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 Over the past 12 months vacancy rates in the community pharmacy workforce
have fallen. Even so, there are still reports of geographical recruitment “blackspots” across
the UK. In the hospital sector, the full impact of Agenda for Change
on recruitment and retention remains uncertain, but the number of locum
pharmacists being employed is reported to have decreased. An increase
in trend for a flexible workforce has been seen and, with the opening
of new schools of pharmacy under way, there is scepticism over whether
there will be enough preregistration places to accommodate graduates
in a few years’ time.
All that said, supportive, statistical information on the current state
of play of pharmacy recruitment and retention in NHS hospitals is still
unavailable. Collection of data for the annual “NHS hospital pharmacy
staffing survey” (which is carried out by the NHS Pharmacy Education
and Development Committee and looks at recruitment and retention of pharmacists
and technicians in all NHS hospitals across Great Britain) was put on
hold for the second year running last year, again because of Agenda for
Change. According to David Scott, regional training pharmacist for Thames
Valley and co-ordinator of the survey, an update to the 2003 survey is
about to take place this month and outcomes of the data collected are
expected to be published by early autumn.
Picture of the workforce across the UK
Although vacancy rates in the community sector have dropped over the
past year, there are still areas of the UK where recruiting pharmacists
continues to be problematic. East Anglia and the North East remain
such areas. Superdrug reports that it is increasingly seeing the recruitment
of pharmacists becoming more area specific and areas where the company
is particularly experiencing recruitment problems include the South
West, East Anglia and parts of the North East and North West coasts.
Boots The Chemists says that other areas where there is a significant
shortage of pharmacists, although not specific to Boots, include Lincolnshire
and the South West. Paul Stretton, the company’s human resources
partner for pharmacy, hopes that the opening of the new school of pharmacy
at the University of East Anglia in 2003 will help with the number
of pharmacists wanting to work in the area in a few years’ time.
At the other end of the spectrum, there are specific areas where there
are high numbers of pharmacists wanting jobs. According to Martin Crisp,
head of pharmacy at Superdrug: “There always seems to be a lot
of interest in London and surrounding areas where our concentration of
pharmacies is greater.” Rowlands Pharmacy has seen an influx of
calls from pharmacists in Glasgow and Manchester looking for work, and
there are currently no vacancies with the company in these areas. There
has also been an influx of pharmacists near schools of pharmacy, for
example, in London, Birmingham, Glasgow and Edinburgh, according to Karen
Wakefield, the company’s pharmacist recruitment officer.
Commenting on the situation in the hospital sector, Jennifer Dorey, chief
pharmacist and clinical director of medicines management at Oxford Radcliffe
Hospitals NHS Trust and secretary of the Association of Teaching Hospital
Pharmacists, which includes approximately 40 different hospital trusts
linked to 25 or more medical schools across the UK says: “Implementation
of the NHS plan over the past five years has generally resulted in increases
in the pharmacy workforce, but this has not been a consistent level of
increase across the country. For example, Thames Valley has generally
fared less well than neighbouring areas and this may reflect the relatively
challenging financial position within this strategic health authority.” She
adds: “Recruitment of preregistration trainees to newly qualified
pharmacists posts is becoming very competitive, with some applicants
deferring a decision on an offer pending the outcome of another interview.
This year we were unable to fill all our resident pharmacist places from
the first round of interviews.” In addition, recruitment of technicians
remains a challenge, especially in areas like Thames Valley where the
cost of living is high. Technicians need to be locally trained and SHAs
are not consistent in provision of supernumerary training posts and funding
for training and assessment costs. There is uncertainty over future funding
of national vocational qualification costs, Mrs Dovey says. Effects of Agenda for Change
The restructure of hospital pharmacist posts created by Agenda
for Change is still not complete in some trusts and this has resulted in
continuing
uncertainty in recruitment. In some trusts initial bandings have been
put in place but are subject to appeal and in others, “a substantial
minority”, initial bandings have not yet been declared, says
Dr Scott. Not knowing the new structures as a result of Agenda for
Change has made it hard for hospitals to advertise posts for pharmacists.
Mrs Dorey comments that Agenda for Change has been enormously time
consuming for both staff and managers. She says that at the Oxford
Radcliffe Hospital
the complexities of weekend working and pay protection arrangements have
resulted in a delay in pharmacists being assimilated, though some of
the job descriptions were submitted more than 18 months ago. In addition,
the uncertainty over grading outcomes has tended to slow down the movement
of pharmacy staff between trusts but this is likely to increase again
once the Agenda for Change process is complete.
Tony West, chief pharmacist, Guy’s and St Thomas’ NHS Foundation
Trust and immediate past-president of the Guild of Healthcare Pharmacists,
adds that although it is too soon to tell what the impact of Agenda for
Change on recruitment and retention will be, the significant salary differential
for newly qualified pharmacists still remains and has not been addressed
at all through Agenda for Change salary changes. NHS financial pressures
Mrs Dorey told The Journal: “The financial pressure in some trusts
has resulted in posts either being frozen or lost to meet savings targets.
In other trusts, strict advertising policies mean that the preferred
advertising mode for those trusts is now through local and national websites.
Pharmacists are still adapting to this change but this is an increasingly
successful means of recruitment.”
The number of locums working in the hospital sector has also “reduced
considerably” over the past year as most hospital trusts across
England are no longer employing them, as is the case at Oxford Radcliffe
NHS Trust. According to Mrs Dorey, this has been for financial reasons
rather than due to the availability of locums or the impact of the Royal
Pharmaceutical Society’s retention fees. Commenting on the expense
of locums, Dr Scott says: “Sometimes a basic grade locum may cost
as much as a head of department because of the agency fees.” He
adds that the effects of deficits in NHS budgets have also meant that
pressures caused by Agenda for Change are more severe because there is
no room to expand budgets.
Mr West comments: “The uncertainty over funding for the NHS, which
has been widely trailed in the national press, is not helping but it
is clear there will be a big push to avoiding the use of expensive agency
or locum staff.” Community pharmacy locums
It was reported in last year’s pharmacy recruitment feature (PDF 380K) in
The Journal (25 June 2005, p793) that established locums in
the community sector were beginning to look for permanent posts. So what
does the community
sector consider to be the situation a year on? United Co-op Health Care,
which now has around 230 pharmacies based across the Midlands, in the
north of England and southern Scotland, says that it has not seen any
evidence of locums preferring to come in-house, although Superdrug has
seen an increasing interest from locums when its vacancies have been
advertised. Martin Crisp, head of pharmacy at Superdrug, comments: “We
believe the uncertainty of forthcoming legislation around the responsible
pharmacist role and the increasing number of [potential] pharmacists
graduating from the new schools are leading to more pharmacists seeking
job security.”
Rowlands Pharmacy has seen some of its locums taking on permanent posts
with the company. Speculating on reasons for the switch from locum to
employee, Mrs Wakefield thinks that the changes to the structure of the
Royal Pharmaceutical Society’s Register and the implications of
being accredited for enhanced services may have both had an effect. “If
you are employed by a company we are more inclined to contribute towards
the training,” she says.
However, analysis of data from the 2005 pharmacy workforce census, conducted
by Karen Hassell, director of the Centre for Pharmacy Workforce Studies,
University of Manchester, and funded by the Society, shows only a 1 per
cent difference in the number of community pharmacists working as locums,
compared with data from the 2002 census (37 per cent for 2005 compared
with 38 per cent for 2002). The full report of the 2005 pharmacy workforce
census is expected later this month. Overseas pharmacists
Companies and recruitment agencies report looking overseas to recruit
pharmacists. Mrs Wakefield says that at Rowlands Pharmacy “we
actively recruit in Europe and have maintained the number of overseas
pharmacists employed with us”. She has, however, seen an increase
in enquiries from overseas pharmacists in EU countries during the past
12 months.
Boots has recently been approached by a number of locum agencies promoting
the recruitment of overseas pharmacists to work for the company as locums.
According to Mr Stretton: “Two agencies [had been] offering introductory-free
offers for [taking on] Polish pharmacists.” His main concerns about
this are the transfer of professional and clinical skills to UK pharmacy
and whether agencies test candidates on use of the English language.
Boots has a stringent process for recruiting overseas pharmacists and,
as well as testing English language skills, spends three months acclimatising
pharmacists into UK pharmacy. Mr Stretton told The Journal: “We
do not currently use, or plan to use, any locums from agencies ‘shipping
in pharmacists’ from overseas.” Of those agencies questioned
as to whether they test overseas pharmacists on use of English language,
two said that they did and one said that it did not.
So what do the agencies say? Although Mediplacements has not seen a difference
in the number of overseas locum pharmacists, agency Orion Locums says
that it has been looking at recruiting European locum pharmacists more
this year than previously. Paul Turner, managing director, Sterling Cross,
comments that there have been a lot of overseas pharmacists that have
been brought into the UK from Poland, Spain and the Czech Republic, mainly
by multiples.
From the hospital perspective, Mrs Dorey says: “The loss of the
reciprocal registration agreement with New Zealand and Australia from
1 June has meant a short-term increase over the past few months in the
number of pharmacists from those countries wanting to complete the one
month preregistration training, but is likely to have a negative impact
on recruitment from now on.” Moving between sectors
There is uncertainty about the movement of pharmacists between primary
care and secondary care, according to Dr Scott. With the reduction in
the number of primary care organisations being implemented at the moment,
the NHS Pharmacy Education and Development Committee “does not
imagine there will be a significant problem [with losing hospital pharmacists
to primary care] in the near future”.
However, there may be job losses involved in primary care mergers and
some community primary care pharmacists may even come back into the hospital
environment, Dr Scott says. A more flexible workforce
Flexibility in the workforce is on the rise, says Dr Scott. He explains
that previously, hospital pharmacy departments would have recruited
one person who perhaps would have stayed for a number of years, whereas
now a lot of people are interested in short-term contracts so that
they can, for example, go travelling or take study leave.
This means that hospital pharmacy departments have to be flexible
about whom they are prepared to recruit, he says. Although there
are costs
involved in maintaining such a workforce, there are also many advantages,
he adds. Influence of KSF on career progression
An integral component of Agenda for Change has been the assignment
of NHS
Knowledge and Skills Framework (KSF) outlines to NHS jobs. Although
such outlines provide a single system of pay progression across the NHS,
satisfactory performance against the KSF is not associated with pharmacist
grade changes.
Katey Hewitt, deputy chief pharmacist, and Barry Jubraj, lead pharmacist
for academic studies and professional development, Chelsea and Westminster
Healthcare NHS Trust, say that the KSF may have a positive effect on
the recruitment of hospital pharmacists. However, it may slow down progression
into senior pharmacist posts. Although they think that the introduction
of KSF will not affect whether pharmacists choose to go into hospital
pharmacy, if pharmacy departments integrate the KSF into the appraisal
and continuing professional development process, there will be a number
of benefits.
Mr Jubraj emphasised the importance of not viewing the KSF in isolation
since, eg, “a major reform is currently going on in the South East
of England regarding postgraduate diplomas which dovetails with the KSF
and will provide more structure to career progression”. The pharmacy
department at Chelsea and Westminster has begun to use the KSF as part
of the recruitment process.
Views from multiples: vacancy rates in the community
have dropped
Superdrug, with 224 pharmacies across the UK,
reports a significant improvement in the recruitment of pharmacists
in the past six months.
The company has a current vacancy rate of around 10 per cent — nearly
a 50 per cent improvement on last year’s figures — and
is currently mainly recruiting for pharmacy managers, although it
is also looking to recruit more relief pharmacists. According to
Martin Crisp, head of pharmacy at Superdrug: “Our pharmacist
turnover is currently fairly stable. This is a trend we expect to
see continue throughout the remainder of 2006.”
The company has internally restructured its pharmacist workforce
in the past year, which has involved the introduction of group pharmacy
managers (GPMs). Mr Crisp explains: “The GPM’s role is
to support around a dozen stores, providing local advice and expertise.
They are also a key point of contact for external agencies such as
primary care trusts. GPMs will typically spend one day a week out
of their base stores to achieve this.”
Boots The Chemists, which restructured its pharmacy workforce two
years ago to increase manager support, also reports that it is doing
better this year — both in terms of filling vacancies and retaining
pharmacists. According to Paul Stretton, human resources partner
for pharmacy at Boots, this may be because the company has recently
put a new training programme in place for both newly qualified and
established pharmacists. However, Boots is still actively looking
to recruit more pharmacists because of the need to deliver more pharmacy
services as a result of the new pharmacy contract.
Boots is expected to merge with AllianceUniChem at the end of July
and the merged organisation will retain 2,600 stores, each of which
will have a pharmacist central to the business. Commenting on the
effect of the merger on recruitment, Mr Stretton says that it will
create more posts for pharmacists in the future as well as “greater
career choices and opportunities to deliver community pharmacy and
the new features of the pharmacy contract”.
For Lloydspharmacy, “2005 was a very successful year in terms
of recruiting new pharmacists”, says Andrew Hainge, the company’s
resourcing manager. However, “there are still some pockets
where we experience recruitment difficulties, but these are usually
the remoter parts of the UK where pharmacists continue to be in short
supply. This is an issue that affects the whole pharmacy industry,
not exclusively Lloydspharmacy.”
The company made two changes to its pharmacy network structure last
year. It created a new role of senior area pharmacy manager, to provide
additional clinical support for pharmacy managers and pharmacists,
and has increased the number of area managers “to give greater
support to pharmacy managers and pharmacists, especially as a result
of the increased demands in implementing the pharmacy contract”,
says Mr Hainge.
The vacancy rate for pharmacists at Rowlands Pharmacy, including
long-term locums, has decreased from 22 per cent to 17 per cent over
the past year.
Karen Wakefield, pharmacist recruitment officer for the company,
says that this may be because some of the company’s locums
decided to become employees and the company also retained 10 of its
12 preregistration trainees who
qualified in 2005. The company is also experiencing far more calls
from both pharmacists and preregistration trainees for jobs at the
moment than this time last year. |
Views from a recruitment agency
Recruitment agency, Mediplacements, which
has recently been listed as a provider of the new NHS “Purchasing and supply agency
national framework agreement”, confirms that vacancy rates
for locum pharmacists are down this year — although the company
says that it is “making a good number of placements for technicians”.
Steve Porter, operations director, comments: “Bookings [from
trusts for locum pharmacists] are definitely down, principally
because of freezes resulting from NHS funding shortfalls.” He
adds: “As with the general trend in the NHS, more people
are taking permanent jobs, including candidates from overseas.”
The company says that the introduction of its loyalty scheme
last year has proved to be popular and although the use of MediPoints
is having a positive effect on retention, the effect on recruitment
is not huge. |
No guarantee of enough places for preregistration
trainees
The current opening of new schools of pharmacy
across England will “undoubtedly” have
an effect on preregistration places and recruitment in a few years’ time.
However, it is hard to say precisely what the effect will be, says
David Scott, regional training pharmacist for Thames Valley Strategic
Health Authority. The NHS Pharmacy Education and Development Committee
estimates that there will be 1,625 pharmacy graduates in England
and Wales this year and 2,543 graduates by 2010. “It is highly
unlikely that the hospital sector and probably the multiples in the
community sector will increase their training places substantially,” he
says. “Therefore, any additional places required, and there
will be a large number, will have to be met by the independent community
sector. In the past that has always worked in that as numbers have
fluctuated both up and down, the independent sector has taken more
or fewer students and almost all graduates have found employment.” However,
he is sceptical that this will continue to happen in a few years’ time.
So what is the Royal Pharmaceutical Society’s view? Peter Burley,
head of preregistration, says: “It is worth bearing in mind
that some of the prospective schools of pharmacy in the pipeline
will not be producing graduates for several years yet. For the next
few years at least we foresee a balance between graduates and placements
if current figures are extrapolated forwards. There are certainly
enough approved training sites for the time being, although there
is never a guarantee that any given site will take a trainee in any
given year. There may be issues around the relative capacity of the
different sectors. The Society is taking forward education and policy
development work to try to ensure that pharmacy education and training
remains fit for the future both quantitively and qualitatively.”
Looking at the short-term recruitment of trainees, Dr Scott comments
that the number of preregistration trainee places will be affected
by Agenda for Change. Under the new pay structure, the pay rise for
preregistration trainees is several thousand pounds and many hospitals
are finding that the full costs of taking on a preregistration trainee
are no longer being met by strategic health authorities, he says.
The outcome of this could be fewer students in the hospital system
for the 2007 intake. |
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The
Pharmaceutical Journal