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Throwing numbers at a problem won't work

The Government’s NHS workforce plan is looking to increase the number of pharmacists but there are some fundamental questions that need to be answered first – including why so many are leaving community pharmacy, says Liam Stapleton

The Government recently announced a workforce plan to meet the challenges that the NHS has with vacancies and shortages of a whole range of healthcare professionals. And it intends to invest in the education and training of many more pharmacists as a result. 

While it is definitely a step forward that these challenges are recognised and some action is being taken, rather than throwing money at the problem it would have been better to invest some thinking time first.

There are a number of challenges with the Government’s approach. The pool in which universities are fishing for students is limited. The workforce plan aims to increase the number of medical school places as well as the numbers in pharmacy schools, so some more able students will be diverted from studying pharmacy to studying medicine. There is also competition for other ‘high value’ subjects. 

There are already campaigns to attract students to STEM courses as more graduates are needed in this area. Even if there was not increased competition from other subjects, schools of pharmacy will be accepting less able students as numbers increase – and in time this duly trickles into the profession.

Let me stress – I do not just mean academic ability. I am a strong believer in the requirement for a broader set of skills, not simply academic success, for people to develop into good pharmacists. Young people mature and flourish at different times and at different rates. I scraped into a school of pharmacy with very mediocre A level results and scraped through my degree as well!

Enough teaching capacity?

We also need to think about our capacity to deliver undergraduate education and subsequent foundation year training with increased numbers of pharmacy students and graduates. Do we have enough pharmacy academics to allow these students to be taught effectively in universities and enough tutors for the foundation year? 

The GPhC is strongly encouraging students to have placements in a clinical setting during their undergraduate studies, so will these opportunities be available with increasing numbers? We are already facing a looming storm cloud with the lack of suitably qualified pharmacists with prescribing experience to supervise the foundation year for graduates in summer 2025.
As we know, these graduates will have completed a course that provides the underpinning knowledge and skills for pharmacist prescribing. 

“Are community pharmacists stubbornly holding onto ways of working that are out of date?”

What I’m saying is: we need to be much more thoughtful about this problem and ask ourselves some fundamental questions.

The first question is why are pharmacists leaving community pharmacy to go to other sectors, or to become a locum, or to leave pharmacy all together? There may be a multitude of reasons including work pressures, staffing levels, job satisfaction, salary levels or unsociable hours. If we don’t solve these problems, increasing the number of people we train as pharmacists will not resolve the bigger workforce challenges.

The second question we should ask is equally important and possibly related to the first. How much time is spent by pharmacists in community pharmacies not doing the job of a pharmacist? Pharmacists are involved in dispensing, accuracy checking, managing stock and paperwork, clinical governance and general dispensary management. These are all activities that could be undertaken
by people in other roles in the pharmacy.

If this ineffectively used resource was released to undertake more appropriate roles, would the workforce problem be as great? The work being carried out by pharmacists in GP practices could easily be undertaken in a community pharmacy. Pharmacists would have greater job satisfaction, which would have a positive impact on retention. 

Old ways of working

The commercial world is littered with businesses that ultimately failed because they hung onto their old ways of working – Xerox (photocopiers), Blockbuster (videos), Kodak (film) and Nokia (mobile phones), to name a few. Is community pharmacy stubbornly holding onto ways of working that are simply out of date?

The solution to having more water in the bucket is not pouring in more water if there are holes in the bucket. We need to be more creative and imaginative. We need to find ways of better using pharmacists across the system if we are to overcome the workforce challenges we face.

•Liam Stapleton is director of Metaphor Development Limited and an associate clinical lecturer at the University of Lincoln.

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