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Employment

How many pharmacists is too many?

Pharmacists who delve into a new thought-leadership paper from the Royal Pharmaceutical Society will learn how complex the workforce dilemma has become

How secure do you feel in your choice of career? Do you think you would easily get a new job if you left, or lost, your current one? Does pharmacy still seem like an attractive pursuit for those entering the profession?

The spectre of a crisis in pharmacist numbers — too many graduates, that is — has been growing steadily, as news and letters in The Journal would testify. Pharmacists are worried. Indeed, workforce concerns were prominent in the latest Royal Pharmaceutical Society membership survey, which took place earlier in the summer.

Workforce was the number 1 concern among the nearly 2,000 survey respondents, across all categories of membership. By sector, it was the number 1 issue chosen by pharmacists working in hospitals and community pharmacy. And workforce concerns came out on top from early through to late stages of pharmacists’ careers.

And pharmacists are right to be apprehensive, if the views of Christopher John, workforce development lead at the RPS, are anything to go by. “There is great concern that there will soon be insufficient jobs for pharmacists in Great Britain,” he says. “The number of schools of pharmacy has more than doubled over the past 10 years or so. Consequently, MPharm student numbers have grown at a similar rate and the General Pharmaceutical Council’s Register has, by and large, seen year on year increases in the number of pharmacists. The situation could be described as a dripping tap that has slowly been filling a jug which is now almost full and about to overflow.”

In recognition of the problem, the RPS has this week published a thought-leadership paper — “Options for controlling entry to the pharmacy profession” (see News) — which describes ways that pharmacist numbers might be managed. Drawing on expertise from the RPS’s Education Expert Advisory Panel and Education Reference Group, the document brings together the views of members in different sectors on the likely benefits and risks of each approach.

The dilemma

The solution to a potential oversupply of pharmacists will not be a simple one. “Some pharmacists have called for pharmacy schools to close,” Mr John says, “but education is increasingly becoming more globalised. For instance, there is nothing to stop GB students studying at a university within the EU and then registering with the GPhC.”

Concerns have also been expressed about the flow of pharmacists from Europe and beyond, yet the most recent (2011) analysis of the GPhC’s Register indicates that, of 46,310 registered pharmacists, 11.8 per cent qualified overseas (compared with 37 per cent in medicine and 28 per cent in dentistry).

Of the 3,824 new entrants to the Register in 2011, explains Mr John, 791 qualified overseas with 517 coming from Europe, 160 from outside Europe and 114 from reciprocal arrangements with Northern Ireland. “The economy, though showing signs of recovery, is another factor. The NHS still faces pressure to save £20bn by 2015 — this leaves little scope for expanding the existing workforce or for funding new services,” suggests Mr John, who is also assistant director (quality and development) at London Pharmacy Education and Training.

Work behind the thought-leadership paper — co-ordinated by Mr John — was underpinned by the following principles:

  • Patients’ needs come first and they and the public must expect to access high quality pharmacy services delivered by a flexible, adaptable, capable and competent workforce
  • Pharmacists entering the profession should be of high quality with the right skills, level of knowledge, values, attitudes and behaviours
  • All education and training delivered to MPharm students and preregistration trainees should be high quality and give a sound grounding in professionalism

“Ensuring an adequate supply of pharmacists to meet the health needs of patients and to support public health initiatives is therefore a complex problem that requires us all to take responsibility for its solution,” Mr John suggests, while acknowledging that there is no single individual or organisation that can “ride to the rescue”.  

The report

Although the 20-page paper does not make for light-reading, it does offer members of the profession good insight into the complexity of the issues and a valuable picture of the options — none of which, it should be noted, provides an overnight solution to the imminent crisis.

Views were sought from members in academia, community pharmacy multiples and independents, NHS organisations (including NHS education and training) and the pharmaceutical industry. The following options were analysed:

  • Continue the free market — the status quo
  • Limit access to preregistration trainee pharmacist placements
  • Control admission to the MPharm degree and match student numbers to preregistration trainee pharmacist placements
  • Post-registration measures — only pharmacists with specific qualifications would be allowed to practise in certain areas
  • Use revalidation to control the number of pharmacists on the Register

To formulate a risk matrix, each option was scored for its likelihood of controlling entry to the pharmacy profession and the negative implications for patients and the profession.

Overall, the third option — that of controlling admissions to the MPharm degree and matching student numbers to preregistration trainee pharmacist places — was believed “likely” to be effective in managing entry to the profession with minor adverse consequences.

With a consultation on the matter expected next month from the Higher Education Funding Council for England and a report on pharmacist supply and demand from the Centre for Workforce Intelligence to follow, the RPS’s work is timely.

Members can find out more from the workforce section of the RPS website (www.rpharms.com/pharmacyworkforce) where the thought-leadership paper, a workforce summit podcast and other resources are available. A Twitter chat is taking place at 8–9pm on 12 September 2013 (#WePh); members can also follow the issue on Twitter via the hashtag #RPSWorkforce.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11124587

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