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Medication safety officers to spot workplace pressure 'warning signs'

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Group chair Janice Perkins: It’s really tough in community pharmacy at the moment

The Community Pharmacy Patient Safety Group will train all its medication safety officer (MSO) members to spot the “warning signs of pressure“ in pharmacy staff.

The group (see more details below) – which consists of representatives of all of the larger pharmacy chains, as well as the National Pharmacy Association (NPA) – has enlisted the help of training provider Mental Health First Aid (MHFA).

The training will provide MSOs with the “skills to help support healthcare professionals within our businesses”, the group’s chair Janice Perkins told C+D last week at the Clinical Pharmacy Congress (April 27).

Training for the group’s members will begin in early June, before the group will begin “[looking] at cascading that training down within our organisations”, Ms Perkins, who is also superintendent pharmacist at Well, added.

“It’s about being alert to warning signs of pressure and then working with people to help manage what might be a contributing factor,” Ms Perkins said.

The MSOs will take part in a full day, face-to-face course, which will include training in the ability to “spot signs of mental ill-health” and skills to “support positive wellbeing”. Members will then qualify as “MHFA champions”, the provider’s website states.

“Really tough in community pharmacy”

“There will always be some tension points and some pressures within the working environment and within the pharmacy,” Ms Perkins said. “But there are techniques to help control that [and to] know [what’s] a red flag…and how to raise a concern.”

While Ms Perkins admitted “it’s not always your employer you want to go to”, she said the group will make sure there are “systems in place” so “people know where to go to for help”.

“It’s really tough in community pharmacy,” Ms Perkins stressed.  “It’s really tough in all healthcare professions at the moment.” 

The group has also been working with the charity Pharmacist Support, to “make sure that everyone’s being open and transparent [and] knows who to contact in their organisation”, she added.

Group’s priorities for 2018

The training builds on one of the 11 priorities for 2018 which the group set out in November last year.

These include the aim to “arrange mental health training for medication safety officers to empower them to champion mental health and wellbeing within their organisations”.

Explained: The Community Pharmacy Patient Safety Group

When was it created?

Facilitated by the now-defunct Pharmacy Voice, the self-funded group was established in February 2015 by the medication safety officers at the larger community pharmacy chains, as well as the NPA.

What is its aim?

“To regularly meet and openly share and learn from each other – as well as from other safety-conscious industries – [and] consider how learning would be applied across the pharmacy network, then work together to create the opportunities to do so.”

You can read more about the group's sector-wide work plan here.

Who are its members?

The group is chaired by Well superintendent Janice Perkins, and comprises representatives of the following organisations:

  • Well
  • Asda
  • Boots UK
  • Cohens Chemist
  • Day Lewis
  • Dudley Taylor Pharmacies
  • Kamsons Pharmacy
  • Lincolnshire Co-operative
  • Lloydspharmacy
  • Morrisons
  • The National Pharmacy Association
  • NHS Improvement
  • Numark
  • Rowlands Pharmacy
  • Paydens 
  • PCT Healthcare 
  • Superdrug
  • Tesco
  • Weldricks Pharmacy
  • WR Evans 

Where can I find out more?

Full details are available on the group’s website here.

24 Comments
Question: 
Would you benefit from having a mental health first aid champion in your pharmacy?

Lucky Ex-Locum, Superintendent Pharmacist

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Lucky Ex-Locum, Superintendent Pharmacist

Given that they are made up of management level individuals from the multiples, what I think they're for is to say 'Nothing to do with us , guv' and pass the blame for anything untoward back onto pharmacists. Thats how it usually works.

Reeyah H, Community pharmacist

I’ve done the course and it wasn’t that great to be honest. What we need is better pay, so we can hire more staff. Not some course instead. Believe me, plenty of pharmacy staff are stressed atm!!

Lucky Ex-Locum, Superintendent Pharmacist

We believe you!

Brian AUSTEN, Administration & Support

All good employers should include details in their contract and handbook of how they should report workplace stress. They should have access to support and advice from an independent source if necessary. Due care!

Jonny Johal, Pharmacy Area manager/ Operations Manager

Workplace stress may not be a management issue, it can be a personality issue. I support psychometric all entrants to the profession to filter out those who can’t take pressures or those who are proned to excessive errors. 

Meera Sharma, Primary care pharmacist

Slightly sceptical of this - same proble as the BPA. You can't be impartial to the results if you are also the organisation being represented on this group. If you really want value in this, it needs to be an independent group - not one affiliated with any one organisation.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Their time would be better spent to study why some pharmacists make more mistakes than others and offer appropriate career advice to those who are not suited to the job. This is a good opportunity to identify those pharmacists who can't take pressure.

There should also be studies to find out if mental health issues affect a pharmacist's error rate and make appropriate policy recommendations.

Lucky Ex-Locum, Superintendent Pharmacist

A pharmacist should not HAVE to take pressure. Would you expect your GP to work under intolerable pressure? Would you yourself do that?? 

Jonny Johal, Pharmacy Area manager/ Operations Manager

As common with life, taking and coping with pressures of all sorts is part of the job, unless you are one of those always looking for a job with no pressures? I think it is the inability to cope with pressures the heart of the subject, and the real debate is what are we going to do about those pharmacists who are at the bottom of the scale, eg I have come across pharmacists who think anything more than 15 items per hour is stressful, and I know people who can double that number and not bat an eyelid. 

Lucky Ex-Locum, Superintendent Pharmacist

Agreed, BUT when the pressures are caused by external factors such as targets, area managers etc, then the problem lies with them, not with the pharmacists. I worked out recently that my working pattern allows me 57 seconds per item and in that time I have to do all of my administrative work as well. I can cope with it because I don't have area management on my back setting unreasonable targets and heaping steamy piles of excrement on me from a great height.

Your world outlook strikes me as very narrow 

A N, Community pharmacist

We would benefit from more and better paid workforce not a mental health firstaid champion. 

Chris Pharmacist, Community pharmacist

Highly commendable I'm sure. I do note however, that the group consists of  medication safety officers/superintendents from all of the major UK pharmacy chains.

Given that the biggest contributor to workplace pressures, anxiety, stress and also arguably patient safety is understaffing and excessive workloads I'm far from convinces that this 'Patient Safety Group' will delve too deeply into the root causes and really improve patient safety and workplace stress.

Take Well for example, who have pretty much imposed a policy of no paid overtime across its stores (certainly local to me anyway). I'd be interested to see how that sits with reducing stress and improving patient safety.

Leon The Apothecary, Student

Mental Health is a very important issue in all workplaces, including pharmacy. Having support can only be seen as a good thing in my opinion to look after the well-being of employees.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Mental health, in my view, is a touchy subject ... would you go to a pharmacy which you know the pharmacist has mental health issues? Do you think patients should be made aware? (Personally, I am aware of and have worked with pharmacists who took their own lives.)

Lucky Ex-Locum, Superintendent Pharmacist

Mental health issues occur in all walks of life and all professions. It is part of the human condition and no, I don't think patients should be made aware. A pharmacist with mental health issues is entitled to confidentiality just the same as anyone else and 'outing' them would only make a situation far worse. 

Jonny Johal, Pharmacy Area manager/ Operations Manager

Lucky, at what point would you say public interest outweighs personal confidentiality? When you said “far worse”, for whom, the public or the mentally ill pharmacist? For argument’s sake, if your GP is a paranoid schizophrenic with homicidal tendencies, do you think you have a right to know?

Lucky Ex-Locum, Superintendent Pharmacist

There is a slight difference between a depressed over-pressured pharmacist and a homicidal maniac. If someone is already depressed then removing their livelihood is hardly going to help the situation for anyone is it? Why are you so down on your fellow pharmacists? Are you so perfect that nothing EVER goes wrong in the sunny life of Jonny Johal? I suspect that your bitterness has other causes. It's management attitudes like yours that tip vulnerable people over the edge and cause suicides.

Jonny Johal, Pharmacy Area manager/ Operations Manager

So, where does the right to confidentiality ends ... what if there is an association between slightly depressed pharmacists and error rates? You forgot, management serves a very specific purpose, there are also stress asscociated with that job, targets which we have to meet, there were days that I am so busy that I struggle to return phone calls, I have never whinged about that and ask for de-stressing or ask for tough targets to be watered down! Indeed, life, and every job has stress, it is how people deal with stress that is at issue here. One's ability to cope with stress is an innate thing, not influenced by external factors. That is why I advocate using psychometrics to filter out the unsuitable personality types at all levels in all recruitment processes, which should begin at the universities.

Regarding my attitude towards some pharmacists, I have been traumatised more and more, especially in recent years, by working with 'pharmacists' whom I think are in the wrong job; those who don't care about making mistakes, only about covering them up, those who take an hour to dispense 100 Paracetamols, those who turn up for work late and think they should be paid the full amount, those who always leave jobs for the next pharmacists to complete, those who find every excuse not to dispense (always looking for something wrong on the Rx and won't ring doctors), those who are always looking for excuses to refuse OTC sales (the sales prevention pharmacists who are forever exercising their 'professional judgement' at every opportunity) ... etc etc etc ... I am qualified since 1979, still seeing new tricks.

Lucky Ex-Locum, Superintendent Pharmacist

Once again (strangely) I agree with you. I've seen plenty of rubbish pharmacists in my time just as I've seen plenty of other people in random jobs who shouldn't be in the job they are in. However, where I strongly disagree with you is the right to confidentiality. This is a right for EVERYONE not just the general public. How far do you take it? Does the pharmacist have to declare exactly how many hours sleep they had the night before? Tiredness is probably the biggest cause of errors. How about if they have had a family bereavement? Should that go on the noticeboard as well? Or should it just be that the pharmacist has mental health issues caused by workplace pressure? Do you, for example, declare your 'trauma' at working with an inept pharmacist because that certainly makes you more likely to make a mistake (oh, I forgot - you don't make mistakes do you?). I cannot ever agree with you on this issue.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Confidentiality in my view is only sensible when it is inconsequential to others. It should not be a license to make mistakes and do harm to ones patients. The GPhC does have data on this - look at the large numbers of ‘hearings in private’ the disciplinary committee do. I say it is about time they say how many pharmacists have appeared before them with mental health issues that have resulted in patient harm. 

Lucky Ex-Locum, Superintendent Pharmacist

Would you advocate the same level of dislosure for everyone? Where do you draw the line? If I was to have knowledge that a patient was in fact a potential danger to the public, should I make this public? Of course not because there is such a thing as patient confidentiality in this country. A pharmacist with mental health issues brought on by idiot area managers is just as much a patient as anyone else. if a doctor was to dislose a patients medical condition, regardless of the job they do, they would be in serious doo-doo, just as we would if we blabbed about confidential information we held on a patient. Why do you treat pharmacists as though they are non-humans? (oh, sorry - I forgot - the job title is the giveaway. Pharmacists are just cash generating machines to you aren't they?)

The reason the GPhC holds hearings in private is out of respect for a pharmacists right to privacy. What good would it do to trumpet a person's illness (and remember that that is what it is) from the rooftops and just send an already depressed and sick individual into a further downward spiral? 

Jonny Johal, Pharmacy Area manager/ Operations Manager

I just wonder what do you think these 'medication safety officers' are for; are they here to protect the public or to let the mentally ill-equipped and the stressed by everything pharmacists to practice? I am also surprised by the GPhC about these hearings held in private, I thought the GPhC is here to protect the public ... umm ... I am probably wrong on this assumption!

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