as such^​1,2​.

While the PWRES data are limited to the NHS pharmacy workforce, data from the General Pharmaceutical Council (GPhC), published in September 2023, show a similar overrepresentation of black, Asian and minority ethnic backgrounds^​3​. This diversity is not only a source of strength but also an opportunity to enhance the profession’s ability to tackle complex issues, including health inequalities.

Recognising and cultivating this diversity is critical for fostering inclusion and equity within the pharmacy profession. An inclusive culture can enable patient-centred care, allow individuals and teams to thrive, and consequently deliver better outcomes and experiences for the communities they serve. The COVID-19 pandemic revealed many of the structural health inequalities experienced by minorities, with data clearly demonstrating that black and Asian populations were experiencing higher mortality rates and worse outcomes compared with white groups^​4,5​. Since the COVID-19 pandemic, the NHS has placed renewed emphasis on tackling these inequalities and improving access to healthcare for all.

Inclusive pharmacy practice

The Inclusive Pharmacy Practice (IPP) initiative in the UK was established in 2021 as a means of co-ordinating the pharmacy profession’s response to the challenge of health inequalities. The IPP is a joint initiative between England’s chief pharmaceutical office (CPhO), the Royal Pharmaceutical Society (RPS), the Association of Pharmacy Technicians UK and 13 other national partner organisations^​6​. It is aimed to promote the creation of a more inclusive environment for pharmacy professionals, enabling the workforce to maximise its impact and improve health outcomes in the diverse communities that pharmacists serve. 

The CPhO has set out three essential themes for the IPP initiative: leadership and representation; education and training; and healthcare service delivery (see Box 1).

One of the aims of the IPP initiative is to address workforce inequalities, which includes ensuring that there is a senior leadership profile that is representative of the diversity of the pharmacy profession and reflects the communities that we serve^​6​. 

The IPP initiative agenda is a positive step for the pharmacy workforce. It has not always been the case that minority ethnic staff are fully supported to thrive and significant challenges remain. For example, salary and job satisfaction survey data (n=1,219) from The Pharmaceutical Journal, published in 2024, revealed that 28% of pharmacists who identify as African/Caribbean/black other had experienced racism from a colleague in the previous year.

The survey also revealed that 19% of South Asian respondents, 13% who identified as mixed race (13%) and 9% of ethnically Chinese pharmacists also said they had experienced racism from colleagues in the past year^​7​. National initiatives such as the IPP are a welcome step towards increased inclusivity and equity within the pharmacy profession.

Building inclusivity within the workforce

In 2024, the current CPhO clinical fellows surveyed senior leaders across the UK to ask about the equality, diversity and inclusion (EDI) initiatives that were in place. The survey was distributed by the six regional chief pharmacists within NHS England to their networks. A sample of convenience was used, based on the accessibility of participants and the networks used.

There were 77 responses to the survey: 75% (n=58) from hospital trusts, 13% (n=10) from integrated care boards and the remaining 12% (n=9) of responses included the local pharmaceutical committee, hospice and mental health trust.

The survey results highlight a strong continuing commitment to EDI initiatives at the organisational level, with a majority of organisations having established various EDI frameworks^​8​. The majority of respondents (86%, n=66) indicated that their organisation has EDI initiatives in place; however, in contrast, only half of respondents indicated that their team had EDI initiatives. This discrepancy indicates a need for better dissemination and integration of EDI practices within pharmacy team settings. It should be noted that the survey was only sent to the managed NHS sector and is not reflective of primary care or community pharmacy. 

Top tips for inclusive pharmacy practice

Based on the authors’ experiences, the insights gathered from the regional surveys and conversations held with pharmacy teams, several successful EDI initiatives were identified. These insights form the foundation of the following tips for how pharmacists and pharmacy professionals can foster inclusivity in the workplace.

1. Senior leadership support is essential

Senior leaders should actively lead the IPP agenda across their organisations. This leadership includes setting clear objectives, monitoring progress and holding themselves accountable for outcomes. Improving EDI should be a component of ‘business as usual’ activities rather than optional work that is confined to siloed projects. Leadership commitment is essential for the creation of an inclusive culture and ensuring that EDI principles are embedded in organisational practices. An example of this style of leadership can be seen in the south west of England, where Kandarp Thakkar, chief pharmacist and clinical director of pharmacy and medicines optimisation at University Hospitals Plymouth NHS Trust, led the creation of a ‘South west inclusive pharmacy practice manifesto’.

2. Optimise your communication strategy

For any campaign for change to be successful, an effective communication strategy is crucial^​9​. Communication should be tailored to the audience so that the message is impactful and consistent. For example, if you are attempting to motivate team members and increase buy-in, it can be effective to provide examples of practical lived experience, showing how initiatives in the workplace have supported people to feel more included in the pharmacy profession. The rationale for change should be clearly explained, with emphasis placed on the benefits that can be unlocked when individuals and teams have a genuine sense of belonging.

Segmentation, where people are categorised into different groups based on their unique characteristics, is another technique that can be used for building a programme that fosters diversity. By learning what motivates each group of employees and offering a customised communication programme, pharmacy teams can optimise their DEI activities and target specific barriers faced by different groups of people.

Another good internal communication strategy is to assign an employee to help when patients struggle with English as a second language or there are location concerns.

3. Actively collaborate and build networks

Working with other stakeholders, including EDI teams within organisations and across integrated care systems (ICS), is crucial for the success of the IPP initiative. Collaborative efforts help share best practices and address common challenges, as well as ensure a diversity of thought that enhances the effectiveness of EDI initiatives. Engaging with these teams can include identifying mutual goals, such as improving workforce diversity or addressing health inequalities, and aligning the IPP initiative with organisational EDI strategies.

Practical examples include:

• Reach out to your organisation’s EDI team to understand their priorities and explore how the IPP initiative can align with those priorities. For example, if the EDI team is working on increasing representation in leadership, pharmacy professionals could propose an IPP mentorship programme to support underrepresented groups;
• Volunteer to serve as an ‘IPP champion’ within your organisation. Champions can act as advocates, organising workshops or lunch-and-learn sessions to educate colleagues on the importance of the IPP initiative and its role in addressing health inequalities;
• Partner with other healthcare professions and EDI teams to launch campaigns that emphasise how the IPP initiative can improve patient outcomes and promote equitable care. For example, the Equality, Diversity and Human Rights Week is a longstanding annual national campaign that provides health and care organisations with a platform to showcase their work and commitment to building a fairer and more inclusive NHS. For an example of how an ICS engaged with the campaign see this webpage.

4. Use data and performance metrics to your advantage

Reviewing available data at both organisational and regional levels is important to identify focus areas for the IPP initiative. A data-driven approach ensures that efforts are targeted and effective. Analysing data helps highlight disparities and measure progress, enabling continuous improvement in EDI practices.

Data from the national PWRES and staff survey have been made available to regions across England to inform local decisions with dashboards created to help teams from different regions and ICSs to use the data effectively. Links to these dashboards are available at the end of the article.

Pharmacy organisations and teams should also develop and track their own performance metrics related to EDI that are responsive to the local context. These metrics can help measure progress, identify areas for improvement and ensure accountability in achieving EDI goals. Examples could include monitoring the representation of women, ethnic minorities or disabled individuals in senior management, analysing gender and ethnic pay gaps, assessing the diversity of applicants and hires during recruitment and reviewing NHS staff survey data to identify disparities in staff experience and career progression.

5. Dedicated champions can drive change on the ground

Local experience from a range of organisations has demonstrated the power of having IPP/ EDI champions in place to help make the workplace more inclusive for individuals. Champions advocate for change, support colleagues in adopting new approaches and help sustain momentum for EDI initiatives by playing a vital role in embedding EDI principles into the organisational culture. Dedicated champions also provide an outlet for staff to have conversations about EDI that they may not necessarily feel comfortable raising with their line manager.

6. Use steering groups to provide strategic oversight

For a system-wide approach to be successful and accountable, the use of a steering group to maintain momentum of the IPP agenda is important. Stakeholders for steering groups should be drawn from a wide range of sectors. Steering groups can help to form a consensus on which components of the strategy and programmes of work are to be delivered regionally and will be the responsibility of individual organisations. Regular meetings and active engagement with steering group members helps to sustain focus and drive progress.

7. Provide access to training and development

Investment in continuous training and development programmes that focuses on EDI principles is essential. It is mandated that all employers have EDI training for staff, but it is recognised that individual employers will have their own specific requirements and expectations^​10​. Education helps to build cultural competence and sensitivity among pharmacy professionals, ensuring they are equipped to meet the needs of diverse patient populations effectively. 

All pharmacy professionals should have equal access to development opportunities and career progression. The NHS ‘Talent management resource tool’ was produced as part of the IPP initiative to improve diversity in senior pharmacy leadership roles by making career development opportunities more accessible^​11​. The resource tool outlines various leadership frameworks, fellowships, programmes, coaching opportunities and mentoring schemes, targeting both pharmacists and pharmacy technicians. These resources are designed to develop leadership skills and provide opportunities for training and development, which supports individuals looking to advance into new roles within the NHS.

Encouraging and supporting staff to explore these opportunities is critical to ensuring they benefit from the resources available. Organisations should actively promote these schemes, provide clear guidance on the application process and ensure that staff feel empowered to participate. Mentoring is particularly important during the application process, as it can help build confidence and provide tailored advice — especially for those from underrepresented backgrounds who may not see themselves reflected in current leadership roles.

Protected time for training across all sectors of pharmacy is essential to enable staff to participate fully in these programmes. This highlights the importance of including development time in job plans, which ensures that all staff have equitable access to career advancement opportunities. Furthermore, embedding DEI principles into routine continuing professional development (CPD) and training ensures that all pharmacy professionals are equipped to contribute to an inclusive workplace.

8. Promote mentorship and develop support networks

Mentorship programmes are essential for fostering inclusivity and supporting personal and professional development in the pharmacy profession. In particular, reverse mentoring bridges the gap between senior leaders and individuals from underrepresented groups by pairing leaders with mentees who share their lived experiences and perspectives. This approach helps senior leaders gain valuable insight into the barriers faced by colleagues from diverse backgrounds, enabling them to implement meaningful organisational changes.

For mentees, reverse mentoring provides exposure to senior leadership, boosting confidence, enhancing visibility and offering opportunities to influence decision-making. Mentorship programmes, such as those supported by the RPS, provide flexible and goal-oriented structures, enabling participants to build connections and achieve their professional goals through tailored support.

9. Review policy and workplace practice

Regularly reviewing and updating organisational policies and practices is essential to ensure that they promote inclusivity and do not inadvertently create barriers for certain groups. A proactive approach helps to identify and address systemic issues that may negatively affect EDI. For example, while NHS organisations are encouraged to provide EDI training for staff involved in recruitment and selection, it is not universally mandated as part of national policy. The ‘We are the NHS: people plan for 2020/2021’ emphasises the importance of EDI in recruitment processes, but there is no explicit, compulsory requirement for EDI training for interview panels or for EDI questions to be routinely included in interviews^​12​. Many organisations do recognise the value of EDI training, as part of their commitment to fair and inclusive practices. In that regard, EDI training is often included in local policies or trust-specific training programmes.

The national PWRES and staff survey data highlighted a gap where pharmacy colleagues reported not consistently receiving compulsory EDI training for interviews, nor did they always see EDI-related questions included in the interview process. Proactively reviewing and addressing this issue at the local level can help ensure that EDI considerations are fully integrated into the recruitment process, in line with broader organisational commitments to inclusivity.

Moreover, awareness of EDI training requirements may be limited among pharmacy professionals. Many colleagues might not be fully aware of the expectations surrounding mandatory EDI training or how it can become a component of CPD. By clearly articulating expectations, organisations can ensure that pharmacy professionals are equipped with the knowledge and skills necessary to contribute to a more inclusive workplace.