For most pharmacists, their daily work has offered a lifelong source of pride, community interaction and career satisfaction, not to mention income. But increasing targets, decreasing remuneration and other workplace pressures are leading to rising levels of stress and low morale that are threatening the wellbeing and businesses of even the most positive proponents of the profession.
CIG Research’s 2016 Pharmacist Attitudes survey found that 75 per cent of those polled feel strongly that more and more is demanded of them each year. Sixty-nine per cent agree that it is hard to maintain a good work-life balance – a view held more by those in independents than in multiples – and 36 per cent want to make a career change.
Pharmacists also said they feel they are not well-rewarded for the work that they do, with nearly 60 per cent stating if they had their time again they would not choose the same profession – and almost three-quarters would not recommend the career to their children.
These results are not a one-off. A recent survey by the Pharmacists’ Defence Association highlighted workplace pressures experienced by pharmacy professionals, leading the GPhC to recently outline a strategy for working with people and organisations from inside and outside pharmacy to understand workplace pressures across the sector. This is to include a seminar that will be held in October.
GPhC chief executive Duncan Rudkin said the regulator recognises that “pharmacy professionals working in a wide variety of roles and settings will experience significant challenges in trying to provide high quality care to patients and the public while dealing with limited resources or other workplace pressures,” adding: “it is important that… a balance is struck which protects and promotes the health and wellbeing of patients and the public, empowers pharmacy professionals to work with service users to make good decisions about care and enables companies to pursue legitimate business interests in an ethical way.
“We know that some members of the profession do not feel that this balance is being achieved. And the distress that some are experiencing is itself an issue which needs to be acknowledged.”
Indeed, a recent Health & Safety Executive (HSE) report indicated that, if not acknowledged early and managed properly, stress – including workplace stress – can lead to more serious mental health problems, issues at work, selfmedication with alcohol and drugs, addictive behaviours, poor diet, physical health problems and, in extreme cases, premature death or suicide.
The latest estimates from the Labour Force Survey show stress accounted for 35 per cent of all work-related ill health cases and 43 per cent of all working days lost due to ill health in 2014/15, with 9.9 million working days lost due to this condition.
The main work factors cited by respondents as causing work-related stress, depression or anxiety (LFS, 2009/10 to 2011/12) were workload pressures, including tight deadlines, too much responsibility and a lack of managerial support – many of which might seem familiar concerns for community pharmacists.
The HSE says stress is more prevalent in public service industries such as health and social care and is known to be linked with high levels of sickness absence, staff turnover and other issues such as an increase in errors.
All of these are worrying factors for anyone working in the profession, and are a concern for one superintendent from a large independent, who admits to experiencing stress and low morale in the current climate.
He says: “I put it all down to the proposed budget cuts. I feel the NHS has given up on the pharmacy profession and, worse than that, I think they are innately prejudiced against pharmacists. I’m still reeling from what I see as a completely cavalier and callous disregard for the value pharmacy brings to society. Prior to this we were doing so much with dementia, men’s health, HLPs, blood pressure monitoring, diabetes testing and so on, but I’ve had to stop all this because I can’t afford to do anything that adds cost but doesn’t bring in revenue.
“I understand things are hard and cuts have to be made, but I feel powerless and destroyed by this. This is three generations of my family’s endeavours that are going to come to nothing.”
He says it’s got to the point where the stress is now affecting his health. “I haven’t slept properly since December and I also worry about every single one of the people I employ. They are all decent, hardworking, committed people who deserve better than this kind of uncertainty and disregard,” he says.
Stress is a natural reaction to pressure, but if it becomes excessive and/or prolonged, mental and physical illness may develop.
Stress produces a range of signs and symptoms, which can include:
If you think you are suffering from any mental health problem or any of the symptoms identified above, it may be advisable to speak to your GP. It is also a good idea to talk to your line manager, human resources department or occupational health provider, if you have one.
For more on dealing with stress, go to hse.gov.uk/stress/mystress.htm
Diane Leicester-Hallam, chief executive at Pharmacist Support, says the charity is receiving more calls every year from those in the profession facing challenging situations. “Stress connects a lot of the calls and emails we receive here at Pharmacist Support – sometimes from very distraught individuals,” she says. “The number of enquiries we receive year on year grows steadily, increasing from 200 back in 2008 to more than 800 in 2015.”
In 2015, 31 per cent of all enquiries related to employment issues (up 4 per cent on 2014 figures) and to the end of May this year this figure stands at 33 per cent of all enquiries. There is a range of topics within this category, including issues around terms and conditions and disciplinary issues, looking for work, workplace stress and return to practice. Other concerns raised have included low staffing levels, a lack of breaks, low rates of pay in some areas, heavy workloads and onerous targets. For some enquirers the issue is long hours.
Reports of low morale are also “relatively common” among the people who call, according to Ms Leicester-Hallam. “Often the pharmacists inform us that they no longer feel valued for a variety of reasons, such as an inability to put patients first, a discontentment with a target-driven environment or a lack of acknowledgement as to the diverse and demanding nature of the role today,” she says.
Pharmacist Support is the profession’s independent charity, providing a range of free and confidential services to pharmacists and their families, former pharmacists, trainees and MPharm students.
Pharmacists who are particularly stressed at work might benefit from the charity’s e-therapy programmes or some sessions with an inhouse counsellor. Those looking for professional guidance may wish to check out the CPPE’s coaching programme or the RPS mentoring support.
Visit pharmacistsupport.org, call 0808 168 2233, or email firstname.lastname@example.org
Ms Leicester-Hallam believes pharmacy could learn from the Chartered Institute of Personnel and Development, which says that for employees to thrive in the workplace, organisations need to create an environment that enables the workforce to have a level of control and choice.
“No control or choice can lead to internal conflict, feelings of anger, frustration and inadequacy,” she says, “so encouraging an open communication and dialogue with management – including the ability to negotiate workload and work pace without fear of reprisals or punishment, ensuring clarity and unity of purpose, supporting flexibility and fair compensation – are essential elements to creating this environment that can have a positive impact on employee wellbeing.”
To pharmacists feeling under pressure, she says “it is important to recognise the signs of stress, to try and understand why you feel the way you do and to do something about it. These are areas we cover in our new Wardley wellbeing workshops, which are free to attend and are packed with information, tools and techniques to help you recognise the signs and symptoms of stress and deal with everyday pressures.
“Talking to someone about how you are feeling is a great first step – that could be someone at work (if you feel comfortable doing so) – a manager, colleague, a member of the HR team or your union. Some people prefer, however, to speak to a person not related to the situation and independent from their workplace. This could be a friend or relative or perhaps one of the charity’s Listening Friends, trained volunteer pharmacists who understand the pressures of the job and provide callers with a confidential listening ear.”
Mr Rudkin admits that pharmacy professionals working in community pharmacy “face different pressures as the businesses in which they work seek to generate income and manage their costs”, and that “this can be very hard, and easy answers are thin on the ground”.
But you won’t find any answers by keeping problems to yourself. As Ms Leicester-Hallam says: “Problems don’t normally just go away on their own and the longer they are left, usually the worse things can get. Talking alone may not resolve the issue(s), but it can be a first step in identifying the options available and starting to deal with the problem.”