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Pharmacy closures, staff shortages and high demand for services have led to an increasing reliance on locum pharmacists within community pharmacies.
“These factors are putting additional pressure on community pharmacists, who are already working long hours and facing high workloads,” says Adrian Hodges, associate director of Pharmacy UK and Northern Ireland at Clarity Locums.He warns that the situation “is likely to get worse in the future, as the NHS continues to face financial pressures and the demand for services grows”.
In addition, pharmacy employers are struggling to recruit locum staff in some of the more remote areas of the home nations, despite locum pay rates being reportedly on the rise.
A recent rates study by Locate A Locum showed that the UK’s average locum rate rose to £38.74 an hour in the 12 months ending 31 March 2023 – a 19 per cent increase on the previous year.
Of the 160,000 shifts analysed, the research showed that around 40 per cent of locums earned between £40 and £50 an hour, while around eight per cent received more than £50 an hour. Wide regional variations also persist. Average locum pharmacy rates in Wales were up almost 50 per cent on the previous year, at £42.91 an hour, compared with £28.11 an hour in Northern Ireland. The average rate in Scotland – the highest of all UK regions – was £46.03 an hour.
There are many different factors that influence the rate of pay, but, according to Jonathon Clarke, chief executive and pharmacist founder of Locate a Locum, it is typically a result of supply versus demand.
“For example, if there are fewer locums available to work in a particular area or on a particular day, the rate tends to increase,” he says, adding that it’s inevitable that shifts have seasonal variations.
Booking advice
As a result, Clarke’s advice for locums looking to increase their earning potential is to target hard-to-fill summer and Christmas holiday shifts. But since the decision on locum rates is ultimately between the locum and the pharmacy, he says there are also a number of things employers can do to attract the locum pharmacists, dispensers and technicians they need.
“Being open to locum negotiation can improve your shift fill rate and reduce the need for emergency cover for employers,” he says. “Another consideration is to look at your locums’ skill base and plan your rota so that you can utilise these skills to deliver value-added services.”
While fee negotiations are an important part of the process, it is also vital to check that a locum is properly vetted, qualified and up to speed when it comes to delivering services, and this is detail that employers can ask locum agencies to supply.
“I ensure all locums who register with Clarity Locums go through a rigorous vetting process to ensure our database only has fully vetted and verified candidates who are able to deliver all relevant services required to fully operate your pharmacy as normal,” says Hodges, “meaning there is no disruption to the service patients receive locally.”
Remote resources
As for the hurdles pharmacies face in sourcing locum staff in remote parts of the country, Hodges says the biggest challenge is simply the lack of available locums in these areas. “Professionals are usually attracted to city life and locums are no exception to this rule,” he says.
A solution, Clarke suggests, is for employers to focus on “locum mobility” when sourcing staff to work at branches in more remote locations. “Think about the incentives you can offer for locums to travel to your location,” he says. “For example, we have multiple rural pharmacies offering ‘stay-aways’ to locums – where a pharmacy would pay for travel and accommodation as well as an attractive hourly rate to attract high quality locums.”
IR35 update
Locum pharmacists were briefly hopeful that tax complications arising from the Government’s IR35 legislation – which ensures that off-payroll contractors and on-payroll employees pay the same tax and national insurance – might have been overcome last year, with the Truss government reversal of the IR35 tax regulations as part of Kwasi Kwarteng’s ‘mini-budget’.
Subsequent Chancellor of the Exchequer Jeremy Hunt quickly performed a U-turn on the U-turn, taking the situation back to where it was previously.
Now, HMRC has announced the removal of sector-specific employment status guidance for locum pharmacists, which classified locum pharmacists engaged on a sessional or daily basis, performing only the statutory requirements of their role, as self-employed for tax purposes, whereas those with more involved roles such as ordering stock and managing staff could be considered employees.
As of June 30, HMRC has said the employment status of individual locums has to be assessed using HMRC’s online check employment status for tax (CEST) tool, with the end user/payer of the locum pharmacist responsible for this assessment.
Training top ups
As the service agenda is pushed forward, locums – and their employers – also need to bear in mind any updates to training requirements, whether this is keeping up to date with professional development or offering clinical services to improve the health outcomes of the communities in which they are working.
Looking ahead, the Government’s recently promised £645 million investment in community pharmacies over the next two years to support a pharmacy common conditions service, along with expansion of the NHS Pharmacy Contraception and NHS Hypertension Case-Finding services, will require the entire community pharmacy sector to deliver these services, including locum staff.
“As this is one of the largest investments into community pharmacy for nearly 10 years, locum pharmacists [will] play a huge role in maintaining consistency for communities in every region,” says Hodges, who is confident that this will not be a stretch for them. “Over the years, the focus on consistent clinical service delivery has been a specific requirement from our clients when requesting locums,” he says. “But pharmacists and staff across the sector are used to undertaking training, and locum pharmacy staff are no different.”
Nonetheless, Clarke believes it’s sensible for employers to make all training requirements clear in locum adverts, right from the start.
“First of all, if you are looking for locums with certain skill sets to provide services to your customers, it is important to communicate this when advertising the shift or role, as this means that you will only receive applications from locums with the appropriate skills,” he says. “Secondly, it is important to set an hourly rate that reflects the service you want to provide as the locum will have to have completed training in order to provide the service.”
Future challenges
With so many professional changes in the pipeline, there are plenty of challenges ahead for locums – and employers.
“Over the last few years, the diverse nature of pharmacy has been explored and new roles and opportunities have been created for pharmacists, including Covid vaccine centres, digital pharmacy and an increase in GP roles,” says Reece Samani, founder of the Lopic app. “To manage this, NHS England announced an almost 30 per cent increase in training places by the end of this decade. I also believe by then there will be an even higher demand for pharmacists, given the shift to the new prescribing course and an increase in clinical services.”
Another challenge, says Samani could be “further time pressure to complete more accreditations, and I think this will be exacerbated when newly qualified pharmacists start to become independent prescribers.”
There are potential benefits for locums too.
“In light of funding challenges, pharmacies are starting to diversify their revenue streams, and a broad range of private services is one way to effectively do this,” says Clarke, predicting that, as a result: “We believe that high quality, well trained locums will be able to achieve higher rates by providing these services.”
Hodges says a number of his clients have either invested in, or will soon be investing in hub and spoke dispensing, which in turn should free up the pharmacist (and pharmacy team) to focus on patient care. “This means that for the locum pharmacist, they will have increased options when it comes to work, and should ultimately lead to better job satisfaction,” he says. However, he points out that one main challenge not just for locums, but community pharmacy as a whole, is uncertainty surrounding future funding arrangements. “Until absolute clarity is achieved,” he says, “a number of the points discussed, such as investing in hub and spoke or the increased clinical services agenda could still be in the balance.”
One thing is certain: change is a given, so employers who can create the most inclusive, supportive and clear working environments for their staff are in with the best chance of recruiting motivated and engaged locum pharmacists.
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