“We’ve got so many staff who are leaving. They just don’t want the late nights, the on-calls, the weekend working, the stress, the relentlessness of it all — it’s too many patients and not enough staff. It’s the same for everyone.”
These are the words of a specialist pharmacist working in the NHS in 2023 and it is one of many similar conversations that we have had in recent months with pharmacy professionals in all sectors. After the stress and long hours of working through the COVID-19 pandemic, there is a strong sense that the recovery is looking even worse.
This is reflected in the Royal Pharmaceutical Society’s (RPS) 2022 workforce wellbeing survey, results of which — published on 12 January 2023 — showed that three-quarters of pharmacy staff members had considered leaving their role or the profession over the past year. Across the profession, the top factors that pharmacy staff said caused them poor mental health and wellbeing included inadequate staffing (70%), lack of work/life balance (53%), lack of protected learning time (48%) and lack of colleague or senior support (47%).
This cocktail of factors is leading some to consider the ultimate step: going on strike. In response to a survey from the Pharmacists’ Defence Association (PDA), results of which were published in January 2023, 94% of pharmacists in Northern Ireland called for industrial action, on a member turnout of 80%, and will now be balloted by the association. In England and Wales, the PDA said that 84% and 70% of members voted in favour of strike action, respectively. However, the turnout of 32% in both countries did not meet the legal threshold required to carry out an industrial action ballot.
This level of dissatisfaction is not unique to pharmacy — a report published on 30 January 2023 by the Medical Defence Union revealed that four in ten doctors and dental professionals may quit the health service over the next five years. But the current pressures on many pharmacy professionals come just as the profession is at a crucial turning point, with important reforms to both graduate and postgraduate training.
As consultant pharmacists Paul Forsyth and Andrew Radley argued in an article published in The Pharmaceutical Journal in November 2022, there is a “window of opportunity” to build a happier pharmacy workforce, outlining a collaborative care model where, as they put it, “pharmacists and technicians rely on and trust each other; healthcare organisations rely on the work of regulators and professional bodies to assure competence; all professionals teach the next generation; healthcare organisations work across boundaries for the betterment of population health; and individual professionals are trusted to deliver their remit in accordance with their skills, values and professionalism”.
It is a compelling vision and many of the building blocks are in place, although action is needed now to allow the time and headroom for pharmacists to develop.
The recent review of UK professional pharmacy leadership may investigate some of these challenges, although much of the detail on how this body will function remains to be addressed. In the meantime, as the NHS strikes continue and morale deteriorates further, experienced staff will retire earlier, younger staff will leave or reduce their hours, and the workforce shortages will worsen — and this is not helping anyone.
Pharmacists have told The PJ that what they need is a sense that things will get better; that there is a long-term plan for the NHS that is sustainable and that they are supported on their own career path. Central to this is giving pharmacists the time to develop their skills. As the RPS has argued, a commitment by the health service and pharmacy employers to regular, paid protected learning time for pharmacists in all sectors, regardless of career stage, would be a huge step forward.
There has to be space made for clinical meetings and support through clinical supervision or mentorship, to learn new things and talk through problems. All pharmacy staff need time from their hectic day job to ensure that they can start to plan a better future for themselves, the profession and — most importantly — patients. Pharmacy also must be included in workforce planning, to ensure that pharmacy professionals are motivated, able to develop and work in the right environment to make the most of their talents.
The most important resource that the health service has is the people working in it and it must try harder to ensure it protects that. PJ