Facing conflict with your colleagues
Disagreements often occur in high pressure pharmacy workplaces. However, when issues become more serious, higher management and external organisations may need to become involved.
Sarah went home in tears every day from her pharmacy job feeling constantly undermined by her boss. She felt humiliated at work and the relentless bullying and pressure was putting her home life under strain and affecting her health. She took advice from a specialist adviser at the Citizens Advice Bureau and decided to give up her job. She remembers: “I resigned because I felt I had no choice and, whatever the final outcome of my case, I can now begin to get my life back together because someone has validated what happened to me and is seeking justice on my behalf.”
John, who found himself the target of a bullying area manager, sought a different solution. After receiving increasingly aggressive emails and visits from his area manager, who complained that John was missing his medicines use review target, he went to the Pharmacists’ Defence Association (PDA) Union. He was advised to keep a diary detailing the events, and he sent copies of the most threatening emails to a senior manager. When the bullying continued, John lodged a formal grievance with his pharmacy superintendent who upheld his complaint, disciplined the area manager for gross misconduct and removed John’s pharmacy from the manager’s patch.
These two cases illustrate that workplace pressures or personality clashes can trigger conflict in the pharmacy. According to figures from the NHS staff survey published in February 2014, 23% of pharmacists had experienced bullying, harassment or abuse from another member of staff in the previous 12 months – compared with 22% of all NHS staff who found themselves in a similar position.
The PDA Union says 60% of the cases it deals with are disputes between employees or locums and their employers. “That’s why we moved into the union sphere in the first place because we wanted to guarantee good representation for our members,” says General Secretary John Murphy. More than 30% of cases are resolved following advice — only a few result in an employment tribunal.
Pharmacist Support, the charity that offers advice and support to pharmacists from across the sectors, says so far in 2014, 20% of its enquiries have concerned employment issues and, of those, 25% were associated with conflict such as discrimination, bullying, harassment or workplace disciplinary action.
So what are the current causes of conflict in the pharmacy and, given the climate of delivering more for less and the changing role of the profession, is conflict on the rise?
Pharmacist Support manager Diane Leicester-Hallam says the number of cases associated with conflict at work has stayed more or less the same in the past year. The charity has dealt with pharmacists who believe they have been deliberately set unrealistic targets by employers in an attempt to make them leave. Others have sought advice after changes to their terms and conditions were imposed on them, or they were bullied into returning to work early when they had been off sick.
Sometimes members just want reassurance that the way they are thinking is not an over-exaggeration
The member enquiry service run by the Royal Pharmaceutical Society (RPS) says conflict at work accounts for a handful of its calls. Professional support pharmacist Wing Tang — one of RPS Support’s nine-strong team — says pharmacists, like other healthcare professionals, have concerns about professional empowerment and workplace pressures. “Sometimes members just want reassurance that the way they are thinking is not an over-exaggeration. Our role includes explaining some of the options available and providing professional support so that members can identify how they might handle the situation,” he says.
Emma Doughty, senior employment law adviser at Ellis Whittam, which provides corporate support to National Pharmacy Association (NPA) members, says pharmacies are small places where people can easily tread on each other’s toes. “The issues are often general, but not always trivial — it can be anything from feeling a bit left out to somebody exploding because they are being criticised,” she says. “A lot of it is because they are working in close proximity. Grievances are probably in the top five issues that we deal with on behalf of pharmacy employers who want to know how they can manage the situation and restore harmonious relations.”
John Evans, superintendent pharmacist at the supermarket chain Asda, who is responsible for 520 pharmacists, agrees with Doughty that people can fall out over “petty things which fester over time”. He says if the tension is affecting other colleagues or the business then the line manager becomes involved and seeks advice from the store human resources manager. “I would only become involved if it was a professional matter or affecting customer service,” he says. “That doesn’t happen very often — maybe only once or twice a year.”
The ‘duty of candour’ dilemma
The final Francis report, which looked at the failings in care at Mid Staffordshire NHS Foundation Trust, was published in 2013 and has led to a lot of grievances, according to Kelvin Cheatle. Cheatle is a former president of the Healthcare People Management Association, which represents HR managers in the NHS, and a former workforce director at Broadmoor Hospital. “I think there are currently two issues — one is a concern about patient safety and the whole Francis report and [the second is] the duty of candour and more openness, which is creating an upward pressure for pharmacists, doctors and nurses to raise legitimate concerns about care in their organisations,” he says. “What that is doing is creating quite a spike in the number of grievances. It’s given people more confidence to raise concerns — the challenge is picking out the real from the fake.”
Cheatle says that some people may resort to lodging a grievance as a ‘cloak’ to cover up their own misbehaviour or incompetence: “A clinician, for example, might be challenged about their performance and come back with a counter-complaint and say ‘I am doing this because I am concerned about patient safety in this organisation’. The difficulty then is to identify the real issue — is it about the individual doing something wrong or does he or she have a point about what is happening in the organisation?”
Every 2–3% of cases raised informally in a trust will end up in a formal grievance, says Cheatle. “That means if you have 1,000 people you can expect to have 20 or 30 official cases on the go at any one time,” he adds.
Pre-registration trainees are especially vulnerable to being caught up in conflict in the pharmacy, according to Leicester-Hallam. “They may not feel able to speak out for fear of not being able to complete their training year and be signed off,” she says.
It is an issue recognised by Rob Darracott, chief executive of Pharmacy Voice which represents the NPA, the Association of Independent Multiples and the Company Chemists’ Association, who explains that trainees have not been through the traditional interview procedures. “Pre-registration trainees come via a different route and the pharmacist may never have met them before and they have got to get on — occasionally they don’t,” he says. In cases where trainees fall out with their tutors it has sometimes been possible to “swap people around” so they can complete their training, he adds.
Pre-registration trainees may not feel able to speak out for fear of not being able to complete their training year and be signed off
Transferring staff to other branches or NHS trusts is one option for resolving or reducing pressures but this is not always possible, especially if a pharmacist works for a small independent community pharmacy. “Large multiples will have access to human resource departments that can offer a range of support mechanisms to try and get over the clashes and, if the geography works and it’s acceptable, have the ability to move people around if the problem is intractable,” says Darracott. In smaller organisations without an in-house HR function, he suggests individuals should contact their trade association for advice and guidance.
Regardless of the size of the organisation, every employer is expected to follow the same advice and procedure in dealing with employee grievances. The basis of any dispute resolution should be modelled on the code of practice drawn up by the employment arbitration service Acas.
“Our advice is that you try and deal with a grievance before it becomes a ‘grievance’ — deal with the problem or issue on an informal basis before it has accumulated any weight,” says Mike Emmott, employee relations adviser at the HR professional association the Chartered Institute of Personnel and Development.
Initially, have a face to face conversation about the problem “somewhere where people can’t be overheard”, he says. If the issue remains unresolved, the employee should then make a written record of the grievance. “This defines what the issue is,” Emmott clarifies. “It’s the point of reference about how things have gone wrong.”
A meeting between the employee — who can bring a work colleague or a trade union representative for support — and employer should then follow. “The expectation is that the manager will have an outcome to the dispute within 24 hours,” he says.
If the employee is still dissatisfied, the next step is to appeal to a higher management level, at which point the individual should seek legal advice and potentially develop a case for an employment tribunal. But Emmott says this should be the last resort: “It’s not the favoured option because it takes time, and you may have to pay costs if you lose and were warned beforehand that your case had little substance.”
His advice is to speak to your trade union, your spouse or a friend: “Make sure you have things in perspective. You can also go to the Acas helpline. They deal with hundreds of thousands of calls a year — they will discuss all your options and it’s free.”
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066603
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