Ross Ferguson
THE recent story in the Guardian newspaper has raised some significant issues, but it’s important not to get distracted by the headline about MURs, or single out one company.
Community pharmacists are enduring severe workplace pressures and there appears to be no help for them – that’s the bottom line. Moreover, this pressure is being amplified by professional expectations (GPhC Standards) which get trotted out as if it’s simply a case of standing up, being professional (by refusing to work in the conditions) and the issue will simply vanish as management comply to appease disgruntled workers.
That simply doesn’t work.
I know of pharmacists who are at the end of the line: emotionally, physically and professionally as a result of the perpetual stress and lack of support, which threatens to wrench them from a profession they hitherto loved. They have spoken to management many times and have been labelled trouble makers for raising concerns.
One can argue that pharmacy businesses are only trying to claim back money that they are due as part of the global sum, without which they would be out of pocket (after all MUR money isn’t new money) but at what expense? This is a symptom of an underfunded pharmacy network, but it doesn’t justify it. Things aren’t going to get any better.
Mark Koziol, chairman of the Pharmacists’ Defence Association (PDA) has it spot on, the profession is in self-denial and the workplace pressure problem has been swept under the carpet for too long. It makes uncomfortable reading, but it’s time these pharmacists got the support they deserved and the perpetrators were called to account, or patient care will continue to suffer.
And let’s not make this about employers (contractors) being evil and employees being good, or myopically focus on MURs – it’s much bigger than that.
What we need is robust and determined professional leadership to tackle this serious issue head on. And we need it now.
Workplace pressure isn’t helped by threatened cutting of funding. If we are to take on more work it won’t be alleviated by technology. If robots were reliable we’d be using them but they aren’t- ask Pharmacy2U.
Remunerated services are incentives to perform those services and quite properly pharmacy owners wish to contribute but also to be paid. The worry is the quality of these services when they are seen as a tick box exercise and dumbed down to a format where they are performance managed by bean counters and their non clinical squads of management.
The issue is clinicians facing workplace pressure from non clinicians. Services, including MURs are not the problem but are they audited? I’ve never been asked to produce my signed consent forms. Dentists have cosmetic surgery targets in some large practices, GPs had QOF and many medication reviews were carried out by receptionists over the phone when patients asked for repeats, some opticians have targets of designer frame sales.
The corporatisation of clinical services by big organisations is the issue. Not the services themselves and professional autonomy must be wrested back by all representative bodies if the tax payer is to have confidence in any professional service. Adequate levels of appropriately trained support staff, in pharmacy, would be a good start
This piece hits the nail on the head, Ross. It’s exactly why the friend I referred to in my in my comment on Marvin’s video (https://pharmacyinpractice.org/2016/04/12/community-pharmacy-expectation-vs-reality/) became so disillusioned within a year of qualifying. I think many pharmacists feel stuck between a rock and a hard place, squeezed from both sides by their employer and their professional obligations to patient safety. I know of pharmacists who have been blackmailed by their employers to perform unnecessary MURs and if they don’t meet their targets they’re threatened with being reported to the GPhC for totally fictional breaches of our professional standards, especially if they have whistle-blown. I even know a pharmacist who is now working as a dispensing assistant instead because she got so I’ll with the stress of the latter situation. Having discussed the Boots articles in the news with the friend I mentioned, we both agreed that if the GPhC, in asking for the evidence from the survey behind the articles, thinks the problem is limited to Boots then it is in denial, as you say. My friend moved from one company to another and found exactly the same situation with MUR pressure, so I fear her next move will be to leave the profession. I’m pleased that fellow pharmacists are now feeling a little braver to stand together to talk about this problem openly, though we need stronger representation by our professional body than just a press statement. I love our profession but there are huge problems it needs to address. Thanks for an honest article.
The GPhC have had abundant evidence of what’s going on and include a question about targeted services in their inspection report. PDA has repeatedly complained to them and supplied evidence.
What have they done?