The journalistic trope ‘If it bleeds it leads’ sprang to my mind when watching the BBC’s Inside Out documentary on pharmacists under pressure. The half-hour programme, which aired last night (January 8), pledged to investigate patient safety and staffing levels in pharmacies – namely, Boots – but the immediate focus appeared to be on the fatal harm caused by rare, but regrettable, dispensing errors.
While rightly highlighting three incredibly tragic cases where patients had died as a result of medication errors by Boots pharmacists, the documentary also made clear these specific cases were not due to a lack of staff working in the pharmacies at the time. So how would the programme link staffing levels and patient deaths?
The short answer is that it didn’t. But it did raise some important issues facing the sector – and not just those specific to Boots.
However, if I were an average viewer with no knowledge of what goes on on the other side of the counter, I would have been alarmed. The picture it painted of community pharmacy suggested a fatal dispensing error is more commonplace than in reality. This made me question the aim of the documentary makers – was it to highlight the daily, industry-wide pressures faced by pharmacists to a wider audience, or was it to comment on tragic individual cases, and specifically to criticise Boots?
The story of a whistleblower, former Boots clinical governance pharmacist and professional standards manager Greg Lawton, was woven in with the patient case studies. It was explained that Mr Lawton felt staffing levels in the health and beauty giant's stores were too low to be safe.
Mr Lawton later described how he was “terrified” that a patient might be harmed or even die due to inadequate staffing levels. His interview was emotional and heartfelt – he felt discouraged from whistleblowing by Boots, yet was compelled to meet the General Pharmaceutical Council (GPhC) in 2015 to discuss his concerns.
The testimonies from anonymous Boots pharmacists were unfortunately marred by the use of white, male, middle-aged actors wearing white coats, playing up to a stereotype that anyone who has set foot in a pharmacy knows is no longer true. But the description of how they feel stretched to breaking point to keep patients safe will resonate with many. Also, the need for the actors highlighted the stigma around whistleblowing at the multiple.
Boots' director of pharmacy, Richard Bradley, was given ample opportunity to respond to the allegations. Mr Bradley emphasised repeatedly that Boots has enough staff in its pharmacies, and all staff have a professional responsibility to speak out about any patient safety concerns. But his suggestion that Mr Lawton’s staffing concerns are not relevant today – as he left the company two years ago – came across as unconvincing.
It was disappointing that the government’s brutal pharmacy funding cuts in England were not mentioned until halfway through the programme, and that the legislation which will decriminalise inadvertent dispensing errors was only given an offhand mention. The documentary failed to explore whether funding cuts will further exacerbate staffing issues.
The fear expressed by some pharmacists on social media – that the public will lose faith in pharmacy after watching this documentary – is legitimate. Millions of patients rely on their community pharmacist to safely dispense essential medication, and in the overwhelming majority of cases, this is done safely. The programme may not have been able to provide any concrete answers to the staffing level problem – it ended rather abruptly – but it has brought the issue of the pressures pharmacists and staff are under to a wider audience, many of whom would otherwise have little idea what goes on behind the counter.
Boots: Pharmacists under pressure? aired at 7.30pm on January 8 on BBC One. Catch up on iPlayer