Inside Tomorrow's Pharmacist (2003)

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Careers in pharmacy

Careers in pharmacy by Trudy Thomas

Most (ie, 60–65 per cent) of pharmacists in the United Kingdom work within the community sector, with about 7,000 independent pharmacists owning their own businesses. However, the trend is for more pharmacists to become employees for larger companies or to be self-employed locums. The advent of supermarket pharmacies, with their long opening hours, has changed working patterns and created an increased demand for pharmacists and made flexible working more widespread.

For those pharmacists interested in the business side of pharmacy, the larger companies offer structured careers, with promotion into management. Pharmacists who wish to concentrate on the professional side can also find positions to suit their interests. Many larger companies will support employees with postgraduate qualifications.

Dispensing is still central to most community pharmacies. There are opportunities for high patient contact, with responding to symptoms, counter prescribing and health promotion as key activities. Most pharmacies are keen to develop relationships with local surgeries and there may be an extended role for the pharmacist here . A significant number of pharmacies offer services to residential homes, including the provision of medicines in monitored dosage systems. However, local service contracts also require pharmacists to provide information and support to homes, giving opportunities to develop a more clinical role. Increasingly, community pharmacists have opportunities to work in conjunction with primary care organisations, on projects such as clinical governance, repeat dispensing, waste management or supply of medicines under patient group directions.

The advantages of working in community pharmacy are that:

• Working arrangements can be flexible

• If you are an owner pharmacist or self-employed locum you have a degree of freedom

• Salaries tend to be higher than in other sectors

• Employees may receive other bonuses (eg, private health care, Royal Pharmaceutical Society fees, paid study leave, etc).

The drawbacks are that:

• Not all pharmacies will have dispensing support staff

• Work is reactive and at times pressurised

• Hours may be long

• Some companies do not encourage lunch breaks

• You are often working in isolation

• Self-employed locums must secure work, although agencies are available, and they must organise their own tax arrangements, sick pay, etc.

The current salary range is:

• £25,000–£42,000 (managers of big retail stores may command salaries in excess of £60,000)

• Current locum rate — £17–£20 an hour for weekdays.

Hospital pharmacy

Demand for hospital pharmacists is great, within both private and National Health Service hospitals. This includes every level, from basic grade pharmacists to senior management positions.

Patient contact is high and clinical activities are at the fore. A and B grade posts — the lowest paid — are often rotational, which means that the employee moves around the different hospital sections to gain experience in all aspects of hospital pharmacy. C and D grade posts usually involve some degree of specialisation and may also have some managerial resp[onsibilities.

Clinical services to wards are undertaken by more experienced pharmacists who are usually required to have a postgraduate qualification. Specialties include radiopharmaceuticals, medicines information, mental health, oncology services, manufacturing or quality control, discharge services or work within an individual directorate of the hospital. There are also posts that are shared between primary and secondary care.

Dispensing activities for inpatients and outpatients are usually undertaken by a regular team. However, other pharmacists working 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 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:

• Salaries tend to be lower than other sectors, especially for basic grade pharmacists

• Employee status is the norm

• Staff shortages may make working pressurised.

Current salary range

• A/B grade £18, 000–£22,000

• C/D grade £25,000–£34,000

• E/F grade £ 32,000–£42,000 (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. 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. Those involved in manufacture or quality assurance may have the opportunity to attain Qualified Person (QP) status, allowing them to finally "sign off" products prior to release.

Pharmacists are employed in many different aspects of the pharmaceutical industry. These include development, quality assurance, production, registration, marketing and research. Opportunities also exist in clinical trials as well as sales and medicines information. It is usual for industrial pharmacists to move around within these specialties as their careers progress.

The advantages of working in industrial pharmacy are that:

• A career structure is possible

• There may be opportunities for travel

• There may be perks working for larger organisations (eg, subsidised health care)

• 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.

Current salary range

• £25,000–£55,000++

Primary care

The evolution of primary care groups and, lately, trusts has allowed many pharmacists to work within primary care. This is the fastest growing sector of the profession.

The majority of primary care trusts (PCTs) have pharmaceutical or prescribing advisers (although job titles are currently changing as part of the NHS reforms). These adviser pharmacists have strategic roles (ie, budget setting, reporting to prescribing sub-groups or to other professional committees, and prescribing plan development). They may also include operational elements, ie, working with individual practices to facilitate change (eg, clinical substitutions and repeat prescribing review, clinical audit, etc).

In some PCTs a purely operation role is undertaken by prescribing support pharmacists (PSPs) who may be full-time or part-time or may be employed on a sessional basis. PSPs carry out work agreed by the PCT pharmacist and the practice. Some practices employ pharmacists directly.

Primary care pharmacists work 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 filled by 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 with their knowledge of general practice. Some posts require a minimum of three years postregistration experience. There may be a requirement for a postgraduate qualification to be undertaken to support the role.

The advantages of working in primary care are that:

• Flexible working is possible

• You are not tied to one place, especially if you have a practice based role

• There is a chance to work with other health care professionals

• There is opportunity to use and develop clinical skills.

The drawbacks are:

• This is still a developing area of the profession and in some cases there is little experience to go on

• You may have to work in isolation

• Travelling may be necessary.

Current salary range

• Posts are usually graded as per hospital pay, with the majority of advisers at grade D or above.

Education

After registration some pharmacists study for higher degrees. Postgraduate study at this level usually includes some lecturing or supervision of undergraduates.

The number of teacher-practitioner roles has increased in the past 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, community pharmacy, pharmaceutical company or primary care organisation.

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

The advantages of working in academia are that:

• Work is varied

• There may be opportunities to pursue research interests

• There are opportunities for self-development.

The drawbacks are:

• Teacher practitioner posts are usually full-time

• Travel between premises may be involved

• Divided loyalties and conflicting interests may exist.

Current salary range

• £27,000–£32,000

• Research posts may be sponsored or attract a bursary. Students may need extra 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 take the form of preparation of scientific papers and documents.

Pharmacists working for the pharmaceutical press may be involved in news events (eg, covering scientific meetings or product launches) or features. Research may be needed to support written work. Editorial work involves identifying, collating, and presenting suitable material. Writing and word processing skills are required. Although 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 opportunity to travel and attend conferences and meetings

• The work is varied.

The drawbacks are that:

• The majority of these roles are based around London and the South East.

• You have to work to deadlines.

Current salary range

• £24,000–£32,000. Higher salaries are available for senior posts

Prison pharmacy

A number of pharmacists work in the prison service. Prison pharmacists are responsible for the planning, co-ordination and delivery of pharmaceutical services to inmates. Dispensing and clinical ward services are involved. Most prisons employ trained technicians to assist the pharmacist. Salary scales are generally the same as for posts in NHS hospitals. Responsibility for health care in the prison service was recently transferred from the Home Office to the Department of Health.

Civil service

There are about 100 posts within the civil service taken by pharmacists. These include scientific and administration posts within the Department of Health and assessors at the Medicines Control Agency (soon to be merged with the Medical Devices Agency to form the Medicines and Healthcare Products Regulatory Agency).

There are also a number of posts for pharmacists within the armed forces.

Agricultural and veterinary pharmacy

There is a shortage of pharmacists within this specialisation. Some positions are available in specific "ag and vet" pharmacies, and also within the veterinary products industry.

Making a break for it

The majority of career breaks are taken by women for domestic reasons. Most women will take an average of seven years off in total 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. The 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 do this.

Some women wish to return to work part-time after their babies are born. The more flexible working within the community, hospital and primary care sectors may make these jobs attractive. Some larger companies offer flexible parenting contracts.

It can be difficult for women returning to work after a break to catch up on current practice. 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 the 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

The pharmacy profession as a whole is trying to blur the barriers between the sectors of the professions. This should offer benefits to patients and other organisations interested in improving working arrangements, eg, PCTs. The Centre for Pharmacy Postgraduate Education now offers joint training, so the separate branches can learn together. Pharmacists with experience of more than one sector can offer real benefits for employers and enhance their own working.

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

This is an exciting time for pharmacy as a profession. The rapid pace of change is bringing more choice for working and types of career for pharmacy graduates.

Whatever path you decide on — Good luck!