Tomorrow's Pharmacist October 2000 p9-13
Edited by Pamela Mason

Careers

Choosing your career

By Trudy Thomas, BSc, MRPharmS

The rapid pace of change is bringing more choice of careers in pharmacy…

This overview looks at the range of options, the salaries you might expect, together with the advantages and disadvantages of working in each of the different sectors of the profession.

Not so long ago, once you qualified as a pharmacist, you went into community, hospital or industrial pharmacy. Today the range of options is much greater and broadening all the time. While the majority of pharmacists continue to be employed in community pharmacy, opportunities exist to work in GP practices, health authorities and various clinic settings. This article outlines some of the possibilities.

Community pharmacy
Hospital pharmacy
Industrial pharmacy
Primary care
Education
Writing and editing
Prison service
Miscellaneous
Career breaks
Defecting

Community pharmacy

Most (ie, 60-65 per cent) of pharmacists in the UK work within the community sector, and about 7,000 independent pharmacists own their own businesses. However, the trend is for more pharmacists to become employees for larger companies.

The advent of supermarket pharmacies, with their long opening hours, is changing working patterns, and has created an increased demand for pharmacists. Consequently, there has recently been a move for more pharmacists to become professional locums in the last few years.

If you are interested in the business side, the larger companies offer structured careers, with promotion into management. Many larger companies will also support employees to obtain postgraduate qualifications.

Dispensing is still central to most community pharmacy establishments. There are opportunities for much patient contact, with responding to symptoms, counter prescribing and health promotion featuring as key activities. Most pharmacies will be keen to develop relationships with local surgeries and there may be extended roles for the pharmacists through this liaison.

A significant number of pharmacies offer services to residential homes, including the provision of medicines in monitored dosage systems. Additionally, local service contracts also require pharmacists to provide information and support to homes, giving opportunities to develop a more clinical role.

The advantages of working in community pharmacy are that:

• Working arrangements can be flexible
• If you are an owner pharmacist or a self-employed locum, you can have a degree of freedom
• Salaries tend to be at higher than in some other sectors
• Employees may receive other bonuses (eg, private health care, Royal Pharmaceutical Society fees paid, etc).

The drawbacks are that:

• Not all pharmacies have dispensing support staff
• Work is reactive and at times pressurised
• Hours may be long
• Some companies do not encourage lunch breaks
• The pharmacist must be on the premises at all times.
• You often work in isolation
• Self-employed locums must secure their own work (although agencies are available), and they must organise their own tax arrangements, sick pay, etc.

The current salary range is: £22,000 — £40,000 (managers of big retail stores may command salaries in excess of £60,000). The current locum rate is £15.50 — £16.00/hour for weekdays.

Hospital pharmacy

Currently, there is a huge manpower crisis — which has actually existed for quite a long time — in the hospital sector. Demand for hospital pharmacists is therefore great — within both private and NHS hospitals — at every level, from basic grade pharmacists to senior management positions.

Patient contact is high and there is a great opportunity for clinical activities. A and B grade posts — the lowest paid — are often rotational which means that the employee moves around the different hospital departments to gain experience in all aspects of hospital pharmacy. C and D grade posts usually involve some degree of specialisation.

Clinical services to wards are normally undertaken by more experienced pharmacists, who are usually required to have a postgraduate qualification. Specialties include radiopharmaceuticals, drug information, oncology services, manufacturing or quality control, discharge services or work within an individual directorate of the hospital.

It is also possible to work on the community services side of hospital pharmacy. This involves liaison with community trusts and supply of, for example, vaccines to surgeries and clinics. The community services team also has a role in nursing home registration and inspection, and is often involved in the training of community heath care staff.

Dispensing activities for inpatients and outpatients are usually undertaken by a regular team. However, other pharmacists within the department may be required to cover dispensing activities on a rota basis. On-call duties are an integral part of many hospital positions.

The advantages of working in hospital pharmacy are that:

• Flexible working arrangements, part time work and job sharing are encouraged.
• Career breaks are possible within the NHS in some circumstances.
• Specialisation is possible
• Some hospitals include on-site child care
• On-the-job time is often given for study
• There are good support staff, including highly trained technicians and pharmacy assistants
• There is a good career structure

The drawbacks are that:

• Salaries tend to be lower than in the other sectors, especially for basic grade pharmacists
• Employee status is the norm
• Staff shortages may make working pressurised.

Current salary ranges are:

• A/B grade £16, 000 — £20,000
• C/D grade £20,000 — £30,000
• E/F grade £ 28,000 — £40,000 (Higher salaries are available for the most senior posts)

Industrial pharmacy

About 1,200 pharmacists work in the pharmaceutical industry. Some also work in the cosmetic industry. Posts are likely to be advertised in the scientific press, rather than the pharmaceutical press. Graduates who start in the industry are often required to have a good degree. However, it is possible for pharmacists from other sectors to move into the industry.

Pharmacists are employed in many different aspects of the pharmaceutical industry. These include development, quality assurance, production, registration, marketing and research. Patient contact is minimal. Opportunities also exist in clinical trials as well as sales and medical information. Those involved in manufacture may have the opportunity to go on to attain qualified person (QP) status, allowing them the responsibility of the final “sign off” of materials prior to release. It is usual for industrial pharmacists to move around within these specialties as their career progresses.

The advantages of working in industrial pharmacy are that:

• A career structure is possible
• Travel may be possible
• The perks from working for larger organisations (eg, subsidised health care) are often available
• Some flexibility of hours may be possible

The drawbacks are:

• You may need to move around the country either within one company or between companies to further your career.
• Posts may be limited.

The current salary range is: £22,000 — £52,000++

Primary care

Pharmaceutical advisers have been working for health authorities for many years. Until recently their role mainly involved work with general practitioners. However, the development of primary care groups and trusts (PCGs/PCTs) has allowed many more pharmacists to work within primary care.

Many PCGs have appointed PCG pharmacists, and these pharmacists have a strategic role, for example, in budget setting, reporting to prescribing sub-groups and prescribing plan development. The role of these pharmacists may also include hands-on work, including working with individual practices to carry out such activities as generic switches, clinical substitutions and repeat prescribing review.

In some locations practice based work is being carried out by prescribing support pharmacists (PSPs). They may be either full or part-time or employed on a sessional basis. PSPs carry out work agreed by the PCG pharmacist (or the health authority adviser) and the practice. Some health authorities have used money top-sliced from the PCG budgets to employ PSPs, and all PCGs in the area can access these pharmacists.

Advisers and primary care pharmacists will be working closely with other health care professionals, so communication skills are essential. Cost control is an important part of the job. Many of these posts are being filled by those hospital pharmacists who have experience of budget setting and working with doctors. However, there is no reason why they cannot be filled by community pharmacists, simply because they have first hand knowledge of general practice. However, for most of these posts, you will need a minimum of three years post registration experience.

The advantages of working in general practices are that:

• Flexible working is possible
• You are not tied to one place, particularly if you are a PSP
• It is a chance to work with other health care professionals
• There is a chance to use and develop clinical skills

The drawbacks are that:

• There may be political constraints
• You are working in a new area and there is little experience to go on
• You are often working in isolation
• Travelling may be necessary

Education

After registration, some pharmacists choose to attain a higher degree. Postgraduate study, if undertaken within an academic institution rather than by distance learning, usually includes some work lecturing or supervising undergraduates.

Additionally, the number of teacher practitioner posts has increased in the last 10 years. These pharmacists work at the interface between practice and academia. The time commitments between the two sectors vary depending on the contract agreed by the university and the other partner, which may be a hospital, retail or pharmaceutical company.

Pharmacists are also involved in teaching technicians, other health care professionals and qualified pharmacists engaged in postgraduate studies. This may be on a full time or a sessional basis.

The advantages of working in academia are that :

• The work is varied
• There may be opportunities to pursue research interests
• There are opportunities for self development.

The drawbacks are that:

• Teacher practitioner posts are usually full time
• Travel between premises will be involved
• Divided loyalties and conflicting interests may exist.

The current salary range is £25,000 — £30,000

Research posts may be sponsored or attract a bursary. Students may need additional funding to pay for their studies.

Writing and editing

The pharmaceutical press, other medical and scientific journals, as well as the lay press, employ pharmacists as writers and/or to carry out editorial work. Medical writing may also involve preparation of scientific papers and documents.

Pharmacists working for the pharmaceutical press may be involved in covering scientific meetings or product launches or writing features and articles. Research will often be needed to support written work. Editorial work involves identifying, collating, and presenting suitable material. Writing and word processing skills are vital. While some travel to conferences and interviews may be required, these posts are largely office based.

The advantages of working in journalism are that:

• Some freelance work is available
• There exists the possibility to work from home
• There may be opportunities to travel and attend conferences and meetings
• The work is varied

The drawbacks are that:

• The majority of these posts are based around London and the South East.
• You have to work to deadlines

The current salary range is: £20,000 — £30,000. Higher salaries are available for senior posts.

Prison service

Currently, about 40 pharmacists work in the prison service. However, it is likely that more vacancies will develop in the future.

Prison pharmacists are responsible for the planning, co-ordination and delivery of pharmaceutical services to inmates, including both dispensing and clinical “ward” services. Most prisons employ trained technicians to assist the pharmacist.

The advantages are that:

• There is a chance to work closely with other professionals
• Opportunities exist for self development

The drawbacks are that:

• Career progression is limited
• Posts are currently limited in number, although vacancies do exist.

The current salary range follows hospital scales.

Miscellaneous

Civil Service There are about 100 posts within the civil service for pharmacists. These include scientific and administration posts within the Department of Health and assessors at the Medicines Control Agency.

Agricultural and veterinary pharmacy There is a shortage of pharmacists within this sector. Some positions are available in specific agricultural and veterinary pharmacies, and also within the veterinary products industry and the Ministry of Agriculture, Fisheries and Foods.

Career breaks

Most career breaks are taken by women for domestic reasons; indeed, most women will take an average of seven years off to raise their families. It is important for female pharmacists to plan their career breaks if they wish to maximise their career prospects. This includes planning the best time to make a break and how and when the return to work will take place. Some work places allow for an official career break, and a woman can return to her original job after a break of up to five years. The return will be phased and will involve retraining. There is, however no obligation for an employer to provide retraining.

Some women wish to return to work part time after their baby is born. The more flexible working environment within the community, hospital and primary care sectors may make these jobs attractive.

For women returning to work after a break it can be difficult to catch up on current practice. However, return to practice courses are available from the continuing education centres.

Many employers are now switched on to job sharing. For the employer this offers the benefits of a mix of people skills. For employees involved it can offer the chance to maintain a more senior post than if taking a part time position. Communication and setting parameters of responsibility for both partners is vital for smooth job sharing.

Defecting

Barriers between the different sectors of the pharmacy profession are gradually blurring. This should offer benefits to patients and other organisations, including PCGs, interested in improving working arrangements. The Centre for Pharmacy Postgraduate Education (CPPE) now offers some joint training, so the separate branches of the profession can learn together. Pharmacists with experience of more than one sector can offer real benefits to employers and enhance their own work experience.

These developments should mean that moving between different branches of the profession is easier. Manpower shortages are encouraging employers to think more laterally about the way vacancies are filled. Skills that transfer from one sector to another are now being recognised as valuable.

Mrs Thomas is a consultant pharmacist from Sittingbourne, Kent

Tomorrow's Pharmacist is an annual publication produced within the editorial department of The Pharmaceutical Journal

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