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Report: Collaborative system-wide approach needed for pharmacist and pharmacy team well-being

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The Royal Pharmaceutical Society and Pharmacist Support charity have stressed the critical need to protect pharmacy teams from burnout, ensuring uninterrupted patient safety

In a new report titled ‘Pharmacy Workforce Wellbeing’, the duo highlighted the demand for strategic solutions due to increasing workload and stagnant capacity in community pharmacies, while suggesting that optimising skill mix and adopting advanced technologies offer avenues for capacity improvement.

Published on Oct. 4, this report resulted from a roundtable event in May 2023 with representatives from the NHS, professional bodies, employers, trade unions, education, and regulators.

According to the report, the duty of ensuring the well-being of pharmacists and pharmacy teams cannot be assigned to a single entity. It demands a comprehensive, system-wide approach involving the NHS, professional organisations, employers, trade unions, educational institutions, charities, regulators, and individual members of pharmacy teams.

“The entire pharmacy workforce, spanning all settings, has endured significant and sustained pressure, impacting individuals,” said James Davies, RPS Director of England. “Many risk factors affecting wellbeing are created by the system in which people work and this needs to be addressed at the systemic level rather than the onus being placed on individuals.”

Workload-induced burnout

During the roundtable discussion, the participants emphasised the prevailing pressure in community pharmacy, impacting the wellbeing of pharmacists. The subsequent report highlighted various risk factors affecting staff well-being, including extended working hours leading to 41 per cent of errors, less experienced staff, high prescription volumes, substantial workloads, imbalanced work-life ratios, excessive administrative tasks, insufficient teaching time, additional professional duties, a dearth of burnout support, and insufficient recognition for their contributions.

The report observed that pharmacists and their teams have grappled with a mounting workload both during and post-pandemic. The Community Pharmacy Contractual Framework has heightened demands on the pharmacy workforce, with minimal added support from the NHS. Since 2019, six new clinical services have been nationally commissioned, further normalising strain on mental health and wellbeing, the report noted.

In 2022-23, pharmacies in England dispensed over 1.075 billion prescription items, a significant uptick of 60 million (6 per cent) from 2017-18. Simultaneously, interactions between pharmacists and patients through nationally commissioned clinical services surged by 80 per cent, surpassing 10 million.

A yearly 6 per cent increase in dispensed prescriptions has resulted in an augmented workload without commensurate funding. “Additionally, over the last six months, 44 per cent of respondents experienced physical or verbal abuse, primarily from the public, contributing significantly to pharmacist burnout,” the report revealed.

The study also highlighted that assigning excessive non-clinical or administrative duties to pharmacy staff imposes an additional mental burden. It further noted that some employers lack resources for managing burnout, and while support is available, accessibility at a convenient time remains a challenge, compounding risk factors.

Furthermore, it criticised the government’s failure to adequately plan and support the pharmacy workforce in coping with escalating workloads and high vacancy rates. It emphasised that addressing pay concerns is crucial in alleviating workforce pressure, an issue that has yet to receive sufficient attention.

“When we launched the charity’s new strategy in 2020, we recognised that for significant change to take place we needed a sector actively working together to improve the well-being of our pharmacy family,” said Danielle Hunt, Chief Executive of Pharmacist Support. “We were delighted therefore to be able to chair a roundtable on workforce wellbeing and to help move this conversation along. It has been evident for some time that a culture change is required, and the roundtable provided pharmacy organisations with the opportunity to come together to provide their individual views and then for the group to start to collectively address workforce well-being within pharmacy.”

Practical and longer-term solutions

Representatives from various bodies, including the NPA, Community Pharmacy England, Association of Pharmacy Technicians UK, British Pharmaceutical Students’ Association, Company Chemists’ Association, General Pharmaceutical Council, Pharmacists’ Defence Association, Guild of Healthcare Pharmacists, Pharmacy Schools’ Council, Care Quality Commission, and NHS England, offered further insights and recommendations during the roundtable discussion. They actively contributed to the conversation on potential long-term solutions for addressing wellbeing challenges within the pharmacy sector.

“While individuals are encouraged to prioritize their well-being and minimise personal burnout risks, it’s crucial to acknowledge that many wellbeing factors must be addressed,” emphasised Davies of RPS. “This necessitates a collective effort from employers, regulators, the NHS, unions, charities, and pharmacy teams. We all have a role in supporting pharmacists’ well-being and minimising potential risks to patient safety.”

The report stressed the importance of commissioners proactively enhancing employer support and integrating well-being considerations, suggesting that this could lead to transformative changes, especially by leveraging technology. The NHS workforce, along with those serving the NHS, require support in terms of allocated time for professional development, supervision, and ongoing learning to ensure the safe and effective delivery of services to patients, the report noted.

Additionally, the report underlined the necessity for further research to understand the intricacies of the current pharmacy team workload and to devise strategies for mitigating systemic stressors. This entails examining the workload implications of medication shortages and addressing system challenges in prescription distribution to reduce administrative burdens.

The report recommended fostering inter-professional learning to cultivate an understanding of the challenges pharmacists face. It advocated providing pharmacy students with opportunities to refine their management and leadership skills. Furthermore, the report emphasised the need for increased research efforts to comprehensively grasp the impact of “system stressors” like medication shortages and prescription volumes on workload.

Continued dialogue and integration are crucial to comprehend the discussions within Integrated Care Boards (ICBs) regarding well-being across all practice domains, the report stated. It is imperative to assess the extent to which these discussions have been incorporated into ICB workforce plans.

The report pointed out that students and learners from specific backgrounds experience an attainment gap, necessitating further research, understanding, and targeted solutions. Additionally, it recognised that discrimination can impose negative effects on wellbeing.

The report advocated for public-facing campaigns and partnerships with patient groups to raise awareness of the abuse faced by pharmacists and their teams. It emphasised that the public’s evaluation should focus on the safety and effectiveness of medication preparation rather than solely on the speed of service.

“We understand that the necessary change won’t happen overnight, but we also acknowledge that levels of burnout have been consistently high for several years,” added Hunt. “Urgent action is needed to reverse this trend. We hope that through this group, we can start to instigate positive change and ensure our workforce is better prepared to support the wellbeing of its colleagues.”

On Oct. 3, Health and Social Care Secretary Steve Barclay introduced a £30 million fund to advance the integration of state-of-the-art medical technology in the NHS. Barclay emphasised the government’s dedication to providing clinicians with cutting-edge technology, highlighting the importance of virtual wards in equipping healthcare professionals with innovative tools for enhanced patient care. This initiative aims to optimise staff efficiency, deliver top-quality care, and tackle priorities like reducing waiting lists.

Meanwhile, the roundtable participants have committed to reconvene in six months to review the progress achieved.

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