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GP pharmacist push blamed for shortfall of 320 in community

Gerard Greene: Community pharmacy needs urgent investment to address the workforce crisis
Gerard Greene: Community pharmacy needs urgent investment to address the workforce crisis

The push to recruit more pharmacists to GP surgeries has resulted in a “catastrophic” shortfall of 320 community pharmacists in Northern Ireland, CPNI has claimed.

“Hundreds” of community pharmacists in Northern Ireland fear that the current workforce crisis in community pharmacy will lead to services becoming unsafe, a survey from Community Pharmacy Northern Ireland (CPNI) has revealed.

A total of 409 of the 532 community pharmacies in Northern Ireland responded to CPNI’s survey, which ran from May-June this year.

It revealed that an estimated 398 pharmacists left the sector in the past two years, resulting in a “deficit of 320 pharmacists to provide safe services to patients”.

General practice was the most common sector pharmacists leaving “the beleaguered community pharmacy network” joined, because of the “attractive salaries and benefits packages on offer”, the negotiator said.

“Main precipitating factor”

Northern Ireland's practice-based pharmacist scheme – which launched in 2015 and aims to recruit 294 pharmacists to GP surgeries by 2020-21 – is the “main precipitating factor for a catastrophic community pharmacy workforce crisis”, CPNI claimed.

However, the Northern Ireland Department of Health (DH) told C+D that the staffing issues are more likely due to a past “lack of transformation of the way [pharmacy] services are delivered” (see more of the DH’s response below).

CPNI chief executive Gerard Greene said he is “shocked” that the DH has allocated £2.19 million to continue the rollout of the practice-base pharmacist scheme in 2019-20.

“We have asked that it should be deferred until the community pharmacy workforce crisis is resolved,” he said.

Community pharmacy is facing “the most severe and critical period ever” and the DH must commit “proper funding and resources” to “stabilise the sector”, Mr Greene stressed.

DH: GP pharmacist scheme “a success”

The DH told C+D that it is “surprised and disappointed” by the comments from CPNI, “given that their representatives have been fully involved in the DH’s pharmacy workforce strategy”.

“The practice-based pharmacist scheme is a notable success in terms of the transformation and improvement of services,” it stressed.

CPNI’s recommendation of stopping the recruitment of any more practice-based pharmacists “curtails transformation” and “is not the answer to staffing issues” in community pharmacy, it added.

“It makes no sense to…halt or reverse service improvements in other areas,” the DH stressed.

Pharmacists’ expertise and skills are in “high demand in all sectors across Northern Ireland”, and the DH is “doing its best” to allocate limited funding in the best way possible, it added.

CPNI has previously warned that the “sustained funding reductions” could trigger a “snowball” of pharmacy closures, and cause pharmacies to withdraw some services.

What did CPNI’s survey reveal about the Northern Ireland workforce “crisis”?

  • 94% of respondents had difficulties sourcing locums
  • 93% raised locum fees and pharmacists’ salaries “in an attempt to compete”
  • 70% of contractors have been unable to fill advertised job roles
  • 47% of independents and small chains, and 31% of multiples had to reduce staff
  • 95% of pharmacy owners have increased their own working hours, with some reporting “regularly working up to 80-100 hours per week”
  • 90% of contractors are either “very” or “extremely” worried about their future workforce

Source: CPNI community pharmacy workforce survey, September 2019


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21 Comments
Question: 
Are you struggling to recruit staff to your pharmacy?

Tired Manager, Community pharmacist

Terrible pay and working conditions with no benefits Vs 6-weeks holiday plus bank holidays, NHS pension, flexible working/9-5 hours. Why would anyone not? I look forward to breaking free and joining the “other side” in a few weeks!

Ben Thiazide, Community pharmacist

I left Northern Ireland five years ago because the market was flooded with locums and the pay was pathetic, to get work I was sometimes being offered less than a dispensers wage. I had no choice but to seek opportunities elsewhere, and I applaud the young pharmacists in NI now doing the same. When I left the universities were churning out 100+ graduates a year, that should be more than enough to fill this deficit pretty quickly, but they'll only stay if the money and job satisfaction are there. If locum rates don't catch up with the mainland pharmacists will continue to leave, and the gp surgeries offering better use for their skills will snap up the best of the rest.

Jenny Etches, Community pharmacist

£25 an hour is still far too low for a professional. I’d get far more as a plumber. I used to get £20 an hour as a locum in the late 80’s. Do the maths re cost of living and inflation. 

Anon Anon, Community pharmacist

While I have some sympathy for honest contractors trying to make a living and have no doubt they work hard, I agree with other posts regarding poor payment that is not reflective of rates elsewhere.  More importantly I am growing tired of CPNI being the representatives of the sector.  They represent contractors NOT pharmacist employees who make up the bulk of the worksforce in the sector now.  Instead of continuous fruitless bargaining with government over dispensing fees (the role of the technician), CPNI should show some vision and work to secure payment for deliverable clinical services in the sector.  They should consider a model that places the pharmacist at the front talking to customers about their ailments not all of them holed up at the back doing ACPT work while the saturday staff help patients with multimorbidities navigate the medicines that are safe for their other minor ailments.  They should also show some vision around development opportunities for those in the sector who currently have limited scope for career progression.  Protecting more time  for pre-reg training (they are not an additional dispenser) and investing in development of the skills of early-career pharmacists to better support them as they enter community pharmacy may make the sector more attractive.  Previous and current approaches at negotiation focus on improving things only for yourselves as contractors and not the sector as a whole. 

I've just looked on Indeed....Pharmacist, Keenan Healthcare - Belfast.

£14.20 an hour. 

No wonder there's an issue. 

On the same site there is an ad for a swimming teacher - £16.89 an hour.

So if “Hundreds” of community pharmacists in Northern Ireland fear that the current workforce crisis in community pharmacy will lead to services becoming unsafe there's a very easy solution. Get real!

C A, Community pharmacist

Or perhaps it is because Northern Ireland pays peanuts? 

What is the going rate £16/hr? If they were paying the same rate as the rest of the UK I'm sure it would be less of a problem. Hell offer £25/hr and you'll probably find it sorts itself out (300 isn't that many pharmacists). Capitalism at it's finest. 

Ex-NI Pharmacist, Industrial pharmacist

I left Northern Ireland pharmacy 10 years ago because of the paltry locum rates and being unable to get a full time role after my pre-reg. That was despite working for one of the larger groups, having got a 1st at Uni and worked for them nearly every weekend for 4 years! I felt like i was used and dumped when no longer useful (or funded!). I got a few shifts at £100 per day - but with my wife and I wanting to start a family it wasn't anywhere near sustainable.

If I returned to Northern Ireland today I would be paid exactly the same as the day I first qualified - there is no seniority, progression or career pathway in community pharmacy. Contractors would employ the cheapest pharmacists they could and then wonder why there is such a high turnover when the workload and pressure is too much for the guys just out of Uni.

I can sympathise with Mr Johnston - many of us too know what it's like to work long hours 5-6 days per week with little family time and I would suggest that it is not the local independents at fault but as usual the 3 for 2, sell them fast and cheap, undercut everyone else sort of pharrmacies that drive down rates and devalue the profession for the rest of us.

I would suggest looking to the CPNI for this mess - pharmacy is a disappointing sham of a career and all they are still interested in is cheap labour and their bottom line while blaming everyone else for their shortcomings. Contractors can't be sure of their income and plan for staff or expansion if they don't have a proper contract in place. How long is it since the CPNI has done that I wonder??

If there was any sort of leadership there then they would negotiate a contract that rewards proper clinical care for patients instead of shifting boxes in understaffed dispensaries, pointless MURs as well as free blister packs and deliveries. What a fantastically rewarding business model - NOT!
Is it any wonder that pharmacists have left for Hospital, GP Practice, Medicine or even abroad when all they have to offer us is stress, breakdowns and £120 a day?? 

Chris Locum, Locum pharmacist

Thanks for sharing the reality of the situation. Unfortunately, too many potential students will register before learning this.

Killian Johnston, Superintendent Pharmacist

Whilst I can sympathise with the comments about taking advantage - this definitely did happen, but it was not the norm, and as a contractor I never reduced my rates for locums. I think the perception that contractors have an easy 9-6 is a load of rubbish. My working day is usually 9 to 7 in work home spend some amount of time with my kids and then start work again about 9.30-1am. This isn’t once a week, this is the norm every night. I would love sick pay, a decent pension, private healthcare, I don’t have them because the business can’t afford it. We should be a very profitable pharmacy with a good counter business and excellent script business, but we aren’t, we make do. I am lucky I have brilliant staff, but I also work in an area where the movement of pharmacists into gp practices happened first, and the effect was instantaneous. I disagree with the depts comments that it was totally a lack of transformation to services that drove pharmacists to gp practices for two main reasons. Firstly the money has not been in community pharmacy in Northern Ireland to properly employ staff to allow transformation and there are plenty of contractors who want transformation but are being blocked at many different levels. Secondly who wouldn’t want a 9-5 Monday to Friday job with all the benefits, community pharmacy can’t compete. So although this may be funny to you, and I am by no means asking you to cry me or anyone else a river, a bit of respect for those contractors out there who do their best for their patients, profession and young pharmacists would be nice, and remember that every kick you get out of laughing at it, it is someone’s life and keeps a roof over their family's heads. 

Dee dee, Community pharmacist

Killian, what do you pay locums for a day worked in your pharmacy? Considering it's an 11k item per month pharmacy? Anything more than £150 and you'd be one of the most generous contractors in NI. Not only is this rate derogatory, it's been the same average rate for over a decade now, and even less is offered by many of your fellow contractors. 

You say that you disagree with the DOH comments, but as a contractor of course you would! How about the laugh that the CPNI gave us by saying that thier main consideration is patient safety? How can anybody take that seriously? They exist for one reason only, to protect your bottom line. It seems that this entails exacerbating recruitment problems in order to sustain a pipeline of £14ph locums. It was so funny watching the DOH shoot that one clean out of the sky using uncharacteristically blunt and direct language. It seems that even the dogs in the street are fed up to the back teeth of the constant cry of poverty coming from contractors, who are all doing very, very well. Seen the goodwill prices of NI pharmacies recently? They aren't that high for no reason.

Spare us the 'poor me' talk. You own a very busy pharmacy, get pharmacists on the cheap, are totally exempt from any competiton opening up and do not have to compete with online pharmacies or 100 hour openings. You must be taking home anually well into the six figures, but have the nerve to compalin about pharmacists abandoning your poor pay rates and your extra work as a result. Get in the real world! As somebody else on here said, pay your pharmacists £25hr and your recruitment problems will disappear overnight. The ball is completely in your court. This is a problem completely manufactured by the greed of contractors and the disgrace of having two schools of pharmacy pump out 300 graduates per year for an area with half the population of greater Manchester. 

Killian Johnston, Superintendent Pharmacist

Dee I can understand your frustrations, and there have always been people in all walks of life that take advantage, its unfortunate and I have never disputed that. I did my fair share of locum work. You do appear to be calling me a liar though, and obviously have no concept of the profit margins or lack there of in pharmacy in Northern Ireland. Not that it is anyone's business but I wish I could pay myself six figures, I have never once put myself into the 40% tax bracket, either with salary or dividends, again you can call me a liar but you are entitled to you opinion. I own a busy pharmacy which I have slogged from the age of 25 doing six day weeks in work, all my own paperwork to keep costs down and for at least the first five years paid myself less than a pre reg. Maybe im just a poor business man, but I have constantly invested in my business, yes to secure it for the future, but also for my patients. There is not one pharmacist who has given more time doing community work and trying to improve the image of our profession than I have, or when I had the oppurtunity pushing for employees to have a voice. I agree totally that we dont have to compete with online pharmacies for the moment, which is a god send, but in the city I work in we have had three new openings in the past 7 years, and more power to them for doing so. I wish I could pay my pharmacist and myself much much more, because there is no doubt she and I are worth every penny of it, but I cant. I think if you look above I didnt complain, I said that I could understand completely why they would do it as the alternative is much more attractive. I like to think that it is a testament of how well we treat anyone that locums for us that they come back time and time again whenever asked, and no we dont pay much more than the £150. I firmly believe that as professionals we are worth much more, but my business couldnt sustain it, if you think that every single contractor is a liar then that is your perogative, but read some of the comments from contractors at the end of report, I find it hard to believe that anyone makes those kind of things up. Im not going to get into a dept cpni row, and I wont spare you the poor me talk, its the truth, you just dont have to listen to it. If I could go back, I probably wouldnt do it again, and although you point out prices of pharmacies, it isnt easy to let go of something you have put everything you have into, and have actually made connections with your patients. You may think that contractors dont care about their patients, but in my experince with independent contractors that is completely false. I wish you could walk a day in a contractors shoes with everything else that goes on behind the 9-6 in practice, its a living but it is not much of one, and it is hard hard work. If we were bringing home the kind of salaries you are misinformed that we are, it might actually be worth it. 

 

 

 

Benie I, Locum pharmacist

11k items per month and you pay less than £150. Crikey.

Killian Johnston, Superintendent Pharmacist

Bernie - no we don’t pay less than £150 never have even when others did and we were only doing 5k items- that’s not what I said in my comment above

A B, Community pharmacist

Doesn't sound like bricks and mortar pharmacies (especially single independents) are part of the NHS long term plan in NI, similar to the situation in England.

ABC DEF, Primary care pharmacist

More like community sector is too sxxx that's why it's unable to retain pharmacist workforce and all fled to another sector when there is a new way out. No surprise here. 

David Moore, Locum pharmacist

Not exactly rocket science to predict this.

How High?, Community pharmacist

Ahahahahahahahahahahahaha. I'm so sad. Not!!

Maybe somebody will be paid a decent wage then instead of the crap £17 per hour being offered by the multiples to newly qualified pharmacist who have just slogged through 5 years of university.

Maybe some owners of pharmacies will start to value the pharmacists they have and support them adequately in order to retain them.

Maybe others will look at their benefits packages and offer sick pay, holiday pay, a decent pension, some private healthcare insurance.

Just saying like..... Wake up owners it's nearly 2020 and it's not all about you anymore.....

Alexander The Great, Community pharmacist

Gosh, you have no idea. In an ideal world, staff wages (including pharmacists) would be really good. I reckon all staff paid above living wage, and pharmacists around £30 an hour. Unfortunately, we live in a world where staff get minimum wage (thats if you can afford any staff), and pharmacists get paid £15 an hour doing everyones job. Something will cave in, and the government is blind until its too late.

Dee dee, Community pharmacist

Cry me a river! For many years now the excess of pharmacists produced in NI has resulted in contractors paying absolutely ROCK BOTTOM rates. I had friends getting paid £80 for a full days work, which was absolutely shameful. This was the norm, as contractors, quite deliberately, took advantage of the over supply and paid very undignified and derogatory rates, all the while absolutely raking it in. One well known local chain of 50 pharmacies cut thier pharmacists salaries by 40% overnight. Those who objected were shown the door, as hundreds of unemployed pharmacists were queued up ready to take the scraps. With decreased registration of EU pharmacists, higher paying jobs in southern Ireland, and a shift in pharmacists to primary care, I hope these greedy contractors pay through the nose. It's well overdue. 

 

N O, Pharmaceutical Adviser

""“Hundreds” of community pharmacists in Northern Ireland""

Editor -- Did you mean Pharmacies??

Benie I, Locum pharmacist

Pharmacists to be offered training to become doctors, NHS England chief executive says...

https://www.pharmaceutical-journal.com/20207031.article?utm_campaign=2483_PJ_weekly_roundup&utm_medium=email&utm_source=Pharmaceutical%20Journal&firstPass=false

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