Half of pharmacists warn not enough staff to ‘safely’ provide Pharmacy First

Just 4% of pharmacists feel confident that community pharmacies in England can deliver Pharmacy First services in addition to their current workload, according to survey data published by the Pharmacists’ Defence Association (PDA) on Friday (January 19).

The union said that “more than 3,500” pharmacists in employed and locum roles responded to its survey on the implementation of Pharmacy First between January 5-14, making it the “most substantive” report of “frontline pharmacist experience”.

It added that it had presented its evidence to NHS England’s (NHSE) chief pharmaceutical officer (CPhO) David Webb and “senior” officials in the Department of Health and Social Care (DH) on January 17 and “suggested changes” to the service’s rollout.

These include phasing in the seven common conditions covered by the service, giving the sector “more time to get ready” and “managing the associated marketing campaign and in this way reducing their exposure to abuse”, it said.

NHSE stressed that the service had been "welcomed by pharmacists" across the country.

Pharmacy First, safety second?

The PDA’s survey revealed that while the principle of Pharmacy First is strongly supported by pharmacists, the conditions that exist in the community pharmacy sector have zapped their confidence that it will be successful.

More than eight in 10 (84%) respondent pharmacists believed it could “improve patient care” if the Pharmacy First service was “properly introduced and resourced”.

But this confidence in the ideal of the service was balanced by pessimism linked to the current state of the sector.

Nearly nine in ten (87%) pharmacists believed that the service could “damage” the community pharmacy workforce if it lacked proper resources or was not properly introduced.

Just 5% of pharmacists responding to the survey were confident that they would be able to deliver Pharmacy First services alongside their current duties.

And even fewer respondents (4%) were confident in the ability of the sector “in general” to roll out the new service in addition to existing workload, with 70% saying that they were “not confident”.

According to the PDA’s survey, 49% of respondents said that there is not enough staff to “safely provide existing services” in community pharmacies, with 30% responding that they “sometimes” have enough staff, 20% saying staffing was sufficient “most” or “half” the time, and just 1% reporting that they “always” have sufficient staff.

One source of worry for respondents was that there has not been enough training prior to the launch of the new service next week - just 1% of respondents had completed “all of the training”, while 63% had completed no training.

When asked about training for the “rest of the pharmacy team”, 53% of respondents said that no training had taken place and 16% said that the training that had been given “was not enough”.

Respondents said that their “confidence in delivery” of the service would be bolstered by measures such as increasing the number of support staff, avoiding a “large-scale public awareness campaign” until the sector is ready, providing “appropriate training” with protected learning time and providing a second pharmacist.

And the PDA added that many of its members were “worried that the hurried launch, which will be widely promoted by a marketing campaign and referrals from the NHS, will result in an increase in their exposure to violence and abuse from members of the public whose expectations will have been raised”.

Contact your MP

The PDA called on pharmacists to write to their local MPs to warn them of the “severe” staff shortages in community pharmacies using a template letter it has produced.

“This vicious cycle needs to be broken,” the union said, adding that the “reduction in pharmacy staffing levels” has followed from government funding cuts.

The PDA noted that pharmacies will be provided with “funding for extra staff”, however it noted that its use was “not being monitored” by NHSE and that 70% of respondents to its survey reported there would “not be any additional staff” in their pharmacy to assist with the service.

“Welcomed by pharmacists up and down the country”

A spokesperson for the DH yesterday (January 22) said that it had met with the PDA to discuss its concerns about the service rollout and “highlight the support available”.

They stressed that “more than 93%” of pharmacies have signed up to deliver the service and that the government is providing “up to £645 million in additional funding to support Pharmacy First and help make sure community pharmacies have what they need once the service is launched”.

And an NHSE spokesperson told C+D that Pharmacy First “has been welcomed by pharmacists up and down the country”.

They said that the service’s rollout from next month “remains on track”.

Wellbeing worries

It comes after PDA chair Mark Koziol told MPs at the parliamentary pharmacy inquiry last week (January 16) about the ““deteriorating environment” in the sector, with government funding cuts, “massive staffing cuts”, rising dispensing volumes and other factors having “a huge effect” on workforce morale.

Earlier this month, C+D reported that the PDA had clashed with the General Pharmaceutical Council (GPhC) and Mr Webb over a joint letter that warned of “further challenges over the coming weeks and months…exacerbated by staff shortages due to sickness or caring responsibilities, as well as the ongoing industrial action”.

The PDA said at the time that “it is not enough for those in positions of authority to just highlight workforce pressures” adding that that their approach may “endanger” the wellbeing of pharmacists by normalising “unsafe practices”.

And in September, the regulator revealed that open cases had reached their “highest ever” level fuelled by an “increase in concerns” against pharmacists from members of the public which followed from “limited resources”, staff shortages and “supply chain disruption”.