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Community pharmacy

Time constraints cause 'overwhelming distress' for one in seven UK community pharmacists

Research has shown that time contraints cause the highest frequency and intensity of distress for community pharmacists working in the UK.

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Source: JL / Shutterstock.com

Pharmacists not having enough time to offer the level of service they want to give is the greatest cause of “moral distress” in UK community pharmacy

Time constraints are the greatest source of “moral distress” for community pharmacists in the UK, with one in seven describing their distress as “overwhelming”, according to a study published in Research in Social & Administrative Pharmacy (29 May 2019).

The research defined moral distress as a “distressing feeling of inner discordance or fractured integrity occurring when an individual’s personal or professional values are compromised due to their action or inaction” and measured the feeling through an online survey sent out to 20,433 pharmacists on the Pharmacy Defence Association’s (PDA’s) mailing list.

According to the 593 people who responded, time constraints cause the highest frequency and highest intensity of distress, with moderate-to-severe moral distress being reported in relation to this problem several times per day.

The researchers noted that 14% of respondents rated the distress associated with time constraints as “overwhelming”.

This comes after the General Pharmaceutical Council (GPhC) updated its ‘Guidance to ensure a safe and effective pharmacy team’ to include greater detail on acceptable staffing levels in pharmacies, but did not suggest minimum staffing levels that a pharmacy should have on duty at any one time.

In light of this, the researchers said: “Given the frequency and intensity of distress associated with time constraints and rising workloads, further evaluation of this issue and the degree of autonomy afforded to pharmacy owners and directors in this regard is warranted.”

The researchers called for “reconsideration of workload and staffing levels, to enable community pharmacists to enact person-centred practice within the confines of the current regulatory framework”. 

A spokesperson for the PDA said they were “sadly not surprised” to learn that the item causing the highest level of distress was time constraints. 

“This aligns with what our members tell us every day about the working environments and standards in pharmacies,” they said, adding that issues with time constraints “would be alleviated by better staffing levels in pharmacies”. 

“The regulator needs to get involved. The GPhC must ensure adequate staffing levels for the safety of patients and the public and, as seems apparent from this research, it could also help improve pharmacists’ wellbeing.”

However, the GPhC said it maintained its view that setting the right staffing levels was best done by the people responsible for managing a pharmacy on the ground, rather than by the regulator at a distance. 

It said that it expected pharmacy owners to identify and manage risks associated with service provision, as well as to review and monitor the safety and quality of pharmacy services, including the workload and capacity within the pharmacy team.

The online survey also found that being unable to dispense a controlled drug in the best interests of a patient owing to an unmet legal requirement generated moderate levels of moral distress several times per month in pharmacists.

Meanwhile, the item causing the lowest level of moral distress was concerning the issue of emergency hormonal contraception. Respondents indicated that this scenario did not typically arise, or generate any distress when it did.

Overall, the study also found that locum pharmacists appeared to experience more frequent and more intense moral distress in relation to customer pressure, emergency supply, and whistleblowing, compared to both employee pharmacists and pharmacy owners.

The researchers said that this could be due to the transitory nature of locum contracts which could expose them to an increased susceptibility to situational pressures and organisational demands.

In addition, they found that younger and less experienced pharmacists were more likely to encounter ethical problems relating to their work and experienced greater difficulty in resolving such issues. 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206609

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