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‘The GPhC risks tarring all locums with the same profiteering brush’

“Negotiating locum rates is an important element of a free market economy”

The General Pharmaceutical Council (GPhC)’s comments about a minority of locum pharmacists “profiteering” from COVID-19 are not what is needed from the regulator, says Mitesh Patel

Last month, General Pharmaceutical Council (GPhC) chief executive Duncan Rudkin warned against “profiteering in difficult times”. He quite rightly called out the behaviour of a minority of pharmacies taking advantage during this COVID-19 pandemic through price hikes of products in short supply. What wasn’t appreciated were his comments about locums, accusing some of “profiteering to take selfish advantage” of the COVID-19 outbreak.

Pharmacists all over the country are working tirelessly on the frontline, sometimes without personal protective equipment – putting themselves at risk of contracting COVID-19. Pharmacy teams have also faced an increase in abusive and aggressive behaviour by patients since the outbreak.

Quite frankly, I was disheartened that the GPhC picked such an ill-timed moment to comment on locum rates. The council would be well-served to remember that they are not the Competition and Markets Authority (CMA).

The ability to negotiate locum rates is an important element of a free market economy operating under a supply and demand model. It is also a key factor used by HM Revenue and Customs when determining the self-employed status of locum pharmacists.

I fear that by having made such an erroneous statement, the GPhC is in danger of tarring all locum pharmacists with the same brush, thus bringing the profession into disrepute. That is not what my peers want from a regulator.

The GPhC ran the risk of permanently alienating a large segment of the register. By contrast, the General Medical Council (GMC) quite rightly doesn’t comment on the rates agreed by locum GPs as that is a matter of negotiation between the locum GP and their prospective employer.

In fact, the GMC said in an article last month  that  “doctors will stop at nothing to provide care in this crisis – our job is to support them”. The GMC took the opportunity to advocate and pillar the great work GPs are doing and reassured them that if concerns were raised about their practice, they would take into account the extreme circumstances in which they are working.

This is the kind of great insight and comfort we desperately need from our regulator. The GPhC should be seizing the opportunity to be more positive and focus on how they can support and champion the great work that pharmacists and pharmacy teams in all sectors are doing in these troubled times.

Since the statement from the GPhC was released, I have noticed that some locum agencies and multiples have used it as a stick with which to beat locum pharmacists into submission so that they accept what is being offered, instead of negotiating a hourly rate that is commensurate to the job being offered.

I shared my concerns with the Pharmacists’ Defence Association (PDA), and it subsequently confirmed that the GPhC has no other legitimate regulatory interest in the rates agreed between locums and their clients. It explained that referring a locum to the GPhC for simply negotiating a higher hourly rate would be “an absurdity and an abuse of the regulatory system”.

Before the GPhC made these comments, I feel it would have been prudent if they had first considered whether the hourly locum rate has kept up with inflation. £10.00 in 2009 is equivalent to £13.51 in 2019 when accounting for inflation, according to the Bank of England, at an increase of 35%.

Employees usually have annual salary reviews and are offered a small wage increase to reflect the increased costs of living year on year. This is what locums are seeking to do when negotiating their pay.

Mitesh Patel is a locum pharmacist in Yorkshire

In response to this article, GPhC sent C+D this statement on April 3:

“We understand the important role that locum pharmacists are playing by helping to keep pharmacies open to provide safe and effective care for patients, and we are very grateful for their contribution.

“We are in no way trying to suggest that all locums are taking advantage of the current emergency to negotiate higher rates or that locums cannot individually negotiate rates with their clients.

“However, we were concerned to hear reports that there was some co-ordination among a small minority of locum pharmacists to significantly inflate their hourly rate. Neither pharmacy owners nor locums should be looking to profit from this situation by involving themselves in anti-competitive action. We will continue to take a balanced and even-handed approach to issues raised about some pharmacy owners and some members of the profession, whilst applauding the great work that the majority on all sides are doing to support the public.

“The requirement to behave professionally at all times remains in place and at this time of national crisis it is more important than ever that everyone’s first concern is for patients and the public.”

65 Comments

Farmer Cyst, Community pharmacist

I don't give a shit if they think I'm profiteering.

 

Any good will/relationship building is long gone.

S J- Locum, Locum pharmacist

Agree. They are still prifiteering at our expense and no one doing anything. They are pleading poverty all the time. Also the massive profits they made and are making at the expense of the NHS. False claims for dispensing of specials etc, False MUR claims!

Dee dee, Community pharmacist

Great point about GMC and locum doctor rates, which reach into the £100's per hour i.e the GMC acknowledge the vital work that the doctor does and don't get involved in an element of the job that does not concern them. The behaviour of the GPhC in this regard has been appalling. They have absolutely no remit to comment on prospective locum rates. If I feel it worth £100 per hour to put my life on the line and work in a community pharmacy, and the owner agrees, it has absolutely nothing to do with the GPhC. They are acting well outside of their remit, and it is blatantly obvious. That begs the question; Why, and on who's behalf, did the regulator wade into a pay issue, which it has absolutely no legal or regulatory power to control? Makes you wonder if the regulator is acting on behalf of the public, or the financial interests of multiples. Fit for purpose?

Thamina Pinky, Locum pharmacist

Not a good timing to put negative statements about locums. Making me demotivated and depressed. This might make many Locums demotivated and frustrated as well. Our nation needs pharmacists now more than ever. We don’t want pharmacies to shut down without a pharmacist who simply asked for a higher rate. Pharmacies have been a gold mine for ages and if a dr can be paid what they demand as locum, then the locum pharmacists can be too

Thamina Pinky, Locum pharmacist

When a locum Dr or other locum health care professionals increase their hourly rate, there is no problem but if a pharmacist increase the hourly rate, it becomes a huge problem. Why? A plumber will work for  £80 to £90 in an emergency. There are pharmacists who are trying to come out of community pharmacies. I know pharmacist managers who will not check anything before my shift and this was informed to me by the pharmacy technician of the same branch. Moreover, the manager himself told me not to any other services apart from checking as there were endless baskets to check. In other branches the pharmacy staffs are trained by managers to make sure that locum does the labelling, dispensing, deliveries, Jump to the till as well as make sure everything is checked and doing multitasking might lead to errors. Running like a headless chicken is not what pharmacists are meant to do. I am so depressed what the pharmaceutical adviser has written and it's giving me stomach churns early in the morning in the weekend. Mentioning all these negative statements about Locums at this critical time rather than appreciating what we r doing is very depressing. Very disappointed and depressed.

Angela Channing, Community pharmacist

If you're young, retrain.
Don't be miserable.
The last decade of no pay rises has been ruinous to many pharmacist's finances and motivation.

Leon The Apothecary, Student

Already working on it Angela! Absolutely no regrets. I occasionally pick up work to refill the bank, and it helps to remotivate me why genuinely!

Benie I, Locum pharmacist

https://www.gponline.com/locum-gps-stranded-work-dries-covid-19-crisis/article/1681725

 

Contrast the above article with Locum pharmacists treatment and the attitude towards them. The likes of Rudkin and his ilk should be ashamed but they won't be. The thoughtless spiteful statements will keep coming no doubt. And his friends at the multiples will rather shut pharmacies than pay phamacists. the public should be made aware. And C&D if they claim to have journalists on their payroll should investigate.

I leave you with a few lines from the article to ponder:

*** 'I think it’s important that we maintain the commitments that we’ve made to locums because they are a valued and important part of the workforce.' The BMA has also held talks with NHS England over plans for a national service for 'cascading additional shifts' in primary care to make it easier for locums to find work. ***

mark straughton, Pharmaceutical Adviser

Locums that:

- Turn up anywhere between 10mins to 1hr late to a shift.

- Constantly on their phone, over and above a reasonable amount, then get stroppy when another staff asks them to check a prescription.

- Spend the majority of time in the consultation room on Netflix, Youtube etc. when there's a mountain of scripts to check (and they know this)

- Refuse to answer phone, label, dispense, do extra services.......they only check!

They do the above knowing they'll probably never get asked back but they're not bothered because they've travelled 2hr to get there, but still get paid £30/ £35 ph and full mileage.

.............they're the locums that give all locums a bad name and tarr with the same brush.

Staff and managers alike get stressed, anxious wondering what clown of a locum will turn up. There's still too many of them around and crop up at short notice for shifts, acting like they're the heroes of the branch! 

Paul Samuels, Community pharmacist

Just get real!!!Welcome to the real world??

Thamina Pinky, Locum pharmacist

Pharmaceutical advisers, do they work as pharmacists in community pharmacies???????

S J- Locum, Locum pharmacist

This is ridiculous. Please learn from the BMA how they support ALL their members. Because they respect them so much so do the staff and other colleagues. We don't have that. We are abandoned by the body we pay to support us.

If it wasn't for the PDA, where would we be? They are the only ones who have ever fought our corner, may they carry on forever.

I have come across few members of staff who do nothing when locums are working other then complain about locums. Checking prescriptions and making sure it is all correct is not an easy job. You need to be constantly alert and worry each time if you have checked everything correctly and the patients are going to be safe. Ultimately we are responsible for that day's prescriptions thet have been checked. and it is a worry and a great burden on our minds. If you are working at different places, as locums do, it is not easy and you have to concentrate even more. You cannot be doing other things you are not familiar with. Too much is expected of locums yet we can only do so much in a day. Our main responsiblity is safe checking, advice and professional services. 

I have observed members of staff sitting in the coffee/tea rooms for most of the day or disappear while the phones are ringing, When you answer the phone you don't know where to look for the staff to deal with the call you can't help with. Delivery boxes lying everywhere from previous day need to be put away etc. The work benches are filty and the sinks in the tearoom and dipensary have not been cleaned for months. Cups are 'washed' and placed back on dirty sinks!! I feel sick most of the day. This is a pharmacy and we should be clean with clean working surfaces. Bins overflowing. 

 Also some staff are utterly rude and disrespectful and never acknowledge your greetings. Some places no-one talks to you all day it can be so lonely and adds more stress.This behaviour is unhelpful.  

If you are not a regular at a branch it can take most of the day to get used to the systems and constant staff shortages do not help either. Yet it is still the locums fault!

It is unacceptable to use Netflx etc at work. I agree but they are a MINORITY who do things they are not supposed to. 

However, our phones are our livelihoods - how we book shifts posted regularly- and working at different places we have to be contactable by family members when needed especially if we have young children or sick members of family. We use the phone to google information as most pharmacies do allow access to the internet. We use phones too add CPD notes etc. rather than use notebooks.

When you start the shift they expect you to know everything about the systems etc. You walk in and there is an overload of prescriptions to be checked. Some managers/pharmacists have left workload from the previous day for the locums. We get constantly interrupted about trivial advice that the staff members should be able to deal with in the middle of checking prescriptions. When you ask for help their behaviour is abrupt and rude.

Although they are a minority they get listened to by the head office or senior staff and because of this their behaviour continues and they take advantage and become area managers'/managers' so called pets, This mentality is beyond my comprehension. If managers/area managers worked with the locums they may find what the reality is. We locums can't win, ever?

I agree there is a very small minority of locums whose behaviour is unprofessional but most of us are hard working and professional.

Gphc does NOT complain about the employers taking advantage when locums get offered ridiculous sums for a professional responsibilty we have to take and the most stressfull conditions, and overload of work we are expected to cope with. The £30 an hour is well below what we should be earning, and we rarely get paid this rate except for emergencies.

The normal rates are a joke for a profession like ours. £100/hr is not unreasonable, considering locum doctors get paid more than that 

Nobody really complains, for example, if a plumber charges a fortune for emergency and a call out charge. And they don't have responsibity for peoples' lives and the workload.

 

 

Tim B, Locum pharmacist

Pharmacist Managers /Owners who a) leave every bit of bench space piled high with unchecked script baskets that should have been done a week ago  b) leave crammed in another room, or even on the same bench , anything up to 50+ or so mds trays for either filling and checking  that should have gone out days ago, c) ensure that all experienced staff are off on holiday so you are left with an assistant who tries hard but hasn't a clue what is going on,d) no hand over notes left,  e) has left a host of unentered CD drugs and prescriptions, f) expecting you to sort out the mess from the latter, g) leave you to take the flack from irate patients. On top of all that demand !! murs to be done, dmrs, smoking cessation etc etc etc.. And last but by no means least, delaying payment until legal action is innitiated. Mr Straughton, it is us locums who wonder what kind of ' clown' manages to own or run a pharmacy. You are talking absolute rubbish .

 

 

 

mark straughton, Pharmaceutical Adviser

You've completely off topic here. What's this got to do with locum profiteering and tarring locums with the same brush??

Thamina Pinky, Locum pharmacist

Pharmaceutical advisers, do they work as pharmacists in community pharmacies???????

mark straughton, Pharmaceutical Adviser

Perhaps stick to the discussion as opposed to the job role .thanks

Tim B, Locum pharmacist

Have you deliberately misundertood ? You made all the above statements about how bad us locums are and I have put part of the other side. I have lost count of the number times I have walked into an absolute shambles. Hardly off topic. And, from inference, it seems you think locums are paid too much anyway. I note that, being a pharmaceutical adviser, you have shifted away from the coal face so really I suspect you are truly out of touch with the reality of it all.

mark straughton, Pharmaceutical Adviser

 

No no, 

I've not said said whatsoever that Locums are paid too much. I do like and respect hardworking Locums. The negative points I make are with respect to the minority who give Locums a bad image (hence tarring with the same brush).

I know there's very good intentioned Locums that turn up to a shift on time and greeted with total chaos. Staff that barely say hello or acknowledge them. Have a mountain of delivery baskets with a frustrated delivery driver standing over, arms folded, keys jangling wanting them NOW. Then 4 addicts turn up and they're not even been made up, and they're stomping around the shop. Then there's 3 waiters with a counter staff impatiently standing over them. Here the Locum is suppose to perform miracles! Then there's no log in details for anything or any instruction but the Locum is suppose to know because 'you're the Pharmacist!' I get it!!!! This is all too common and it's so demoralising.

But chaos, short staffed shops, poor management is the norm. Unfortunately though, everyone remembers a bad Locum more then they remember a competent, good Locum who does their job well.

The biggest threat to the community pharmacists workforce is remote supervision. The pharmacy rebalancing board are doing what they can to obtain legislation to impose remote supervision. This will obliterate the Locum pharmacist workforce and it doesn't matter how good Locums are and how experienced they may be. The fact is they're expensive and they want 13/hr technicians in instead.

Every bad Locum experience, however few and far between will only support their cause. The only glimmer of hope is for the Locums  workforce to pull together to stamp out the bad Locums and promote the hardworking image which the majority possess and promote.

Ps. Please don't go down the route of mentioning my role to try and discredit my points. Remember the pharmacy profession is subject to the opinion of everyone. Thanks 

 

 

 

S J- Locum, Locum pharmacist

You say locums are expensive? WE haven't had a rise in years. We are performing more services, worse working conditions, and so on.

Hence, you are left with 'bad' locums.

I agree with some of your points about what locums are faced with when they turn up. If you pay peanuts you get monkeys. The biggest drawback of this profession is that there is no financial benefit for the work and responsibility. 

If YOU were a locum what would you expect to be paid for work overload (catching up on two or more days workload for one days' patheic wage), legal responsibilityy, understaff, abuse, rude staff, pressure, professionalism, and so on.... Please answer Honestly, if you can!!

At least you have locums turn up and can operate your business 

 

R A, Community pharmacist

Hi Mark,

So:

"Refuse to answer phone, label, dispense, do extra services.......they only check!"

Just checking for the sake of clarification if the locum is unable to focus on checking the prescription properly if they are too busy helping the branch staff doing their job and if they make a mistake will you and your colleagues be prepared to take 50% of the blame and face the consequences alongside that locum? 

Obviously if you are expecting your pharmacist to help out with those tasks to me it seriously indicates that you have staffing problem!

Ironically this is the type of enviroment that actually forces good locums to leave the locum line of work and guess what you end up with those "clown of a locum" because they are the only ones who will be happy to turn up.

Thamina Pinky, Locum pharmacist

thanks for your statements. Many pharmacists are indeed leaving the community sector and pursue their career in other sectors. 

mark straughton, Pharmaceutical Adviser

Rubbish!!

Don't tell me during the course of a day, a locum can't chip in and answer the phone on the odd occasion when it's clearly busy, all other staff on dealing with queries/serving customers/ on other calls. 

And this is not to discredit the job and concentration of checking but bear in mind from the staff point of view, it's likely that their usual Pharmacist will answer the phone as well; and this is the comparison they will draw.

What's your answer for the phone ringing 9pm on a late shift, the other member of staff is serving a customer, the shift is winding down, are you saying it's still not expected to answer the phone?

It doesn't matter how many staff you have there will always spring an occasion when the locum answering the phone to ease release the pressure on the other staff.

S J- Locum, Locum pharmacist

99% of the time I answer the phone it is a query only a regular member of staff can deal with. So you still have to pass it on. Yo need a telephonist!

You are living in cukoo land

R A, Community pharmacist

For the record initially you stated "Refuse to answer phone" but now you are saying "answer the phone on the odd occasion". Two different situations. Walk into a dispensary and the phone is ringing constantly so you really do need to be more specific i.e. do you want someone to be courteous enough to help out ocassionally when they are free or pretty much doing all the support staff work as well as their own job? 

I've had it both ways and as a locum I was always happy to help staff if I was free. However I've been in other places where they expect me to do everything. I always returned to do additional shift in the former but I avoided the latter like a plague.

Also I'm not sure how anyone has the time to watch netflix or youtube in a pharmacy most of the time its just checking basket after basket. 

mark straughton, Pharmaceutical Adviser

I used answering the phone as an example. Read my post, I mentioned how locums 'refuse to answer the phone' point blank and how answering on the odd occasion is what they should be doing; hence the 2 different situations.

R A, Community pharmacist

I did read your post. This is what you wrote originally:

"Refuse to answer phone, label, dispense, do extra services.......they only check!"

On the other hand a fair statement should have been along the line of:

"Refusing to help staff with their jobs such as answering the phone occasionally when free"

FYI a pharmacist shouldn't be labelling or dispensing if they are checking because that's how mistakes happen. Interestingly I noticed you didn't say whether you would be happy to take part of the blame if the pharmacist made a serious dispensing error because they wanted to make you happy so checked what they dispensed? If that pharmacist gets dragged to fitness to practice committe they would be lynched because a pharmacist shouldn't be dispensing and checking at the same time.

Read this case: 

https://www.chemistanddruggist.co.uk/news/7-month-suspension-pharmacist-whose-dispensing-error-led-death

Dispensing and checking should be done by two different people its the most effective way of reducing error. You only need to make one big mistake. If the store is up to its neck with script then I do think customer should be told their prescriptions can't be dispensed until current back log is cleared. It furstrates me so much when you have one dispenser and one pharmacist somehow no one has the commonsense to say to patients we cant take any more scripts.

In 2007 a pharmacy was busy if it did 200 items per day with one pharmacist and one dispenser suddenly in 2020 its fine for a pharmacy to do 550 items with the same level of staff?

I can see why no competent pharmacist would take shifts because its asking for trouble and plus for all your hardwork you have to accept £20odd per hour. Nevermind the workload and added risk these days. 

mark straughton, Pharmaceutical Adviser

Ok to explain....I don't mean label, dispense and check the same prescription.

But you can:

-label a bunch of prescriptions for someone else to dispense then you check;

- do a download at 8pm,for example, label and send the order, ready for the staff in the morning

- can dispense a bunch of labelled prescriptions for the pharmacist in the pm shift to check.....or even an ACT

The list is endless.

As for the phone comment......however you want word it, the point is there's some locums who will never answer the phone, when they can

Tim B, Locum pharmacist

You really have a dislike of locums , don't you .All what you say above is done by locums , certainly by the ones I have taken over from. It is not a good idea to make blanket statements which cannot be backed up and which are dismantled by argument later down the line.

R A, Community pharmacist

Hi Mark, 

I would advise you that perhaps you should articulate your opinion more clearly in the future. What your saying now is very different to your original statement. 

I literally had to pry this information out of you. For the record for most pharmacist the issues you've described are issues of contention. 

No pharmacist wants to come and clean someone elses mess and have their own work load to deal with during the day on top.

Benie I, Locum pharmacist

You're dead right. It's similar to how [email protected]@ts for example give contractors a bad name I suppose. Just shrug your shoulders.....

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