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The workload problem in numbers

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There are currently concerns overthe number of pharmacists and their increasing workload.  I've pulled together a few numbers which mighthelp inform the debate.

Below is a graph showing how the number of pharmacists has increased in comparison with the number ofpharmacies.  I've used 2002 as areference point as it's the earliest year a complete dataset is available.  

Pharmacies vs. Pharmacists

The number of pharmacists hasgenerally increased at the same rate as the number of pharmacies at 1.8% comparedto 1.4% per annum. 

The 100-hour control of entryexemption in England, which began in 2005, explains a large part of theincrease in pharmacies from that point on. In Wales, pharmacy numbers remained static.  In Scotland, pharmacy numbers grew at halfthe rate of England.

The increase in pharmacy numberswill slow since the 100-hour exemption was abolished in 2012.  This will mean fewer jobs, especially as longeropening hours require a greater number of pharmacists per pharmacy.  Pharmacist numbers can be expected to continueincreasing at an even faster rate as newer schools of pharmacy see their first studentsenter the workforce.

The number of pharmacies is currentlya limiting factor for the number of jobs, but it isn't a measure of workload.  It might be that there are more pharmaciessharing the same amount of work.  As‘work' in community pharmacy largely means dispensing, items dispensed is abetter measure to use. 

Items vs. Pharmacists

The number of pharmacists has increasedat a slower rate than the number of items dispensed.  The gap between the two lines reflects thefact that each pharmacist has been worked harder, dispensing a greater numberof items.

The number of pharmacists hasincreased at 1.8% per annum while the number of items dispensed has increasedby 4.9% per annum.  The 3.1% differenceis the increased productivity squeezed out of pharmacists every year.  The net result is that, compared to 2002, in2012 there were 17% more pharmacists but 54% more items dispensed. 

Consider the addition of MURs in2006, and NMS in 2011, coupled with more local enhanced services, and you'llunderstand why the workload problem is not the figment of pharmacists'imagination.  It also explains why therecan be a lack of engagement with new services. Service quality and the number of errors are no doubt also affected.

Work cannot continue to be addedlike cards to an ever more precarious stack. A solution to the workload problem is a prerequisite for a service-basedfuture.  The solution will either involvemore pharmacists per pharmacy, perhaps one for dispensing and one forservices.  Or will be a drastic change inthe current working model, with technicians taking over the dispensing process andpharmacists only clinically screening, thus freeing them to deliver services.

The latter is more efficient andcost effective and therefore most likely I think.  Especially since the direction of change isaway from rewarding supply, which the Department of Health has made clear theyfeel is overvalued through their contract negotiations.

If that's the case, it means jobnumbers in community pharmacy are likely to remain static which will not bewelcoming news for newly qualified pharmacists and pharmacy students.  But it will be a step closer to a visionof pharmacy I think we'd all prefer.

Follow me on Twitter @RanveerBassey

All data relates to community pharmacies in England,Walesand Scotland.

The numberof pharmacists includes those who are not-practicing and not employed incommunity.  I think it's safe to assumethat the percentage of these groups has remained largely the same, so thisshouldn't misrepresent the trends shown.

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