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Impact on UK workforce of the contractual framework for community pharmacy revealed

19.06.2008
Increased workload, higher levels of stress and higher rates of delegation to support staff have resulted from the initial implementation of the contractual framework for community pharmacy (CPCF), a study reveals.

The research, part of a larger body of work evaluating the implementation of the CPCF, investigated issues related to work load and job satisfaction and was led by Professor Alison Blenkinsopp of Keele University, together with Professor Christine Bond, University of Aberdeen and Gianpiero Celino, Webstar Health.

The research funded by the Pharmacy Practice Research Trust (the Trust) and published today reports the findings from the largest survey to date of community pharmacists undertaken since the introduction of the contract.

There was evidence that all three tiers of the CPCF led to increased community pharmacists’ work load but there was a particular rise related to paperwork, the research reported. Respondents spent up to 25% of their time counselling patients and up to 25% on other management tasks in addition to existing services such as dispensing. Some community pharmacists interviewed expressed disappointment that workflow management systems to support and manage existing workload such as repeat dispensing and the electronic prescription service (EPS) had not materialised.

Sixty-eight per cent of respondents indicated they had delegated more work to non-pharmacist staff members with a further 34 per cent indicating they planned to make other staff changes in the next year. Pharmacists providing medicine use reviews (MURs) were more likely than other responders to have devolved more work to non-pharmacists and 23 per cent had specifically employed a locum to either conduct MURs or provide cover for conducting MURs.

The report found that 58 per cent of respondents felt stressed within their job and only 17 per cent of community pharmacists stated they were more satisfied overall compared to before the contract was introduced. Pharmacists providing the MUR service were more satisfied than those who were not. Overall, only a third (33%) stated they would be likely to still be working in community pharmacy in the next ten years – a concern for future workforce planners.

The findings from the study describe experiences of pharmacists on the ground and highlight the areas that should be addressed in future planning of services, namely robust management programmes such as EPS and identification of training needs for technicians and pharmacy support staff as they move into cascaded evolving roles. Greater use of IT to reduce paperwork, as in the implementation of the Scottish community pharmacy contract, will also be important.

‘It may be that a better more appropriate skill mix is emerging, although detailed exploration of this would be needed to identify the tasks delegated, the competencies of those now delivering them, and the outcomes”, said Alison Blenkinsopp, Professor of the Practice of Pharmacy, Keele University. “These changes in the pharmacy team may result in higher job satisfaction across the team, particularly among pharmacists who report that job dissatisfaction is related to a feeling that they have insufficient time to do justice to the job. We therefore welcome the timing of the publication of the recent DH White Paper for pharmacy and its recognition of the need for a more robust support framework and its endorsement of the evolving role of pharmacy technicians.”

"The value of commissioning a study like this is that it identifies barriers that might inhibit the full implementation of new policies and areas where further research is necessary and policy makers can take note of these" said Sue Ambler, Director of the Trust. "The research indicated that the vast majority of pharmacies are engaging well with the new contract and that participation in the MUR service was associated with increased pharmacist satisfaction but it did also identify areas where pharmacists were indicating some stress.”

The report and an executive summary of the main findings from the full national evaluation of the CPCF is available at www.pprt.org.uk/Publications/2008Publications.aspx

Bonnie Green | alfa
Further information:
http://www.pprt.org.uk/Publications/2008Publications.aspx

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