Last month the UKCPA asked its members about their personal experiences of work-based pressures and the impact these are having on their health and well-being. We received a range of responses from colleagues working in various areas of practice. These responses were analysed using a thematic framework approach and we identified three key themes which are explored in more detail below.
Workload unmatched by resources
This theme has several components. Firstly, there is an issue of volume of work. Individual pharmacists are being asked to care for more patients, and the increased use of more medicines with more complicated monitoring profiles means that patient reviews take longer. In addition, length of stay reductions and increased bed occupancy means that there are no ‘quiet’ days with opportunities to catch up.
The impact of this is not related to the individual’s willingness to work hard; rather, the impact is the anxiety that they may ‘miss something’ or do not have time to see the patients they need to see.
Secondly, the volume of work results in it over-flowing into rest periods of lunch breaks and finish times. This is not limited to physically getting work done, but also to the emotional burden: pharmacists are finding it difficult to switch off because of the lack of breaks and longer working days.
Pharmacists are finding it difficult to switch off because of the lack of breaks and longer working days
Finally, there is a recognition that the profession is somewhat a victim of its own success. The desire to become part of the multidisciplinary team and to extend roles has led to increased expectations from other professions and management. For example, new roles which started as funded pilots may not receive ongoing financial support, and yet these roles are difficult to withdraw once they have been established. In addition, pharmacists are taking up tasks from other members of the multidisciplinary team and are under pressure to prescribe outside of their scope of practice. Practitioners find it difficult to decline these tasks because they know that they are right for the patient, but this results in individuals being overloaded.
Practitioners reported several non-clinical skills that seem to be lacking within the pharmacy workforce. At a personal practice level, they identify a need for practical training in finance, business case development and commissioning. In addition, they recognise that skills in resilience, coping strategies, assertiveness and delegation are needed to equip the modern pharmacist for life in practice.
There may also be a skills gap in pharmacists working as managers. Pharmacists reported experiencing behaviour from managers which contributed to their work-based pressures. For example, managers not listening to staff who try to flag up issues, adding workload to the same individuals, and not evaluating the impact of one project before starting another. Others felt that their managers undervalued the team and had unreasonable expectations of them.
The generation divide
Respondents included both foundation and advanced practitioners, and there were some clear differences in experiences of work-based pressures. Foundation pharmacists believe that a diploma qualification is necessary in order to gain skills. However, working whilst completing a diploma is stressful and sufficient time is not provided during work to support the studying.
In contrast, experienced practitioners report that foundation pharmacists appear unwilling to spend time gaining basic skills due to a desire to climb the career ladder. They perceive that they would rather undertake extended roles than support core services on wards and in the dispensary. Both generations reported stress being caused by these experiences.
The issue of mental health and well-being and the impact this has on individuals and their ability to practice is now being better recognised. The UKCPA is keen to ensure that we play our part in supporting our members to protect their mental health and equip them for practice in the 21stcentury.
We are very grateful to those who took the time to share their experiences with UKCPA and we will use this information to develop a questionnaire in order to seek a better understanding of the issues which have already been raised. Results from this survey will help us to shape the member services we offer in the coming years.
If you would like to talk with someone directly or more urgently about pressures you are experiencing, we would recommend contacting the charity Pharmacist Support for advice: www.pharmacistsupport.org
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.