The addition of pharmacists to the shortage occupation list highlights that there is a problem in attracting people to the profession, or with recruitment and retention in certain parts of the sector. There is no single cause or solution, however this multifaceted issue requires a detailed workforce strategy for pharmacists, backed by appropriate pay structures and workplace conditions at all employers.
The PDA was created because the system and existing organisations did not adequately represent the interests of individual pharmacists and the PDA is acting on the issue. In recent years the PDA has begun negotiating for better increases and fairer, more transparent pay systems at various employers. Three pay deals have already been secured at Boots since recognition was secured in 2019 and pay talks at LloydsPharmacy will commence later this year. This means pharmacists can now collectively negotiate pay with employers, through an independent union focused entirely on the profession. While that is real progress, it will not fix the systemic challenges overnight.
A so-called “market rate” for any profession is a consequence of pay offered by all employers, including the public sector. The government in England has recently suggested a 1% increase to pharmacists in the NHS, despite 2.1% already being in the DHSC financial budgets, which is therefore damaging to the whole profession if implemented. If inflation forecasts are correct this is likely to be a further real-term cut for NHS employees, including pharmacists, and so that would hold the market rate for pharmacists down. This is a clear example of why whether locum or employed, and no matter who employs or engages them, the positive outcome of any talks on pay and conditions for pharmacists matter to us all.
In fact, many pharmacists report that their hourly rates have barely increased or have even reduced over the last decade. That pharmacists are now to be included on the shortage occupancy list while such rates stagnate or even fall defies a basic rule of economics. At times of limited supply, the rate for a resource should increase and that this doesn’t happen to pharmacist pay shows the system is broken. While the PDA acknowledge that, particularly in England, the funding provided to community pharmacy is inadequate, responsibility for providing qualified health professionals with a reasonable package of reward and recognition ultimately still sits with their employer. However, the cause and solution are not just about the money and employers have the ability to change other factors too.
Many pharmacists are locums and while care must be taken to avoid action which might breach markets and competition regulations, the PDA supports the efforts of our locum members to charge a decent rate. We also support those who report to the NHS instances where pharmacies are choosing to close, thus reducing vital access to medicines and health care and breaching NHS contractual requirements, despite locums being available to work in that pharmacy. A significant additional factor for locums is the rollout of IR35 tax regulations into the private sector next month. This is already changing some larger employer behaviours and putting a greater focus on the level of locum rates, or more importantly for those individuals their net earnings after tax.
Due to the provisional registration arrangements, no new pharmacists in Britain could become locums over the last year, this is another one-off current factor impacting the existing supply of pharmacists. However, this year will see newly qualified pharmacists from both the 2020 and 2021 cohorts join the locum population once exams are passed in March and the summer. The profession’s inclusion in the occupancy shortage list must be kept under review.
The pandemic has provided a real opportunity to emphasis the purpose and value of community pharmacy, to persuade decision-makers not to tolerate closures that deny communities their local pharmacist, and to properly fund the sector. However, unless employers properly fix the pay and environmental aspects of working as a pharmacist, importing additional pharmacists through the shortage occupation will be nothing more than a short-term benefit.
Long-term solutions are needed
This is truly a complex UK-wide issue for other stakeholders in the sector too and in order to secure long-term political support and funding for a more highly valued profession, it is for the sector to jointly demonstrate what we can offer and every pharmacist can contribute to that effort in some way.
The PDA will continue to play our part to work with reasonable employers to lobby governments for sufficient sector funding, to negotiate fairer more appropriate pay settlements, and to improve safety and other conditions. There is also a challenge to encourage the next generations to join the profession as an attractive career choice, potentially made much more difficult by the situation of the current GPhC exam arrangements, but there too the PDA works to support the future of pharmacy.
The PDA works tirelessly to emphasise to decision-makers how the community pharmacy sector is the most accessible part of the health system, why access to a pharmacist is a benefit to every community and how the role of pharmacists across the rest of the system is also essential to patient care. However, while we promote pharmacy as a critical part of the NHS, this is undermined when some encourage a perception that pharmacy is a retail transaction performed in what becomes considered as a “shop”. That approach will ultimately push the sector towards Amazon and other more efficient retailers.
Promoting a sense that community pharmacists are somehow not clinical health professionals compared to their counterparts working in other parts of the NHS are also concerns regularly raised by PDA members. That perception also perpetuates the cycle of governments redirecting funding from community pharmacy into primary care, which in turn reinforces the current shortage of community pharmacists. More needs to be done to celebrate the value to the health service of having a pharmacist readily available in every community.
As the defence association and only independent trade union exclusively for pharmacists in the UK, the PDA sees other material reasons why pharmacists willing to work in pharmacy may be in shorter supply, such as lack of professional respect and decision-making autonomy, concerns over safety and limited flexible working arrangements. We do not believe that hiring others from abroad who are willing to work for the pay on offer, while such concerns continue, is a sustainable answer.
The PDA belive that the best way for the profession to ensure employers do not simply use the shortage to engage people on lower pay rates, without addressing those other concerns is through professional unity. Every employed pharmacist, regardless of where they are trained, or their nationality, can join the PDA Union if working in the UK and together we can stand up for the interests of individual pharmacists.
Though the PDA already brings together more than 32,000 members, every additional supporter also grows the influence pharmacists have on employers and others that may not have the profession’s interests as their priority. A strong voice of a united profession influences decision-makers across the UK. The PDA believes this is the way to collectively protect and enhance existing pay rates and tackle shortages, even if employers think differently.
Related links
- Boots pay claim update
- Boots Pharmacists Pay Claim 2020
- Pay and bonus update at Boots
- LloydsPharmacy and the PDA Union reach recognition agreement for pharmacists
- LloydsPharmacy and the PDA Union reach recognition agreement for pharmacists
- Anger and disappointment as government suggest it may be 1% pay rise for NHS employees
- PDA urges locums to ensure they are ready for roll out of IR35 into private sector
- PDA Safer Pharmacies Survey 2019 suggests safety may be improving, but concerns remain
- Community Pharmacy NHS Contractual Breach Concerns