How NHS pharmacists can secure a promotion
Few hospital pharmacists abandon their desire for promotion when they reach NHS ‘Agenda for change’ pay band 7. But how difficult is it to secure an 8a band post and what can you expect from an 8a role?
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For a pharmacist working in the NHS, getting promoted usually means progressing to the next ‘Agenda for change’ pay band. A newly registered pharmacist typically starts at band 6 (currently £25,783–34,530) and may seek to progress to band 7 (currently £30,764–40,558), usually after gaining 1–2 years’ experience and completing a clinical diploma. Achieving a promotion to band 8a (currently £39,239—47,088), however, can be a bigger hurdle.
“The biggest difference when moving from a band 7 to a band 8a post is the increase in non-clinical responsibilities,” explains Anna Watson, a highly specialist pharmacist for acute medicine at Guy’s and St Thomas’ NHS Foundation Trust. “Examples of such responsibilities include business planning tasks — for example, writing a business case for getting additional staff to deal with winter bed pressures — and horizon scanning to determine future drug spending. You’ll also find that, once you’re in charge of a particular area and you have a problem, there won’t always be someone to ask for the answer.”
Watson says those hoping to move to band 8a also need to develop the ability to manage their time effectively. “At band 7, you may well have a mixture of clinical and non-clinical responsibilities but you are typically given dedicated time to separate those tasks. At 8a level, your time won’t be so structured but you’ll be expected to get everything done.”
Most band 8a roles involve some element of financial monitoring, adds Vicky Hoskins, lead pharmacist for urgent care for University Hospital of South Manchester NHS Foundation Trust. “This can include providing advice on drug costs within a specific therapeutic area, highlighting where spend is higher than expected and making recommendations for cost saving.”
Mary Williams is lead trauma and orthopaedics pharmacist at Morriston Hospital, Swansea. In her role, as well as undertaking clinical duties, Williams supervises audits, provides training for junior staff, acts as a diploma tutor and has responsibility for co-ordinating training for the pre-registration pharmacists. “You are expected to interact more with senior clinicians — often at high-level management meetings or audit committees,” she adds.
More than just a pay rise?
Most people apply for a promotion to get paid more. But are there other reasons for applying for a band 8a post? “It offers different opportunities than you get at band 7 level. You start working with people from other hospital departments who you never previously knew existed and it gives you a better understanding of how a hospital operates,” suggests Arlene McGuire, specialist clinical pharmacist for dermatology and allergy at Guy’s and St Thomas’ NHS Foundation Trust. “It also allows you to get greater recognition for your role as a pharmacist and more opportunity for leadership.”
Hoskins agrees: “You develop a different working relationship with medical staff. Rather than only interacting with them to deal with clinical issues for individual patients, you start attending directorate meetings and working with them to develop services.”
Mo Abdelkafi recently became advanced practitioner in informatics for City Hospitals Sunderland NHS Foundation Trust — a role that involves him in several IT-based projects, such as developing clinical decision support software. For him, the movement to band 8a has brought greater autonomy. “It has given me an opportunity to lead and I like being able to do things the way I want to do them. With that comes a real sense of reward and the feeling that you are making things happen.”
A rising hurdle
Is it getting more difficult to get a band 8a promotion? Today’s crop of band 7 pharmacists inevitably believes so. The results of the latest pharmacy staffing establishment and vacancy survey (see ‘Pharmacy workforce survey’) arguably offer some backing to that notion. Although band 8a jobs were never doled out like sweets, the impression now is that applicants need to go the extra mile.
“Getting an 8a job was one of the hardest things I’ve had to do as a pharmacist,” admits Abdelkafi. “You’re really expected to earn your buck as you’ll be compared with all other 8a level staff across the hospital — which includes senior nurses.
“Delivering excellent clinical care is not enough now — employers expect that as a given and will ask what else you can bring to a role, such as project work, management, emotional intelligence or involvement in trust-wide audits. You need to consider how you can make an impact beyond just pharmacy and you can’t expect to get a promotion just for working at the same place for several years.”
Advice for future 8a staff
Abdelkafi, who moved from Manchester to Tyneside to begin his band 8a role, suggests it might be necessary to look beyond the immediate geographic area. “When I became a band 7, there were opportunities available at most of the local hospitals. That wasn’t the case for 8a posts and people may need to accept that they need to spread their net a little wider.”
That said, for those who are keen to reach band 8a level as quickly as possible, Watson advises patience: “It’s beneficial to gain as broad an experience as possible at band 7 level before deciding the area in which you want to specialise. An 8a role requires lasting enthusiasm and dedication to a particular area, so it should be something that you really want to do.
“Gaining a breadth of clinical experience is important because, as an 8a, you are often required to utilise that knowledge in the context of unusual clinical cases requiring senior input.”
Impressing at interview is a must, so you should start getting prepared. “Look at the advanced and consultant-level framework and at job descriptions for band 8a roles — this will give you pointers for ways to start planning how you need to develop,” Watson advises. She also notes that a guide written by the UK Clinical Pharmacy Association on how to be a directorate pharmacist, along with its clinical masterclasses, helped her become competent in her role.
“Being seen to be doing higher level tasks before you seek promotion to 8a will stand you in good stead,” Williams suggests. “Take all the opportunities you can to deputise for senior colleagues or take on additional responsibilities. Seek to take on additional tasks — don’t just wait to be asked.”
Hoskins suggests that pharmacists go beyond what is expected of them in their band 7 roles. She adds: “The transition from band 7 to 8a is much greater than from a 6 to a 7. Offer to attend directorate meetings, prepare budget reports, investigate incidents and demonstrate your drive and commitment. That will help you prepare for the step up.”
Pharmacy workforce survey
The 2014 national NHS pharmacy staffing establishment and vacancy survey, the results of which were announced in October 2014, indicates there are some hurdles to becoming a band 8a.
- Vacancy rates
In England, 93% of 2,227 band 7 posts were occupied, compared with 96.2% of 2,436 band 8a posts. A total of 199 (10.5%) band 7 posts were therefore not permanently occupied, with 107 of these having not been occupied for three months. For band 8a, 142 posts were not permanently occupied, with 75 posts having not been occupied for three months.
- Pool of potential candidates
In England, there are 1,356 band 6 pharmacist posts, 2,226 band 7 posts and 2,435 band 8a posts. Therefore, there are fewer potential candidates looking for promotion to band 7 than there are seeking a band 8a promotion.
- Change in the number of established posts
In England, there was a 10.1% increase in the number of band 7 posts between 2013 and 2014. This compared with a mere 1.8% increase in band 8a posts over the same period and a 0.8% reduction in band 8b posts during the same period.
Examples of band 8a roles
Most band 8a roles involve being lead pharmacist for a particular directorate, such as cardiology, critical care paediatrics, general surgery or nephrology.
Other examples include senior roles in aseptics, medicines information, clinical trials or dispensary management. Some trusts also have roles based around homecare, quality assurance and primary care interfacing, or teacher practitioner positions.
At Sheffield Teaching Hospitals NHS Foundation Trust, an in-house training programme has been developed to help the band 7 pharmacists prepare for the next stage of their careers. “Our pharmacists have completed their clinical diploma but there are further skills they require to prepare them for working at an 8a directorate level,” explains Saima Annett, principal pharmacist at the trust — who is responsible for developing the trust’s band 7 pharmacists.
The training programme was developed in response to comments made by the trust’s band 7 and band 8a pharmacists about areas in which they felt they needed to learn more. It is based around the Royal Pharmaceutical Society’s advanced pharmacy framework and includes education sessions on:
• Directorate pharmacist role, including drug expenditure reports;
• Leadership and the personal qualities needed in a senior role;
• Time management — balancing clinical and directorate work, audit, risk assessments, guideline writing and policy development;
• Non-medical prescribing;
• Writing shared care protocols and patient group directions;
• Payment by results, funding streams, finance and commissioning;
• Contracts and purchasing medicines, unlicensed medicines and homecare;
• Using technology in a clinical role;
Giving band 7 pharmacists an idea of the skills and competencies that they need to develop helps them to be proactive in seeking the necessary experience in advance of applying for a promotion.
Citation: Clinical Pharmacist DOI: 10.1211/CP.2014.20067237
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