There are two major components to pharmacy workforce requirements: quantity and quality. Both feature in this week's issue. The quantity component is considered in a paper giving the results of a pharmacy workforce survey in the West Midlands (p909). The quality component is considered in our report of a Guild of Healthcare Pharmacists meeting, where a motion was debated calling for pharmacists to be re-examined every five years in order for them to continue to practise (p919).
Both components are, of course, intimately related. Changes in respect of one can greatly affect the other. For instance, the extension of the undergraduate course to four years in order to improve the quality of the output from schools of pharmacy will do nothing to improve recruitment levels in an already difficult employment market. Likewise, crude attempts to maintain standards among practising pharmacists could deplete workforce resources and compromise standards by requiring those that remain to work harder than would otherwise be the case. The West Midlands paper provides documentary evidence that many pharmacists already work long hours.
The key objective of any periodic re-examination, if that were introduced, would be to maintain appropriate standards in the interests of the public. There are, however, other ways of achieving this that do not amount to a professional steeplechase, with fallers at each fence. These are regular monitoring and appraisal backed up by audit. Indeed, this is what the Health Secretary (Mr Alan Milburn) has in mind for the medical profession in England (PJ, November 20, p807). He wants all doctors to participate in external clinical audit and to take part in an annual appraisal of their performance. Doctors suspected of poor practice would be referred to assessment and support centres, which would consider whether retraining was necessary and whether the General Medical Council should be notified. While such a set-up is not expected to be benign, it should be capable of dealing with poor performance in a timely and sensitive fashion.
For the time being, no such proposals exist for pharmacy. But there is clear recognition, as exemplified within the Pharmacy in a New Age document "Building the Future" (September, 1997) that standards of practice must be raised. The document calls for a review of professional standards and recognises a clear need to raise participation in clinical audit. Also recognised is the need for a full review of the Society's disciplinary machinery, which is something that the Society already has in hand (PJ, May 2, 1998, p622). Significantly, the Society's views on the form that new disciplinary machinery should take include the ability to order retraining or supervised practice.
Meanwhile, the workforce crisis continues. There are not enough applicants for the posts available, despite a growing register. The reasons for this are explored in the West Midlands paper. The paper would repay close study. Fresh insights into the working patterns of the modern locum pharmacist and of part-timers are provided. Perhaps the message is that, as the move to employee status continues, a growing number of pharmacists want control of their working hours. They want a life as well as wanting to be pharmacists.