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Insight: I am optimistic... yet burnt out

It feels like the winds may – just may – be changing in our favour with widespread recognition that community pharmacy is both underfunded and a potential solution to the crisis in the NHS. However, the day-to-day grind is taking its toll

Before you start to groan that we’ve been here before — believe me, I’m just as cynical as you are — there are some genuine reasons to be optimistic. 

Pharmacy First is being touted as a potential game changer for a system that is absolutely swamped with demand. A network of 11,500 community clinics in England, ready to provide walk-in access to a healthcare professional, could easily provide 57 million minor ailment consultations a year through pharmacy, at a fraction of the £2bn it would cost to provide these same appointments in general practice. 

Pricing the service at, say, £17 per appointment would yield close to £1bn of extra funding for community pharmacy and still save another £1bn in GP capacity. Economically this seems to make absolute sense, but could we do it? And could we do it for that price?

But before we can even begin to talk about Pharmacy First, we need to address the problem of chronic underfunding in our core functions. If that gets sorted, we then have to look at what sort of a service we would need to deliver. 

As a key point of principle, there cannot be any referral gate. It must be a walk-in service. If the NHS is concerned about the service being too ‘successful’, there could be some protections such as maximum activity levels built in. We also need to ensure that the service isn’t 100 per cent reliant on pharmacists. With our teams adequately trained and quality assured, there is no reason why some of these consultations couldn’t be handled by our pharmacy technicians or medicines counter assistants. 

In my head at least, Pharmacy First isn’t just about minor ailments. I see it as a switch in mindset to transfer work that could and should be done in a pharmacy setting. I fully understand that we can’t do that overnight, but with the right financial package and support, anything is possible.

Facing up to burn out

Pretty much every day of my professional career, people have asked “how are you?” – and I’ve invariably answered “I’m fine” or “not too bad”. But when people ask me how I am now, the honest answer would be that I feel numb, like
a bystander in my own life.

I’ve always been mindful that I walk a fine tightrope between just about managing and doing too much. Professionally, my skills have never been in more demand, but they have simultaneously never been as poorly valued. I’m not necessarily talking about money here but about respect, whether it is the folk who “don’t want to bother the doctor” but are perfectly happy to bother me, or the people who get annoyed that they have to wait for their prescription because I am trying to help another patient.

I have people coming from all over the place to see me because their GP/regular pharmacist/dentist/chiropodist/nurse/window cleaner can’t or won’t. I should be flattered but I just don’t feel anything. I recognise these symptoms and I know that they are likely to indicate that I am suffering from depression. 

If I’m feeling like this, how is everyone else feeling? I fear for our new pharmacists who have come into practice at a time when we have the challenges of massive patient expectations, rising workload and falling resources. 

When I was newly qualified I didn’t have to deal with anything like the pressure that these new pharmacists do. It is easy to see why they might get disillusioned and end up in Primary Care Land seeking a different work-life balance. 

If what I have said about my mental health makes you feel uncomfortable, I apologise, but it is important to let others know they are not alone if they are feeling something similar. It happens to the best of us – and tomorrow, as they say, is another day.

Are you burnout and want to leave pharmacy? Email 

*Alexander Humphries is the pen name of a practising community pharmacist. The views in this article are not necessarily those of Pharmacy Magazine

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