Lloydspharmacy superintendent: More pharmacists needed to stop partial pharmacy closures
A dearth of trained pharmacists, an expanding role in healthcare and rules around self-isolation are causing an epidemic of temporary pharmacy closures, says Victoria Steele
Community pharmacy faces many challenges in England. Our record of success as a sector during the COVID-19 pandemic is now a given: we kept pharmacy doors open while most high street retailers were shut, we maintained the supply of medicines to patients, and we delivered millions of hours of healthcare advice – lots of it for free.
Yet still, community pharmacy fails to achieve the parity of esteem we seek within the healthcare system, from fair and sustainable funding to equivalence with other primary care providers in the business rates system, to investment in our profession.
Now, one of the newest and most acute challenges facing our sector across the whole of the UK is the availability of skilled pharmacists, who are at the core of our community pharmacies. This shortage is the driving factor behind the rising number of partial closures the sector is currently experiencing, which in turn is driving a sometimes aggressive and toxic culture of debate in parts of our sector – particularly online – about the current situation.
As LloydsPharmacy’s superintendent, my chief responsibility is to make sure our patients have safe and appropriate access to their medicines, and I take that seriously. I believe that everyone in the sector has this same focus on patients, and so I believe that the abuse levelled at me and others from colleagues in the sector is extremely disappointing and does a disservice to our profession.
In reality, there are multiple reasons why we are facing a shortage of pharmacists in England, some of which are long-standing, such as seasonality, and some of which are new – but many are driven by national policy decisions.
Firstly, a shortage of pharmacists is a sector-wide problem. In March this year, pharmacists were added to the Home Office’s shortage occupation list. This proved what the sector knew already – that there are simply not enough pharmacy professionals in the UK to serve patient needs. We therefore need to do our best to recruit bright and compassionate people into pharmacy.
Secondly, we are in some ways a victim of our own success – as pharmacists are becoming more integral to the health system, including as clinical pharmacists in primary care networks and primary care settings, or as vaccinators in the COVID-19 response, there are more roles available – all while fewer people are choosing it as a career option.
Thirdly, an acute problem we are facing is the need for pharmacists to self-isolate when “pinged” by NHS Test & Trace. While the opt-out for some healthcare workers is welcome, in reality many of our colleagues do not meet the very strict criteria, and so we are dealing with very high levels of absence.
All these challenges mean that LloydsPharmacy, and others in the sector, are currently facing a challenging time in opening up all of our pharmacies, all of the time. Let me be clear: closing a pharmacy, for whatever period of time, is a last resort for us. We have a fantastic rota team who do their utmost to secure pharmacists – whether it be in-house pharmacists or locums – to make sure we continue to provide healthcare services in the communities we serve.
Where we fail to secure a pharmacist, we have made a strategic decision to adopt a part-closure policy. This means that instead of one pharmacy being closed for a full day, we will ask a pharmacist to open one pharmacy in the morning, and another in the afternoon. I was visiting some of our pharmacy teams in North Wales recently, where I saw this in action, and I felt reassured that this was the right thing to do. The team rang all the patients that needed their pick-ups that day, to make sure they understood when their medicines would be available.
As you can imagine, it is not my preference, but this has the benefit of ensuring that two communities have access to their medicines and healthcare services. It does, though, have the disadvantage of our part-closure reporting being higher. I make no apology for making decisions based on the impact on patients, rather than on making sure our numbers look better.
Closures are a challenge we at LloydsPharmacy are tackling head on, with a multi-pronged approach. We have reviewed our recruitment, retention and relocation policies to make them more attractive. We have adjusted our locum rates in our hard-to-fill areas and reviewed our rates for our regular locums. We have incentivised our overtime rates, to make it worthwhile for colleagues to cover extra shifts over and above their contracted hours.
We are reviewing our opening hours to ensure that our pharmacies are open when our patients need us most. Longer-term, we are also investing in career pathways for our pharmacist colleagues, to make sure community pharmacy remains an attractive career option into the future.
While LloydsPharmacy continues to address this ongoing issue in the ways that we can, as a sector we need to start acting smarter. If the full potential of community pharmacy is to be realised, we need to stop pointing fingers and picking faults with one another and start working together to secure our future – something that is now not only dependent on a sustainable funding model, but also on having enough pharmacists to provide vital medicines and healthcare services to the communities we serve.
The road continues to be a bumpy one, and despite the challenges we are facing I am excited for the future of LloydsPharmacy, and community pharmacy in general. We are, and always have been, a resilient profession and I am confident that together we will negotiate the bumps ahead of us.
Victoria Steele is superintendent pharmacist for LloydsPharmacy