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The Area Manager: 'Staffing in multiples like Boots is not broken'

"The amount of research that goes into multiples' staffing models is staggering"

The Area Manager gives his take on last week's BBC investigation into Boots' staffing levels

Last week’s BBC documentary excited a lot of people in the sector, and this area manager was excited in particular to see the route it would take – especially since he has worked with two of the people featured on the show.

I had hoped the programme might help the public to understand more about the amazing stuff pharmacists do beyond simple dispensing, but no. It could have talked about how funding cuts have forced tighter belts in the sector, but no. It could have removed the stereotype of the slightly glum, middle-aged white male pharmacist in a white coat, but no again.

The programme made too much of the shock and not enough of the evidence. We know a bad dispensing error can lead to patient harm and death. Did we really need to make patients more afraid of us in order to give Boots a kick?

Across my years of work with several multiples, I have seen many staffing models used. I have used them, taught people how to use them and judged my pharmacy managers on their success in using them. All the models I have seen use a huge amount of data about the specific pharmacy, its business profile and its layout. They create a model that defines not just volume of resource, but also skill mix and even manager type. The amount of research that goes into these models is staggering.

It will make me unpopular to say this, but for safe and optimum operational practice these staffing models are actually very well thought-out. They use the resources of pharmacies on the whole very well, within the constraints of funding, and allow the salary budget to be shared between the individual stores in as fair a way as possible.

I often say that the hardest part of the role of pharmacy manager in a multiple is changing your current team to reflect what the models instruct them to have in their pharmacy each year. Interestingly, this often seems harder for qualified pharmacist managers to do, than those with a management, dispenser or retail background.

The cause of problems with these staffing models (and the resulting feeling of lack of resources) is inconsistent understanding and application of them by local pharmacy managers. Even as a new area manager I often find I have to teach the basics of established models to pharmacy managers who are much more experienced that I am, but have chosen to avoid learning about them until a problem arises.

The models also fall down when holiday absence is poorly planned, for example, if a pharmacy manager allows too many people to have holiday at the same time. There will also always be pressure when sudden sickness strikes a small team.

I can’t understand why Boots didn’t offer to share their model, or at least the principles it uses. Despite my general aversion to them as a business, I can’t say that their models are broken.

Whatever we think of the BBC programme, and of Boots, I hope it helps every pharmacist in the multiple sector, whether they manage a pharmacy or are managed in one, to take a more active role in understanding and using the resource model their company operates. I hope they use the tragic stories as a reminder that the worst can happen, and that planning their teams and recruiting for flexibility is as important a safety measure as any check that’s performed on a script.

Multiple pharmacies that plan their teams well within these models, and build in flexibility and resilience, provide the best standards for patients and the lowest conditions for pharmacist stress.

The Area Manager has worked for all of the large multiples

18 Comments

Amal England, Public Relations

Dear area manager, not every pharmacist falls into your opinion that pharmacists don't know enough about these models. When I first qualified my area manager gave me a task to find about and put together a model for staffing the pharmacy. Upon completing this, the next task was to use the model to cut the time taken to complete various day to day tasks. At that point I told the area manager I wanted something else to do or I was going to quit. The reason is that I was also covering those branches as a pharmacist and I could see what they were trying to do- make Pharmacy staff walk on water. That was 20 years ago! So I'm guessing you were probably in your diapers when I was looking into these models??

Leon The Apothecary, Student

I wonder if you'd be willing to align your words with your actions and show us your witnessed models, particularly if you have an interest in providing care for your patients beyond your personal business bubble? Even a redacted outline would be a good first step if "trade secrets" is an issue.

Because, to put it bluntly, there's no reason to believe any single word that is said without a shred of proof when it comes to that subject, in my humble opinion.

Amal England, Public Relations

Just to add.......so the problem is pharmacists don't understand these models and area managers don't understand Pharmacy.

Brian Smith, Pharmacy technician

Throw the models in the bin and go work in one of the pharmacies for a few months and then maybe you might have some idea about how bad things have become in community pharmacies. 

Paul Dishman, Pharmaceutical Adviser

I hope you found an old white coat to protect your nice suit from the whitewash you've been throwing around, Mr Area Manager.

Arun Bains, Community pharmacist

A typical area ‘manager’.... living in cloud cockoo land.

Lucky Ex-Locum, Superintendent Pharmacist

Do Boots adhere to the models? Tesco certainly don't by allowing lone working and self checking in direct contradiction to their written protocols. 

M Yang, Community pharmacist

I find this hard to swallow. I've worked in independently owned pharmacies as a locum up and down Scotland for the past 5 years or so and I can say the majority are fairly well staffed. Granted, there are times when we could do with more but then I think back even further to when I worked as an employee pharmacist at Boots.

Most of my memories are littered with days working alongside one counter assistant and no one else, or staff with a few weeks of dispensing training and a "dispenser" badge slapped on their chest. Not only that, at a performance review my line manager once asked me what could the company do better. As a plucky 24 year old at the time, I blurted out "more staff would be better" and was immediately asked to rephrase my answer. Confession: I've never had a good performance review while working for Boots.

If the staffing levels are not broken, then why is everyone in upper management pretending everything is perfect and hushng up people like me? Why is it that the few staff available in a Boots are running around like headless chickens when further down the road, in the same village or town, your local independent seems to be managing without the backing of a billion pound company?

Ilove Pharmacy, Non Pharmacist Branch Manager

This fella tells lies.

James Mac, Community pharmacist

Have never heard of a serious incident and thought "if only they'd learned about the model". Also the stereotype pharmacist is Asian, according to boots adverts. I would not have reckoned that much specific research went into these so called models either, unless there's specific citable research that they funded that I'm not aware of. Infact didn't the whistleblower say his 10 million figure came from external research into exactly that?? Did you forget it?

Dave Downham, Manager

Maybe stop employing modellers and replace with staff?

Mung Kee Majiq, Community pharmacist

I would also like to add that it is not only 'Boots staffing model is broken'  - It is the other well established multiples including Tesco's ,Asda .... and the rest that are broken. Staffing levels are dangerously low to breaking point for the business in most stores. Staff are stressed and leave; and  are not replaced when they have left. Scripts increasing . Little to no help in the dispensary for the stressful pharmacist on duty - commonly harrassed by the customers because they've waited too long for their prescriptions. Pharmacists are also pressured to do 2-3 MURs  and an NMS a day , or you won't be asked back to work at the store again.  Generally , community pharmacy is a disgrace and a danger to the public!! 

Another Pharmacist, Community pharmacist

The Area Manager is a tad naive to think staffing models are for the benefit of a safe, smooth-running and well-motivated workplace. That's how it's sold to us of course, but in reality, the model can be tweaked endlessly to achieve any given result....a reduction in branch hours and more profit for the powers that be.

PoPeYe- Popeys Car Wash, Locum pharmacist

My idea of the concept of a "resource model" or a "staffing model", is to skate on as thin ice as possible without actually breaking through. This is in order to rinse the maximum amount of pennies as possible out of the necessary evil of costs, from a sector suffering from admittedly disgraceful cuts, and expectations to carry out free services as if a charity. The ice breaks all the time.

I don't really care what magic goes into each multiples formula to set staffing levels, the facts of real life are that community pharmacy is literally an open door business. It's requirements on a day to day basis, beyond a certain point, are impossible to predict, for all the reasons I don't need to tell you about.

If models are not good in practice then they are not good in theory. Let your managers work out what they need for goodness sake. Or maybe now it's just time to nationalise this whole thing and become a non-profit making government service and they can fund the lot. Margins are clearly too low for the big boys now, relative to the past.

On another note, this articles bemoaning of the BBC not talking about what we do, how we are being shafted in funding, and the middle-aged white male pharmacist in a white coat stereotype is absolutely spot on.

I'm with the BBC on the slightly glum bit though. Maybe a tad understated.

Z ZZzzzz, Information Technology

I agree about nationalising the service. Why should anyone make a profit out of 'dispensing' medicines? These days a totally managed NHS service makes more sense than a profit-driven one, given the state of our country's finances. Any 'profit' from medicines etc purchase deals could be kept in the system rather than fund the greedy owners of the multinationals etc.​

Jonny Johal, Pharmacy Area manager/ Operations Manager

I used to have views like those expressed by The Area Manager, however my view had shifted somewhat when it comes to Boots because of recent visits I made to their stores. I do feel that Boots is placing too much emphasis on the retail part of the stores and neglected the professional areas. Twice recently, *** I witnessed pharmacists working without support, dispensary left empty when the pharmacist went into the consultation room, queues at the chemist counter while staff on the perfumes standing around, laughing, joking with each other and totally oblivious to the plight of the lone pharmacists. The Boots staffing model is broken, how can I describe it as otherwise?

*This comment has been edited to comply with C+D's community principles*

L H, Community pharmacist

"I witnessed pharmacists working without support, dispensary left empty when the pharmacist went into the consultation room, queues at the chemist counter..." 

Standard practice in many stores it seems, especially weekends.  Scarily often I emerged from the consultation room to find a tourist (who didn't know any better) in the dispensary checking out the POMs as they had easy access with the forward dispensing design and a perpetually broken retractable barrier.  My complaints to fix the barrier and requests for staff fell on deaf ears, of course.     

M Yang, Community pharmacist

Many Boots pharmacies (or should that be shop that happens to have a dispensary?) have ridiculous open plan dispensing that allows members of the public to see what you're doing. I've never heard any solid explanation for why this is the case, the only conclusion I can draw is that it's a deliberate design flaw to increase stress.

In one of my experiences, I turned my head for two seconds while dispensing a fucidic acid cream and found the item had been pinched. I was a pre reg at the time and both myself and the RP  believed the patient had done it. With hindsight, we think she may have been bipolar or schizophrenic (excessive salivation, inconsistent attention).

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