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'Pre-reg places are unfilled because the sector has an image problem'

“The numbers make it impossible for everyone to recruit successfully”

Many pre-registration places in community pharmacy are unfilled, with brutal funding cuts and competition from hospital pharmacy at the root of the problem, claims Khalid Khan

In the next few weeks, pre-registration employers across the community pharmacy and hospital sector will find out the outcome of the 2020 Oriel recruitment process. Many will be disappointed – but is this the fault of the process, or has it just become a convenient scapegoat?

The first thing to note is that Oriel has never guaranteed pre-reg recruitment. As in previous years, there are currently more pharmacies recruiting via Oriel than there are students to fill the places.

Health Education England (HEE) data for the 2020 intake – based on figures from 2019 – shows that there are 3,189 hospital and community pharmacies attempting to recruit 2,084 candidates, which means there are over 1,100 pharmacies we know won’t receive a trainee via Oriel.

As highlighted by the table below, the majority of training places for the 2020 intake (2,369) are within community pharmacy.

Intake year
Hospital places
Community pharmacy places
Total number of places

Source: HEE

Then there are the numerous community pharmacy employers who will be recruiting directly, outside Oriel. Even if you factor in the roughly 800 students attempting to secure a place directly, the numbers make it impossible for everyone to recruit successfully. 

Ultimately it’s the students who decide where they apply, with their offers depending on how they performed in the exams. There is no conspiracy or undue influence from the hospital sector, large multiples or HEE, who coordinates Oriel.

The table below shows the 2018 fill rate for community pharmacy, broken down by employer size and demonstrating how independent and smaller pharmacies perform in comparison with the large multiples (200+ branches) and the medium-sized chains (25-200 branches).

NHS Hospitals
Large pharmacy groups (200+ branches)
Medium pharmacy groups (25-200 branches)
Small pharmacy groups (6-25 branches)
Independent pharmacies (1-6 branches)
Training places available
Training places not filled
0.3% (3)
55% (398)
62% (201)
54% (187)
58% (407)
Training places filled
99.6% (787)
45% (326) 
38% (122)  
46% (156)
42% (294)

Source: HEE

So what’s changed since the advent of Oriel? Well, essentially nothing. Hospitals and large pharmacy chains are still the most popular with students. Location is also important to most students, as are long-term career prospects and the training offered. Recruiting pre-regs to community pharmacy was already becoming progressively more difficult in the years leading up to the launch of Oriel in 2014. All Oriel has done is highlight this trend and translate it into cold hard numbers.

Unfortunately, community pharmacy has an image problem. Firstly, there are the brutal and well-publicised funding cuts imposed on the sector. Secondly, there are a small number of employers who tarnish the sector through the mistreatment and neglect of pre-regs. This rogue minority detracts from the exceptional community training sites we know exist, and who are worthy of being celebrated.

The good news is that the existence of these exceptional community pharmacy training providers is widely acknowledged within HEE. And if the organisation worked with community stakeholders such as pharmacy schools, the General Pharmaceutical Council and the Royal Pharmaceutical Society, it could perhaps develop a “kitemarking” standard for training providers. This could help guide students towards quality-assured sites and away from unscrupulous employers.

Oriel isn’t a perfect recruitment tool, but nothing is. One of the drivers behind the launch of Oriel were reports of questionable recruitment practises that unfairly discriminated against certain students. Oriel gives students a more level playing field to compete for popular training sites. A fairer and more inclusive recruitment process is something I’m sure we can all get behind.

Khalid Khan is head of training at Imaan Healthcare


Industry Pharmacist, Head/Senior Manager

Improving the image of community pharmacy is akin to polishing a turd.

A.S. Singh, Community pharmacist

hopefully this will lead to a shortage in the sector which would lead to increased wages

anti-depressed Pharmacist, Manager

So this is why they are trying to force the 5 year apprenticeship/slave

Caroline Jones, Community pharmacist

I think what it shows is that there are too many Pharmacists graduating.......massive increase in numbers over the last few years!

Maybe the quality of pre ref places needs to be looked at; as currently I suspect there are pharmacies offering places just to cas in on the fee they are paid.

As others have said, the numbers don’t lie......presumably students are looking at the horror show that is the role and responsibilities that will be on offer once they qualify....this combined with the downward spiral in wages make community pharmacy an unattractive option:(

Benie Locum, Locum pharmacist

Incredible, It's almost as if these people exist in a parallel universe. The best question is always 'Would you advise your child to go into community pharmacy or study pharmacy'. 

Benie Locum, Locum pharmacist

Image problem? Are you sure? I thought everything was ok ? in all honesty this is a positive. It demonstrates that students are finally waking up to reality and realising it is generally foolish to take the community route. The figures don't lie.

Joan Richardson, Locum pharmacist

I actively encourage students to try to get into hospital pharmacy - chances to specialise, a well-defined career path and respect - the latter certainly helps with mental health later on in ones career.

Funding cuts, minimum staffing levels, long hours and no idea where community pharmacy is heading make it an unattractive prospect.  Training has to be done in your own time after a long shift or at weekends impacting further on your worl/life balance.

There is a long way to go before community pharmacy becomes an attractive career option.

Leon The Apothecary, Student


When Mr Khan mentions pharmacy has an image problem, I wholeheartedly agree and would say it's not without merit. There are many within the sector who would actively encourage students to follow different career paths other than community for a myriad of definite benefits, many of which have been discussed before, such as work/life balance, stresses, harassment, pay, and overall reputation.

Even looking at documentation such as the Five Year Forward View, it appears the goal is very clearly looking at bringing community pharmacy into the modern age with technology, efficient workflows, and centralisation, and this also will be detracting from the community in my opinion, as one demonstrates that with this sort of direction job levels are naturally going to decrease, and this leads to reduced wages and job places where there are more people than vacancies, and therefore no incentive for wages to increase.

Pharmacy has an image problem because it doesn't know what it wants to look like.

Those are my thoughts on the matter, anyway.

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