As all InPharmacy readers know, the community pharmacy sector across the UK is under great strain from the coronavirus pandemic and several other, structural factors.
Many pharmacies are struggling to maintain full services in the face of relentless pressure and an ongoing shortage in the workforce.
Phil Galt, Managing Director and Superintendent Pharmacist Lindsay & Gilmour, which has 31 pharmacies in Scotland, gives his candid thoughts on the current pressures and how it’s affecting his pharmacy day to day…
Phil Galt on pharmacy services
“We've had the challenge of a reduction in the level of service and accessibility of GP services to patients due to the pandemic.
“The general public are seeing a relaxation of many controls that were in place at the height of covid. They can’t get through to GPs and when a GP does issue a prescription they expect it to be ready almost immediately. Patients have little understanding or even awareness of what’s facing pharmacy. We’ve certainly see an increase in the level of abuse from the general public.
“One of our pharmacies in October had over 25,000 phone calls incoming. There's no way they could answer that many calls. Many of them are trying to get through to GPs and can’t so they ring the pharmacy. As a result we’ve had to implement voice routing systems to manage the volume of calls. When it comes to Pharmacy First [NHS scheme] we’ve had evidence that some GPs are not triaging patients appropriately but are sending these patients directly to the pharmacy for an Pharmacy First assessment.
“Everyday we’re looking across our business and saying ‘have we got enough pharmacists to open the pharmacies? Have we got enough staff?’ We've also got the continued issue of people being forced to isolate when they’ve had contact with a positive case, so that adds further challenge into the mix of it all. It's incredibly challenging without a doubt.
“Compared to other settings, we don’t have an option to reschedule workload. To reduce the number of walk in appointments. In a community pharmacy we can’t tell patients 'we’re not dispensing medications today, because we haven't got any staff’, you'll need to come back tomorrow.' That’s the issue we have.”
Phil Galt on key challenges on workforce
"We currently have challenges securing pharmacists and support staff including locums. Like many other sectors we are struggling to recruit qualified pharmacy support staff so we're having to recruit people and then train them up which creates a lag and affects the skill mix in the pharmacies. I would say 2021 was even worse that 2020 at the height of the pandemic.
“Our existing staff are battered and bruised – and that’s an understatement. But I would say they are amazing and have been absolutely exemplary. I can’t praise them enough.
“We’ve seen pharmacists and technicians moving into primary care from community pharmacy in the last three-four years. We've seen this historically but it shows no sign of stopping. There’s not enough technicians and dispensers coming into the community pharmacy sector and many are going to work in other settings. The flow to primary care is impacting the sector. Community Pharmacy Scotland called for a pause on recruitment to these posts but I don’t see any change.
“Last minute absences due to COVID has meant we are pay higher rates for locum pharmacists, that's not sustainable for our business. I'm aware that some of the larger multiples are closing pharmacies. We’re not there yet but we are in close discussions with our local NHS Board to make sure they are aware of the challenges local contractors are facing. I believe we will see an increase in pharmacy closures - it’s inevitable. My concern is the potential impact on patients. The impact on patient care is the biggest concern for me.
“The solution for me? There needs to be an absolute halt to recruitment to these posts into secondary and primary care. There needs to be a realisation from government of the additional costs to pharmacies. I know we have a better funding situation in Scotland than England but these increased staff costs are going to have to be managed. Locum rates in Scotland have more than doubled recently, more so than other areas of the Country.
“If we don't have a sustainable community pharmacy network it will impact on patients, and this will certainly have impact other services. The Boards simply cannot keep taking qualified staff out of the network.”
Phil Galt on public behaviour
“Our staff are exhausted. In 2020 we had a peak of the pressures, but it’s never stopped and just carried on. Also when our neighbouring pharmacies are closing we end up having to deal with their patients and end up getting the abuse.
“We’ve recently employed security guards to work in three of our pharmacies, managing queues, and customer behaviour One of our staff was nearly assaulted, this just illustrates how bad it has become. It’s dire.”
The NPA is continuing to have conversations UK wide and with Scottish pharmacy stakeholders to seek ways to improve the current pharmacy workforce situation. To promote working in community pharmacy as a pharmacist or pharmacy support staff in Scotland, the NPA worked collaboratively with the Company Chemist Association to produce the Community Pharmacy – A career choice in Scotland resource.
If you are worried about workforce and retention in your pharmacy, please email any concerns to Helga Mangion at [email protected]. If you prefer to talk over the phone, please let us know and we will arrange a suitable time with you to discuss the issues.