Transcript karen hassell, manchester - Professional Standards Authority

Unsupported and over stretched pharmacists: is
there a role for the regulator?
Karen Hassell
Ellen Schafheutle
The Centre for Pharmacy Workforce Studies
Manchester Pharmacy School
March 2014
The presentation
• Pharmacists/pharmacy in brief
• Evidence about work related stress
– sources
– which pharmacists
– organisations
• Employers responses
• GPhC
Pharmacy in GB (i)
• Third largest HC profession: > 47,000 pharmacists
• Culturally complex and diverse workforce (and student body)
• 26 Schools of Pharmacy in GB; 10,599 students (2011)
• Most pharmacists employed in retail pharmacy
– Self-employed small business owners
– Locums
– Employees
Pharmacy in GB (ii)
• Large and varied network of community pharmacies:
–
~12,000 pharmacies
–
Includes independently-owned businesses
–
And (inter-)national chains, supermarkets
• New contract in 2005
• Community pharmacies play a key role in healthcare systems:
– Essential services (eg, dispensing)
– Advanced services (eg, Medicines Use Reviews (MURs))
– Locally commissioned services (eg, Minor ailments schemes)
Pharmacy in GB: workload increasing
• 473 million items dispensed in 1995; 1000 million in 2012
• 17,745 locally commissioned services in 2005/6; 29,526 in
2009/10
• 152,854 MURS in 05-06; 2.43 million MURS in 2011-12
Hassell K, Seston E, Schafheutle EI, Wagner A, Eden M. Workload in community pharmacies in the UK and its impact on
patient safety and pharmacists’ well-being: a review of the evidence. Health and Social Care in the Community, 2011; 19,6:
561-575
Stress a growing concern
• Evidence suggests that growing workloads are leaving
pharmacists feeling unable to cope:
– new contract; more roles; paper work; MURs
– Unpredictable nature of work
– Being under-utilised or under-valued
– Target driven culture
– Lack of resources (eg, inadequate staffing)
– Long days without rest breaks
Stressors and type of pharmacy
ALL pharmacy
types
Independent
Small chain
Medium
multiple
Large
multiple
Supermarke
t
ANOVA
Sig.
17.37±6.92
17.59±7.86
18.65±6.36
21.96±7.49
22.03±7.44
p<0.001
12.76±5.24
11.24±4.83
11.73±4.66
12.70±4.34
13.91±4.72
p<0.001
11.70±4.46
10.75±4.46
11.5±4.40
14.69±4.74
13.64±4.54
p<0.001
11.49±4.22
11.94±4.67
13.03±4.27
12.52±4.11
12.94±4.38
p<0.05
10.66±7.90
11.32±4.76
12.95±4.23
15.58±4.77
14.07±4.47
p<0.001
9.77±4.46
10.51±4.57
12.18±4.26
12.52±4.39
12.57±3.97
p<0.001
23.38±6.56
22.63±7.09
23.51±6.29
27.93±6.70
27.91±7.10
p<0.001
2.55±1.45
2.94±1.50
3.24±1.49
3.45±1.53
3.28±1.51
p<0.001
Work stressors
Work relationships
Work-life balance
Overload
Job security
Control
Resources and
communication
Your job
Pay and benefits
20.19±7.61
12.62±4.71
13.26±4.85
12.32±4.29
13.66±5.20
11.64±4.55
26.03±7.08
3.16±1.56
Well-being and type of pharmacy
All
pharmacists
Small chain
Medium
multiple
Large
multiple
Supermarke
t
ANOVA
Sig.
Independent
Physical health
12.75±4.22
12.56±4.22
11.90±4.18
11.53±3.94
13.00±4.24
13.54±3.35
p<0.05
Psychological well-being
22.13±7.63
21.87±7.58
20.11±7.58
20.00±6.74
22.67±7.80
23.66±7.80
p<0.01
Well-being
Stress interventions: what are employers doing?
Individual level
Interface between
individual and
their organisation
Organisational
level
• Return to work schemes
• Counselling services
• Coaching
• Appraisals
• Improving communication/engagement
• Conflict resolution
• Encourage rest breaks
• Have appropriate staffing levels
• Improve physical environment
Discussion: what should/can GPhC do?
Standards
GPhC standards of conduct, ethics and
performance: the seven principles
1.
Make patients your first concern
2.
Use your professional judgement in the interests of patients and the
public
3.
Show respect for others
4.
Encourage patients and the public to participate in decisions about their
care
5.
Develop your professional knowledge and competence
6.
Be honest and trustworthy
7.
Take responsibility for your working practices.
GPhC standards for registered pharmacies: five
principles
• The governance arrangements safeguard the health, safety and wellbeing
of patients and the public.
• Staff are empowered and competent to safeguard the health, safety and
wellbeing of patients and the public.
• The environment and condition of the premises from which pharmacy
services are provided, and any associated premises, safeguard the health,
safety and wellbeing of patients and the public.
• The way in which pharmacy services, including the management of
medicines and medical devices, are delivered safeguards the health,
safety and wellbeing of patients and the public.
• The equipment and facilities used in the provision of pharmacy services
safeguard the health, safety and wellbeing of patients and the public.
Leverage of new approach to inspection
• Eg: GPhC standards for registered pharmacies
– Purpose: to create and maintain the right environment,
both organisational and physical, for the safe and
effective practice of pharmacy
– The standards are a clear indication of GPhC’s
commitment to improvement in pharmacy practice
• Effective regulation can and should be enabling & can be
used as a lever for improvement in pharmacy services
• Aspiring to excellence – professionalism
Work with the professional body (the RPS)
• Professional
empowerment:
– Help improve culture around
raising concerns
– Management training
– Raise awareness among
employees about relevant
legislation
– Resources
– Physical environment
– Rest breaks
Stress and poor well-being: the evidence
Study
publication
Locum study
Shann P and Hassell K. Flexible working: Understanding the locum pharmacist
in Great Britain. Research in Social and Administrative Pharmacy; 2006; 2; 3:
388-407
Work patterns of
female pharmacists
Gidman W, Hassell K, Payne K, Day J. The impact of increased workloads and
role expansion on female community pharmacists in the UK. Research in Social
and Administrative Pharmacy; 2007; 3,3: 285-302.
Barriers to learning
study
Noble C, Hassell K. Informal learning in the workplace: what are the
environmental barriers for junior hospital pharmacists? International Journal of
Pharmacy Practice, 2008: 16: 257-63
Leavers study
Eden M, Schafheutle ES, Hassell K. Workload pressure among recently qualified
pharmacists: an exploratory study of intentions to leave the profession.
International Journal of Pharmacy Practice; 2009; 17: 1-7
Job satisfaction
study
Ferguson J, Hassell K, Ashcroft DA. Qualitative insights into job satisfaction and
dissatisfaction with management among community and hospital pharmacists;
Research in Social and Administrative Pharmacy; 2011, 7: 306-16
Pharmacy workforce
censuses
Seston L Hassell K. British pharmacists’ work-life balance – is it a problem?
International Journal of Pharmacy Practice; 2013:
Workplace stress
survey
Jacobs S, Hassell K, Ashcroft DA, et al. Workplace stress in community
pharmacies in England: associations with individual, organizational and job
characteristics. Journal of Health Services Research and Policy 2014, 19: 27-33