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The Locum: Pharmacies are getting dangerously busy

"How much more can the sector take before reaching breaking point?"

The manic pace of community pharmacies caused by dispensing demand and medicines shortages is wasting the skills of pharmacists, says The Locum

I have come to dread bank holidays.

Firstly, as I work as a locum, I don't get to enjoy the feeling of having an exciting, paid holiday as many of my contemporaries do. I don't mind having a day off, but in the case of bank holidays it is shared with pretty much everybody else in the country, meaning the enjoyment of scuttling around town while everyone else is at work is sadly lost. Everywhere is too busy and the public, patients and my colleagues are at large. I generally stay at home and read.

Secondly, and more importantly, a ridiculous increase in workload seems to materialise out of nowhere on the days leading up to, and immediately following, any non-routine closing of the pharmacy. People panic to a stupid degree. It appears to be a commonly known fact among the patients I see that if you don't have at least three months of atorvastatin saved up before a bank holiday, the surgery will never let you order them ever again.

Back when I was a teenager working in retail, I used to marvel in shocked fascination at the people inexplicably buying 12 pints of milk and four loaves of bread the day before a bank holiday. This unwarranted panicking used to make me laugh. Now, it makes me want to cry.

All that has changed is I've swapped ready meals for tablets. Crucially though, it's quite hard to kill somebody by mixing the spaghetti bolognese with the lasagne on the shelf. In pharmacy, an unexpected increase in workload has the potential for longer waiting times, lower standards of patient care and a greater potential for error.

It seems that in the few years I've been doing this job, the workload has increased rapidly. I remember fondly the days when Christmas and Easter would be busier than usual, but in a predictable and manageable way, and otherwise things would tick over fairly nicely. An hour before closing, everything would be done, and you could catch up on date checking or keep on top of paperwork, before going home feeling reasonably accomplished.

These days, there seems to always be work left over for the following day. Every pharmacy I work in seems to forever be chasing its tail. It appears there are no longer busy and quiet periods, just different levels of manic ranging from 'full concentration required for eight continuous hours' to 'unmanageably, dangerously busy'.

People will say that I am making a rod for my own back by choosing to work in busy independents, as opposed to a supermarket pharmacy where 50 items is considered a hectic day. This, I suppose, is true. But I have been there, done that, got the name badge and the thought of being harangued by a store manager for failing to do medicines use reviews, despite not seeing a single patient in the six-hour shift, does not appeal.

I want to work in a pharmacy where I can have patient contact when I feel it is necessary, use my clinical expertise for the benefit of the public, and not spend eight hours a day just staring at boxes and labels. The current delegation of dispensing workload I encounter every day is, in my opinion, a waste of pharmacists’ skills.

The sad reality, however, is that pharmacies are closing, the funding situation is worse than ever, and contractors are cutting back, meaning fewer staff for fewer hours. This is all occurring at a time when the number of prescribed items is higher than ever, the number of out-of-stock products is spiralling upwards, and the role of pharmacists is being promoted like never before. We have fewer and fewer resources to do more and more work.

Working as a locum in 2019, it is no longer a case of busy and quiet periods. It is a case of how much more can the sector take before breaking point is reached? I don't know, and I am not sure I want to hang around to find out.

The Locum has worked as a community pharmacist in more than 200 pharmacies

8 Comments

Peter Williams, Community pharmacist

"opposed to a supermarket pharmacy where 50 items is considered a hectic day"

 

I'm offended by that.

Paul Kelly, Community pharmacist

I only locum a couple of days a week but do like to do Saturdays at one of my local pharmacies, Note from the manager on Saturday, sorry we've managed to process most of Thursday's eps but haven't done anything with Friday's. Crazy busy with walk-ins and services Friday. Please do what you can

Ruth Hulton, Community pharmacist

It is weirdly reassuring to know we are not on our own. We are a busy independent and very fortunate that I am allowed to maintain very good staffing levels but we still have to break even and the pressure is relentless 

Michael Achiampong, Community pharmacist

I sincerely commiserate with you Locum.

Given that the workload situation is not going to change for the better anytime soon, this is a test of our collective transferable skills for example: effective communication to manage the expectations of patients on prescription waiting times; teamworking and delegating skills. Basic tasks like issuing owings slips so that patients have a copy and the pharmacy has a copy; keeps everyone in the loop.

It is also essential to take "mini-breaks" throughout the day for a "breather" and for a  bigger picture perspective. It only takes one slip of concentration to make a potentially catastrophic dispensing mistake. And usually, we only get one chance, inadvertent error or not?! Above all, everyone working in the pharmacy frontline has to draw upon leadership skills to survive the relentless tsunami of frontline pharmacy practice. Good luck!  

Chris Locum, Locum pharmacist

Many staff dream of 'mini breaks' and do not get them. They don't always get a proper lunch break like the locum they come over to interrupt. As for the so-called '50' item pharmacies, I think they will disappear when profit/loss is too negative. It explains recruitment problems, but not on the grounds of insufficient personnel. Why would they put themselves in an environment where they could potentially hold the can for catastrophe, and theoretically, lawsuits and jail?

David Moore, Locum pharmacist

50 item a day supermarket pharmacy? In my experience, as rare as rocking horse s***!

There’s still quiet shifts in these supermarket pharmacies dotted about..

Leon The Apothecary, Student

Dunno, I've worked Sunday shifts before where it's mainly pointing people in the direction of BWS.

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