Low recruitment leads to NHS pressure

Casualty. Holby City. ER. With the white-coated world of the medicalprofession saving lives every night on prime time television, you wouldthink there would never be any shortage of would-be hospital heroes inthe real world

This article has been prepared by the SalvaDore to highlight its Workplace Pressure campaign


Workplace pressure

Casualty. Holby City. ER. With the white-coated world of the medical profession saving lives every night on prime time television, you would think there would never be any shortage of would-be hospital heroes in the real world.

Think again!

Liz Kay, clinical director for medicines management and pharmacy at Leeds Teaching Hospitals, says recruitment and retention of pharmaceutical staff is the most serious issue she faces, and the one which most significantly contributes to her workplace stress.

Not enough pharmacists

“There are simply not enough pharmacists out there to fill the roles in hospital pharmacy,” she says. “Pharmacy is much more patient-focused now than it was 10 years ago. Pharmacists’ roles have grown but employers don’t have access to sufficient numbers, particularly in specialist areas.”

Professor Kay is not alone. Since the launch of the Society’s Workplace Pressure campaign in January 2009, many online survey respondents and writers of letters to the Society’s President, Steve Churton, have spoken of the chronic shortage of pharmacists to fill positions in NHS hospitals.

It is a problem affecting even Leeds Teaching Hospitals which, since the merger of Leeds General Infirmary and St James’ Hospital in 1997, has gone on to have one of the most innovative and future-focused pharmacy departments in the UK.

Under Professor Kay’s direction the new, patient-centred service has developed programmes to support and extend its staff, and has been rated by the Acute Hospital Portfolio Review as one of 18 “excellent” services nation-wide. Yet there is no simple prescription for attracting and holding on to staff.

One reason, says Professor Kay, is the starting salary gap between hospital and community pharmacists. “There is easily a £10,000 difference. In addition, there is more flexibility and better working hours in community pharmacy. Many pharmacists graduate with huge debts — how can they pay them? That is a huge influence on junior pharmacists.

“What we provide in hospital pharmacy has grown into a seven-day service. We have to mix medicines in special environments away from clinical areas, we deal with a complex case mix and we need staff to work outside core hours.”

To best support pharmacists, Professor Kay and her team have taken an unusual approach to technical and support staff, with pharmacy technicians being purposefully trained to assume management roles.

In conjunction with Leeds University, Leeds Teaching Hospitals hosts a technical and support staff training unit, available through technical college and work-based training.

“Without that, we would have struggled. We have had to take a modern approach and create opportunities for technicians. We have a technician on our management team, which is not common. When I took this post a decade ago, pharmacists wouldn’t dream of prescribing. Now, pharmacists run their own clinics and much of their previous work is done by technicians and support staff.”

More needs to be done

But while Leeds Teaching Hospitals’ pioneering work in this field has given internal support staff a clearer career path, Professor Kay says more needs to be done by the profession as a whole to put pharmacy careers on school-leavers’ radars.

“Many school-leavers are not aware of the opportunities that exist; we need to make pharmacy more visible. We also need to be clearer with graduates about career opportunities and we need a consistent approach to training, from preregistration to advanced levels.

“Paediatric and oncology training programmes simply do not attract numbers.”

A cohesive, inclusive approach to pharmacists’ training would ease some aspects of workplace pressures in the profession, Professor Kay believes.

“We need to work with universities so undergraduates gain experience of hospital pharmacy, and we need to work collaboratively with the healthcare community — and by that I mean community pharmacy.”

Citation: The Salvadore URI: 10314373

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