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Pharmacists query open letter from the GPhC and Chief Pharmacist for England

A letter from the Chief Executive of the General Pharmaceutical Council (GPhC) and the Chief Pharmaceutical Officer for England has raised questions among pharmacists.

Sat 6th January 2024 The PDA

The PDA, as the largest representative body of pharmacists, knows that a challenging workload is not a new or temporary phenomenon. Workforce pressures are a constant feature across all areas of practice and have been for years, with pharmacists’ well-being often sacrificed to provide safe patient care.

However, in an open letter from Duncan Rudkin, the Chief Executive of the GPhC, and David Webb, the Chief Pharmaceutical Officer for England they have acknowledged that the already “ …high and sustained demands and pressures…” will be exacerbated “…over coming weeks and months…” due to factors such as “staff shortages due to sickness or caring responsibilities, as well as the ongoing industrial action [in the NHS].”

Workforce pressure is consistently raised by the PDA, including in their response to the government consultation on minimum service levels in the event of strike action, where the PDA highlighted that the lack of resources, workload pressures, and safe staffing levels in hospitals are issues of ongoing and significant concern to pharmacists every day.

Issues raised by the letter

The GPhC is the regulator for Great Britain, but the letter appears only to have been sent to registrants in England. PDA members in Wales and Scotland have therefore asked what this means for the workplace pressures in those countries.

The intended audience for the letter is not specified as it is addressed to ‘colleagues’ and mentions ‘everyone working in pharmacies’. It is therefore unclear if just pharmacists, all registrants, or everyone who works in pharmacy is being asked to deal with workforce pressure.

In the experience of PDA members, it is often non-registrant managers that place undue pressure on pharmacists to work in unsafe conditions or with inadequate resources. However, such individuals are outside the reach of healthcare regulation. On this issue, the PDA has previously called upon the government to accept the advice of the Kennedy and Francis Inquiries and either constitute a new arm’s length body to regulate non-pharmacist managers or give that task to an already constituted regulator.

The letter asks recipients to use their professional judgement to assess and mitigate risk, and to deliver safe and effective care for their patients within their scope of practice, offering reassurance that, “in the unlikely event that you are referred to the regulator, they will consider the context you were working in at the time, including factors relating to the environment in which you were working and all relevant resources, guidelines or protocols.”

In the PDA’s extensive experience of fitness to practise (FtP) hearings, prosecuting barristers instructed by the GPhC and the independent committees hearing the case will criticise pharmacists who continue to work despite having insufficient resources or in unsafe environments.

This recent quote from an FtP case highlights that, “[The Registrant] made a number of serious errors of professional judgement in working excess hours, in practising in an environment where there was insufficient staffing support, in continuing to supply a controlled drug without the support of a second checker and in working when he was stressed and overtired.”

Constant evidence of workforce pressure

Pharmacists responding to the PDA’s Safer Pharmacies Survey and other member engagement activities demonstrate the extent of workforce pressures, including unachievable targets, unrealistic time pressures, and numerous instances of bullying and harassment, all of which have an ongoing impact on their health and wellbeing.

For example, in the most recent PDA pharmacist workforce survey 30% of respondents were looking to change their role or employment status in the next 18 months and worryingly one third of those are looking to leave pharmacy altogether.

In the PDA’s survey of hospital pharmacists, over three quarters of respondents were looking to change their career or employment status in the next 12-18 months and, for around a third of those, the primary concern was pressure and mental health concerns.

Another one of the PDA’s surveys of pharmacists working in general practice found that over two thirds felt that they were given a volume of tasks which cannot be managed safely in the allotted time, and over 45% have been asked to expand work to non-routine or inappropriate areas.

Solutions are needed

The PDA believes that it is not enough for those in positions of authority to just highlight workforce pressures and say the regulator will be understanding when considering complaints. This approach could lead to normalisation of unsafe practices and continues to endanger the individual’s wellbeing.

The PDA reiterates the offer to work constructively with the government, employers, and others to find sustainable ways to reduce workplace pressure.

In the meantime, PDA members are encouraged to contact the PDA Member Support Centre if they have any specific concerns about workplace pressures, employment, or professional practice matters.

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