Hemant Patel
Many pharmacists are complaining of stress and prolonged level of stress leads to serious health and wellbeing problems. There is evidence that the stress levels are increasing due to changes taking place within the NHS. As all professions are experiencing work-related stress in increasing amounts, pharmacy must take action. Stress is a significant barrier to making pharmacists’ happy and healthy. All pharmacists and employers must be concerned about taking the three main pillars for happiness and health seriously and have a plan to improve emotional health, physical health and financial health.
‘Work-life balance issues are endemic to corporate life,’ said Husemeyer, Google’s lead for ‘Optimise your life’ initiative which is part of employee benefits programme. He also added ‘everyone needs to take responsibility for their own work-life balance.’
In health care, there have been several studies confirming a relationship between the wellbeing of healthcare staff and the quality of healthcare that patients receive.
Public Health England promotes the national Workplace Wellbeing Charter, which is endorsed by NICE. The charter ‘is a way of showing your commitment to the health of the people who work for you’, providing a framework on how to make workplaces safe and productive places to work, and an award to aspire to.
Recognising this the NHS, as an employer, is taking the needs of the staff more seriously than ever as staff health impacts on quality of care for patients.
It says, ‘Everyone should feel able to thrive at work. That is why we are working with NHS England and NHS Improvement to offer increased support for NHS staff to improve their health and wellbeing. The launch of the NHS Health and Wellbeing Framework sets out the standards for what NHS organisations need to do to support staff feeling well, healthy and happy at work. The framework focusses on:
Organisational enablers – the essential leadership, structural, cultural building blocks for improving staff health and wellbeing. This includes leadership and management, data and communication and healthy working environments.
Health interventions – the core health areas to focus support for staff. This has been informed by research on the leading causes of absence due to poor health from NHS organisations.
It has been reported that four times more GPs than expected contacted the NHS GP Health Service to seek help for mental health and addiction problems in the first two weeks of its launch. The ‘GP Health Service’ which opened at the end of January 2016 as a dedicated service to support GPs with mental health and addiction problems, and was one of a host of measures announced to help alleviate pressure on general practice was a direct result of the pay settlement following GP Forward View.
Before its introduction, many GPs felt they had nowhere to turn to seek help, feeling that their medical reputation could be at risk if recognised by colleagues or patients at mainstream NHS services.
As important is also a commitment of £19.5m (£16m of which is new funding) for a new national service to provide GPs with free access to mental health and support, which has been available from December 2016. This is long overdue and will hopefully help to address soaring levels of stress and burnout in the GP profession.
What is good and necessary for the GPs should also be good and necessary for community pharmacy and I demand that the new contract for community pharmacy includes adequate resources for the same framework as the NHS to be implemented in community pharmacies. That NHS Health & Well-being Improvement Framework is an interactive document that makes the case for staff health and wellbeing, sets out clear actionable steps and provides guidance on how organisations can plan and deliver a staff health and wellbeing plan. It should also focus on a positive approach that complements the traditional focus on illness, stress, depression, and burnout, as well as recognising pharmacists’ resilience as a resource in the context of work pressures. And, as such, should become part of the new contractual framework for community pharmacy.
Community pharmacy, like GPs, and as NHS providers have an independent contractor status and should make a strong case based on precedence and evidence of stress and negative impact on pharmacy users care in community pharmacies. And, an important condition of the granting of the contract should be that the contractor will adhere to all the conditions including the NHS framework so that pharmacist health and wellbeing is also delivered to the same standard as GPs and NHS employees.
Symptoms of stress in pharmacy
It is well known that stress can affect how you feel emotionally, mentally and physically, and also how you behave.
There is anecdotal evidence of pharmacists drinking or smoking more, snapping at colleagues and customers, and withdrawing into a shell. There are also reports of difficulty in concentrating, constantly worrying and having difficulty making decisions. I know of a case where a pharmacist had two car accidents in a week.
What makes pharmacists stressed?
Whilst there is anecdotal evidence of stress overwhelming working pharmacists everywhere RPS as a professional body nor contractors’ organisations (PSNC, NPA, CCA and AIMPs) appear to have not done anything to take action which would highlight the soluble problem to the NHS with a view to secure similar resources to GPs or taken steps to help pharmacists.
Impact of Mental health issues in general
Across all sectors, around a third of new incidences of ill health at work are due to work-related stress. An average of 31 working days is lost for each case of stress – several times the average time taken off for sickness per employee per year. Across all employers the HSE reports that stress, anxiety and depression are estimated to account for 12.8m self-reported working days lost each year. This is not a problem the NHS nor pharmacy can ignore. There are enormous costs to the NHS of work-related stress: around 30 per cent of sickness absence in the NHS is due to stress, with a bill to the service of £300-£400m per year2. However, stress can also contribute to accidents and errors by employees, low morale and poor performance. It has a significant impact on the well-being of staff, their productivity and effectiveness.
Employer’s responsibility and workplace stress and the courts
There have been a number of cases of work-related stress which have been examined by the courts. Although every case is different, some general points have been made by the courts which should provide guidance for employers.
Employee responsibilities
Under the Health and Safety at Work Act 1974, employees also have a duty to be responsible for their own health and safety at work and that of those around them. employees should be encouraged to become knowledgeable about stress.
Time is up for inaction
There hasn’t been enough thought or investment into the provision of health and wellbeing care for pharmacists and education and communication about the benefits of investing in the best way for all pharmacists including employees. I will work tirelessly to correct this omission that is important for valuing our professional input as pharmacists and for sake of equity in the NHS workforce.
RPS must take appropriate and timely action to help improve patient care
As an elected member of RPS’s EPB, one of my first tasks is to secure a debate about the devastating impact of stress in pharmacy and mobilise action. A special focus on community pharmacy that has an independent contractor status with the NHS and so is out of the direct remit of NHS is also needed to help the largest pharmacy workforce. Many pharmacists are grossly underpaid and have no benefits of any kind, especially if they are locums.
RPS, as a professional body with a Royal Charter, has no direct role in negotiations about payments for community pharmacy services, however, it has a clear role in ensuring that factors that affect quality of service offered by pharmacists are taken into account and systems are designed for excellence as described in the national Workplace Wellbeing Charter. The shape of the contract and stress at work both undermine that quality and so, RPS must act with urgency to protect the public interest as well as the professional interest. Health and wellbeing of pharmacists should now be a part of the remit of the newly appointed Director of Pharmacy and Membership Services. I suggest that the title is changed to Director of Pharmacy and Pharmacists Needs to clearly articulate the focus on pharmacists’ broader needs including services.
Hemant Patel, FRPharmS, DipPharmacol, M.I.Mg is a community pharmacist, RPS board member and four-time former president of the RPSGB.