How much longer can community pharmacists push linctus up the hill?

You know when enough is enough. Someone has to say something.

Well here we go.

When I qualified as a pharmacist I was sold a dream. Basically said dream went a little like the following.

1. Get on the register.
2. Get experience, probably with a multiple community pharmacy chain.
3. Buy a community pharmacy.

Sorted.

Mmmmm maybe not…

I saw a notification the other day on Facebook and it guided me to a post within which yet another talented community pharmacist was set to jump ship to work in a primary care pharmacy role. This pharmacist was standing, leaving gifts in hand, trying to look sad. The reality was nothing of the sort. A polite facade hid a great degree of relief behind the eyes.

And who can blame the ambitious community pharmacists calling time on pushing linctus up the hill?

Low pay, targets, performance management and no lunch break. Some complain of feeling guilty for taking a toilet break. The miserable conditions many community pharmacists have to put up with have been well documented in pharmacy circles. That said, really very little has changed in community pharmacy in the last 30 years.

And as usual, it’s about how the money flows through that system. The odds are stacked against the conscientious community pharmacist with ambition. There’s basically no money in delivering excellent pharmaceutical care.

And you may as well forget about becoming a prescriber.

There has been an element of window dressing to attempt to add depth to the role in certain quarters. The ubiquitous community pharmacy pilot. The trouble with this attempt to deliver ‘clinical services’ through community pharmacy is quite frankly the money rarely follows. To deliver complex services in community pharmacy would require investment in pharmacist training and medical supervision. The streams of money running into community pharmacy mean that this grand ambition will always just be that unless there is a huge shift in policy.

I have wondered recently if we have ever delivered pharmaceutical care in community pharmacy to the level that the people who access the service deserve? And this I think is probably the root of the problem, the symptoms of which we are seeing played out on the myriad of millenial inhabited social media groups. These youngsters have no reason to believe in community pharmacy. Those that stay have a life of considerable responsibility, commercial pressure and long hours standing on their feet to look forward to.

Are they just being snowflakes?

Largely I think it would be unfair to say they are. But they are aware that it doesn’t have to be that way. The profession of pharmacy provides many exciting opportunities for career development. The trouble is with the acute lack of investment in community pharmacy these opportunities sit elsewhere. The lure of working in general practice is proving too tempting for many.

The perfect storm for community pharmacy becomes starker when you consider the rise of ‘health tech’. The Government have already put multiple markers down saying that the community pharmacy network is too expensive when we consider the supply function. The Amazonisation of pharmacy is coming. This will lead to fewer, more centralised jobs which will largely be robotic.

And robots are accurate and fast.

Centralised prescribing and remote consultations are well on their way to the mainstream. Again community pharmacy will find it harder to compete as the digital natives coming through want to access healthcare immediately. Sure some community pharmacies these days have impressively long opening hours but I think expectations have gone through the roof in this regard.

So where does this ranty analysis leave us?

Well, it has resulted in an incredibly disillusioned workforce. This ill-feeling is overflowing in public and private forums online. And who can blame them?

At the risk of hopping up on to my moral high horse, I do feel sad when I see foul language and direct criticism of patient behaviour. People accessing community pharmacy services will often exhibit complex health-seeking behaviours. For pharmacists to criticise or mock this in public or private groups where they feel disinhibited is a big problem and a step too.

This is a sign that the professional wheels are coming off.

Again on one hand who can blame these pharmacists for trying to express their frustrations?

So we arrive where we are today. Low community pharmacy wages across the UK, considerable responsibility on the shoulders of responsible pharmacists and poor working conditions.

Am I being too negative?

Realistic more like.

The Grouchy Pharmacist is everyone and no-one.