Putting the patient first: how pharmacy can get it right

This was published when the organisation was the Royal Pharmaceutical Society.

Pharmacy is under significant pressure. Pharmacists across all sectors of the NHS have remained accessible to the public and provided essential services throughout the Covid-19 pandemic. The challenges of the pandemic and its longer-term consequences continue, and these are now being compounded by the escalating cost of living crisis. Many fear what is around the corner, when winter pressures are added to the mix.

With unprecedented levels of burnout among pharmacists, pharmacy closures and the potential for strike action, the Royal College of Pharmacy (RCPharm) calls for three things: professionalism, respect and prioritisation. Specifically:

1. We call for pharmacy employers and pharmacy trade unions to come together to a round table meeting to agree principles for a way forward that ensures patients benefit consistently from access to high quality, adequately staffed, safe pharmacy services.
2. We call on Governments, NHS organisations and individual pharmacy teams to define clear prioritisation plans, which can be embedded in organisational business continuity plans, that set out the pharmacy services that are essential and must always be provided and which can be de-prioritised at specific levels of pressures.
3. We call for zero tolerance of abuse across pharmacy.

Professionalism

Pharmacists are highly trained and regulated health professionals who work right across the NHS: in communities, high streets, general practices and hospitals. The first duty of every health professional is to make the care of patients their first priority. That means pharmacists must do everything they can to maintain pharmacy services for patients, but this must be balanced against ensuring services are safe. Pharmacy services which are closed are unable to help patients at all; but neither are pharmacies with unsafe working conditions.

Therefore, as the professional leadership body for pharmacists, we urge pharmacy employers, trade unions and pharmacists (both employed and self-employed) to work together collaboratively to ensure patients can benefit consistently from access to high quality, adequately staffed, safe pharmacy services.

Respect

Closely linked with professionalism is respect. Pharmacy employers and superintendent pharmacists should respect pharmacists by providing healthy working environments including effective systems, safe staffing, appropriate rest breaks, access to training and development, and a supportive culture. Against a difficult economic backdrop, pay demands and subsequent remuneration needs to be financially sustainable and fair to both pharmacists and pharmacy employers. This includes fair funding from governments for pharmacy services in all sectors. If this mutual respect is missing, it is patients who suffer the most, whether that is through reduced availability of pharmacy services or through safety issues arising from poor working environments and low staff morale.

Crucially, everyone involved in providing pharmacy services must respect patients and, likewise, patients should respect pharmacy teams. The cost of living crisis is putting the vast majority of the population under stress, and this will undoubtedly worsen over the winter. Sometimes these pressures will result in impatience and frayed tempers, but this should never escalate into abusive behaviour. During the pandemic, many pharmacy teams reported an increase in abuse, violence and aggression from some members of the public. De-escalating threatening situations is yet another pressure pharmacy teams face which detracts from delivering patient services. RCPharm has consistently highlighted zero tolerance to abuse and condemns it in the strongest terms.

Prioritisation

One of the causes of impatience among patients is waiting. This brings us to our final point: the need for prioritisation. At a time when pharmacy is already under immense pressure, it is sensible to prioritise the essential services that must be provided if those pressures grow even further. For pharmacy, this will mean temporarily prioritising core pharmacy activities such as the prescribing and supply of medicines along with providing pharmaceutical advice. As winter approaches, clear plans must be developed between NHS organisations and individual pharmacy services which define what must always be provided to ensure safe patient care, and what can be de-prioritised as further pressures hit. Enabling more efficient ways of working, such as allowing community pharmacists to make professional decisions to supply alternative medicines during medicines shortages, and maximising the roles of the whole pharmacy team, is also necessary.

The months ahead will be challenging. However, pharmacists consistently demonstrate great resolve in delivering outstanding patient care. We call on everyone involved with pharmacy services to consider our three points of professionalism, respect and prioritisation, and reflect on how they can realise them in their own practice. Now is not the time for division: only by working together can we develop long-term solutions which benefit all and put patients first.