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Are contractors heading for burnout?

The latest C+D Salary Survey 
paints a bleak picture of contractors' working hours

It’s often said that if a job is worth doing, it’s worth doing well. But a desire to do a good job is often not enough on its own – especially in community pharmacy. When this is coupled with too little downtime and mounting pressure, it can quickly have a negative impact on how you feel and how well you are able to perform at work.

Pharmacy owners can often find themselves in just such a situation. The usual pressures of a life in a pharmacy – busy dispensaries, frustrated patients and a growing list of services – will be all too familiar. But if this weren’t enough, they must also contend with the added stress of the administrative tasks that go hand in hand with running any business, such as managing staff, paying bills and filing mountains of paperwork.

According to C+D’s Salary Survey 2016, 
this mixture of responsibilities has resulted in a worrying trend for pharmacy owners to work dangerously long hours, putting their wellbeing, business, relationships – and potentially even their patients’ health – in jeopardy.

The latest figures from the Office for National Statistics show that the average Briton working full-time clocks up 37 hours per week on the job. Contrast this with the 48 contractors who responded to the Salary Survey, which C+D conducted between October and December last year. Just 29% said they worked fewer than 40 hours per week – compared with 58% of employee pharmacists.

Nearly half (46%) of contractors said they worked at least 51 hours in an average week, while a further 30% said they worked between 46 and 50 hours. One individual said they had upped their number of hours from 50 to 70 in the past 12 months.

Unsurprisingly, this intensive work ethic is taking its toll. Indeed, the survey painted a bleak picture of life as a contractor. Some 80% said they suffered from stress, 54% said they had trouble sleeping and 26% said they felt their life was dominated by work. Most damningly for the sector, 81% said they would not recommend pharmacy as a career.

An unhealthy balance

Working long hours can have many downsides. Diane Leicester-Hallam, chief executive of Pharmacist Support, a charity that provides pastoral care and financial advice to pharmacists, says contractors who have to prioritise their work and are not able to 
make time for themselves, their family or personal interests, are putting their state of mind at risk.

She points to advice from the Mental Health Foundation, which says that a healthy work-life balance helps safeguard against the potentially detrimental effects of work-related stress.

Ms Leicester-Hallam is keen to point out that it is not just contractors who should take responsibility for a healthier split between work and downtime – this task falls to many other parts of the sector. “Everyone can play a role in helping to ensure a better balance,” she says, “including policymakers, trade unions, membership bodies, employers and employees”.

Mark Pitt, the director of defence services 
at the Pharmacists’ Defence Association (PDA), says concerns about stress and mental health are on the rise. While the PDA represents individual employee pharmacists, Mr Pitt says the complaints it receives ring true throughout community pharmacy.

“It’s not unusual for people to work through their lunch hour [and] after the pharmacy has closed, just to keep up with the demands,” he says. “Pharmacists are always juggling priorities: ‘What do I do next? Answer the phone? Check that prescription? Serve the six people on the counter?’ It’s a really difficult situation where they’re trying to meet the demands of their employer and provide a safe service without having a nervous breakdown.”

Share the load

Some pharmacy owners can share the pressures of the job by delegating some of the stress of running the business to others. Fiona McElrea, contractor at Whithorn Pharmacy in Dumfries and Galloway, western Scotland, runs 
the business alongside 
her husband.

He handles the administrative workload, while she focuses on her role as a pharmacist. Were she unable to offload the pressure of paperwork, she says, she would not be able to cope – and she fears for contractors who juggle both sides of the role.

“I totally empathise with people who are doing it themselves; it must be really difficult. It’s quite hard having a full-time business and a family to deal with as well, so how people do that plus all the extra admin… it must be a nightmare,” she says.

Ms McElrea recognises that those without the same level of support may find themselves unable to work to the best of their ability. “If you’re coming to work demoralised and exhausted, having been up a lot of the night doing paperwork, you’re not going to be able 
to concentrate or be as good a pharmacist,” 
she says.

10 ways to prevent burnout

Pharmacist Support chief executive Diane Leicester-Hallam offers some 
pointers to help pharmacists maintain their wellness in the workplace

  • Prioritise your tasks Leave the least important work until last and delegate wherever possible.
  • Take control Consider your options: make a list of the things you want to achieve, then make a plan to do them. This could be reassessing your terms and conditions, or even considering an alternative role – you may not have to stick with what you have.
  • Talk to someone Do not struggle on alone: if you have a problem, ignoring it will not make it go away.
  • Get support from friends and family. They can provide you with much-needed support.
  • Try to maintain a healthy diet Think about what you are eating and drinking, as this can affect how you feel.
  • Be active Exercise comes in many forms – 
you do not have to go to a gym. Join a running club, take up gardening, or go for a walk. Exercise will help you get a good night’s sleep.
  • Make time for yourself It is important to relax and socialise, particularly if you work long hours.
  • Volunteer Spare whatever time you can – you can give as little as an hour a week.
  • Challenge yourself Take on a new hobby, join a sports club, study a new language. Learning builds confidence and resilience.
  • Embrace mindfulness This 
practice of choosing and learning to control the focus of your attention may help you manage anxiety. Simple mindfulness exercises can be done for a 
few minutes at any time – even on 
your commute.
Fear of the future

However, many contractors, such as Nick Kaye, who owns a pharmacy in Newquay, Cornwall, are not able to employ a dedicated business manager. As a result, he finds himself bogged down in admin at the end of every month.

For Mr Kaye, the planned cuts to pharmacy funding in England and the upcoming falsified medicines directive are his “biggest workforce worries”. From early 2019, this European anti-counterfeiting legislation will see pharmacists scanning all medicines at the point of dispensing – potentially adding even more to a pharmacy’s workload.

“We do 22,000 prescription items a month on average. When you add [another] layer, managing the workload is going to be really, really challenging.”

He concedes that this is “probably not sustainable”, and is looking at ways to mitigate the impact of the extra tasks, such as “shifting around the way we work and working smarter”. But, he admits: “I’m kind of running out of ideas.”

Taking a load off

Many contractors might wish that the solutions to burnout were as simple as shifting work around or taking time off to recuperate from long hours in the dispensary. Mike Hewitson, who owns two pharmacies in Dorset, points out that many people think employers are the first to give themselves time off. But he stresses that, often, the opposite is true. “I always end up putting the needs of my staff ahead of my own, and I know loads of [owners of] independents do exactly the same,” he says.

Mr Kaye finds that his Cornwall setting gives him a good quality of life outside of work, although working such long hours presents obvious personal challenges. “My work-life balance is not right by any stretch of the imagination, but I’d like to think that when I’m not [working], I can let it go,” he says. “But it is hard, and it is tiring, and you feel like you miss out on the kids growing up.”

Making ends meet

There’s no getting away from the fact that a dwindling income may present another reason for owners to extend their hours. The Salary Survey found that 34% of contractors had seen their personal income fall in the previous year, and 43% said it had stayed the same.

Hassan Khan, who owns Cullimore Chemists in Edgware, north-west London, says he worked “silly hours” – sometimes up to 11 hours a day – seven days a week for nine months to meet loan repayments and avoid bankruptcy. Even now he still works six days a week, with the pressure of the job leaving him with “no social life”.

“I struggle when my pre-registration student goes on holiday – that shouldn’t be the case. A pre-reg should be an extra pair of hands, not having to do everything.”

Mr Khan says the relentless workload has forced him to seek a job outside of the profession. “I’ve just had enough of pharmacy altogether,” he explains.

Mr Hewitson says that long hours and “intense pressure” are part and parcel of the role. He works “a minimum of 50, maybe 54, hours a week” – but says the problems affecting pharmacy at present are not unique to the sector. Walking away may not necessarily bring about a better work-life balance, he adds.

“In any professional walk of life right now, there may be different dissatisfactions, but everyone has something they’re not happy about,” he says. “Doctors are annoyed about their working conditions, dentists are the same – lawyers and accountants, too.”

Working for change

While all healthcare professions are facing stress, ignoring it altogether could have dangerous consequences. The PDA’s Mark 
Pitt says he has heard of a pharmacist attempting suicide – an extreme situation, but one he calls a “significant and growing problem” for the sector. A similar sentiment was expressed by a pharmacist manager in the Salary Survey.

It’s all too clear that something must be done to challenge the culture of long working hours currently plaguing the sector. However, it’s been difficult for community pharmacy to determine what action would improve the situation.

Sandra Gidley is chair of the Royal Pharmaceutical Society’s (RPS) English pharmacy board and a locum pharmacist. 
She accepts that there is “still a lot to do” 
in terms of improving pharmacists’ working conditions.

“I know a number of pharmacists who have taken time off due to stress, because a pharmacy can be such a busy, pressurised environment,” 
she says.

Ms Gidley says the organisation is raising concerns about pharmacists’ working life with sector leaders.

But in the meantime, while contractors wait and hope for solutions, they can make their working day a little more bearable by remembering what they enjoy about their job. Mr Hewitson says the satisfaction he gets from helping patients means he would still recommend pharmacy 
to graduates, despite the many challenges 
it presents.

“Community pharmacy on the whole is a rewarding career,” he says. “Dealing with people, trying to help them and trying to use your skills and knowledge to make their lives and healthcare better [is] still a worthwhile thing to do.”

If contractors can keep the importance of their role at the forefront of their minds, hopefully they can bring themselves back from the brink of burnout.

Read editor James Waldron's comment this week: Are contractors buckling under the pressure?

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