'Community pharmacy's decline reminds me of The Emperor’s New Clothes'
A recent shift in a community pharmacy got Chris Grahame thinking about how long it will take for the sector to realise it is exposing its problems for all to see
I currently work in a very progressive and empathetic GP surgery in the east Midlands as a senior clinical pharmacist.
I’m honoured to be one of over 4,000 pharmacists and pharmacy technicians currently working within a primary care network, professionally fulfilled, valued and making a huge difference to patients and their carers.
I know that every single day in the surgery, I help to reduce the workload while providing additional specialist resource to a primary care organisation.
I work in a defined healthcare setting, I’m treated with respect, I have good working conditions, a salary that is appropriate given my training and qualifications, protected training time and an abundance of development opportunities.
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In addition to this role, I support the Centre for Pharmacy Postgraduate Education (CPPE) with the primary care pharmacy education pathway while undertaking regular shifts for a high street pharmacy multiple.
At one stage in my career, I walked away from community pharmacy only to find I needed the income stream and flexibility afforded through locum work.
I vowed to always stay in touch and up to speed with its processes and procedures.
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I recently did a shift at a local branch of the high street pharmacy chain, where I was tasked with running the COVID-19 vaccination hub.
Over lunchtime, the hub closed so I wandered over to the healthcare counter and up the three steps into the dispensary. There, I bumped into an experienced colleague we'll call Luke.
Working alongside Luke has been really insightful.
I’ve known him for many years and spoken on many occasions, but I’ve never really chatted at any length with him.
“So, Chris, how’s it going in the practice?"
This single open question sparked an in-depth discussion about the perilous state of community pharmacy.
Luke and I compared in detail how the working environment in general practice is the polar opposite to community pharmacy.
The constant pressure to hit targets and profit margins as well as the necessity to work weekends and bank holidays represents an ongoing struggle for pharmacists and counter staff.
“You know what it is though don’t you?" Luke asked me. "Community pharmacy is just like The Emperor’s New Clothes. Things are so bad at the moment with funding cuts, work stress and huge pressures that loads of pharmacists and technicians are leaving to work in primary care.
"It’s right in front of us but no one is openly coming out and admitting it."
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After completing the last of the COVID-19 vaccinations, I returned to the dispensary later that day to support the team, arriving with the afternoon delivery that contained four separate controlled drug packages.
Although not nominated as the responsible pharmacist, I started to check and enter the controlled drugs into the register.
Mid-calculation, I was distracted by a patient asking, “Is anyone serving?”
I politely replied: “Do you need anything from behind the pharmacy counter? If not, please could you pay over on the main tills, as I’m midway through the afternoon order?”
This prompted a rather indignant “I came over here as there’s [a] massive queue!” before the lady indignantly stormed off to the other side of the pharmacy to pay for her shampoo and conditioner.
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I didn’t really process this interaction until several days later. Attempting to take a paradigm shift and view things from the customer’s perspective, I could see why she would want to pay quickly and not queue.
However, was it a reasonable expectation that a member of the pharmacy team should stop immediately to take payment for a retail item?
Comparing the situation to my day job I wondered if a patient would interrupt and be allowed to interrupt a doctor or practice nurse mid-consultation to ask about a repeat prescription?
It has long been my assertion that as pharmacists, technicians, trainee pharmacists and dispensary assistants, we are healthcare professionals operating in a healthcare environment, albeit in a small section of a larger retail footprint.
This all leaves me with two nagging questions: do patients and the general UK public simply consider community pharmacy an extension of a retail environment? If so, what can be done about it?
Chris Grahame is a senior clinical pharmacist, independent prescriber and a CPPE pathway mentor
