Workforce
Solving problems
From Mr N. Sodha, MRPharmS
SIR,-Despite the number of pharmacies being relatively static in the past few years, there has been an acute shortage of pharmacists in all sectors of the profession. Clearly, all stakeholders need to reflect on how to resolve this situation, especially with the impending fallow year.
The most obvious reasons for this shortage is the advent of supermarket pharmacies with extended hours, a greater number of women pharmacists, a lesser number of independents (which tend to open longer) and the emergence of practice advisory pharmacists. Measures that seem to be taken are attracting pharmacists back to work, getting them to work longer, "importing" some and possibly "over-employment" by the larger multiples. I believe that at least one of the following options is also worth exploring by all decision makers:
- 1. Hospital pharmacy outpatient dispensing should be reduced or abolished. The role of the hospital pharmacist is a specialist one, and as such this should not be over-burdened with mundane, original pack dispensing. There is already a very good distribution of community pharmacies so the patient would not be disadvantaged. It can be urgued that the hospital system buys its drugs much cheaper. This can be compensated for by following a general rule of five- or seven-day supply for all outpatient prescriptions, which will generate savings in the supply chain and professional staff time. And, as regards the global effect on the National Health Service, whatever discounts that the community pharmacies get are taken back in the form of discount claw-back anyway. This seems to be a win-win scenario for the patient, pharmacy departments, and health authorities.
- 2. For various reasons, the emergence of practice advisory pharmacists has been very good for the profession as a whole and, one hopes, the patient and the Department of Health. However, decision makers need to consider innovative solutions to finding these pharmacists rather than just attracting them from hospital pharmacy departments or providers of clinical diplomas and training. There are various dual roles that can be combined in settings of low volume dispensing such as essential small pharmacies or be performed in quieter periods in pharmacies. These can be shared costs.
- 3. Training meetings should be combined with those of GPs in local settings. This would increase professional interaction, enhance skill profiles and be in keeping with the principles of clinical governance. Formulary development needs to be shared within the existing national framework of the National Institute for Clinical Excellence and local health improvement programmes with the use of websites, such as the generic PrivateRx or the multidisciplinary Healthnet.co.uk to avoid duplication of work.
Some of the above initiatives are probably already happening but, if followed nationwide, every aspect of pharmaceutical care should benefit, including solving in part the current pharmacist shortage.
Nitin Sodha
Redditch, Worcestershire