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The Big Debate #6: Is there a shortage of community pharmacists?

Started about 1 month ago

The live element of this debate – which asks: is there a shortage of community pharmacists? – will start at 7pm and last until 8pm, but two of the panellists who are unable to join the live element have preprepared statements. Please find them posted below to read before the live discussion.

For planned topics of conversation in this debate, see here.

See you online from 7pm.


Ps. C+D has introduced a streamlined functionality that allows users to mention each other in a comment. Simply use ‘@’ and type in the person’s name.

Evening folks! Apologies but we're going to have to delay the start of the Debate by 15 minutes due to some unforeseen technical difficulties. 

The Big Debate will now be starting at 7:15 and ending at 8:15.

We'll see you then!

Ravina Barrett, senior lecturer in pharmacy practice at the University of Brighton

“There's no point in pointing fingers at people (eg. pharmacists and community pharmacies), if you cannot pay their wages.

“The wages I earned as a newly minted pharmacist back in 2005 was £30,000 or approximately thereabouts. I’m not sure today’s typical salaries for newly qualified pharmacists has kept up with inflation and living costs. Why is that? How does this attract the best people?

“More and more, pharmacy and pharmacists have been expected to do more within the same timeframe and actually the wages we earn in terms of remuneration from the government are low – in direct head-to-head comparison, these figures have not been adjusted for inflation.

“Equally, we do not have a supply chain resiliency which means that we are still dependent on receiving medicines from India and China. This means that there will be more owing and out of stock as we have seen, necessitating the government to implement very quietly the serious shortage protocol, which encourages practise that would not normally have appeared in the last decade. If you don't call this a loss of basic quality standards, then what do you call it?

“70% of UK pharmacists are of ethnic minority background, only 30% are white Caucasians. Hospital pharmacists are predominantly white Caucasian and one could argue that there is some form of misrepresentation of the profession itself with more white people being employed within hospital settings.

“It seems inevitable that the government is not backstopping this sector even though this sector has made every effort to lobby the government. It will be the small independent family-run businesses that will go bust, not the large mega corporations that ultimately send their profits and revenues to the United States.

“Yet, the government is not prepared to rehouse these services for the 67 million patients that the UK has, and we need to have the patient narrative alongside this argument. We are already beginning to see that people in their 60s and above with chronic long-term conditions are struggling through the course of this pandemic, a struggle that has become more difficult since the start of the pandemic, but does not belie the underlying trend that there is difficulty in getting the medicines at the prices that we are being reimbursed at. This alone will build in a time lag, which we know through clinical practise could mean that some diseases and conditions escalate to points where they cannot be then dealt with.

“This does not speak of the emotional and health burden that individual patients carry within our community, which breaks pharmacists’ hearts, because these patients are our allies and champions in maintaining good health within the communities where we work and live and play.

“If not already visible in the data, there will come a time where more pharmacists will retire or leave the profession, meaning that even more has to be done for an ageing national population through even fewer pharmacies and pharmacists. This is when technology and robotics kick in, which is all good, but we need a person to speak and explain to another person how to take their medicine and why they should take their medicine, because people still need advice and guidance from emotional/understanding people. A hand being held, a tear being wiped and a discreet drink of water in a consultation room can make the difference between somebody taking their own life versus somebody putting their chin up and carrying on.

“More and more people cannot go see their doctors, they're coming to see their pharmacist for a variety of non-pharmacy related issues because they are a trusted profession on the high street.

“However, if it is not financially viable, why would any sane individual or firm undertake this type of work?”

Over the last year or so we have seen a coordinated campaign from certain employers and employer representative organisations to blame pharmacy closures on an alleged shortage of pharmacists. This campaign has been ramped up in the last couple of months where we’ve seen companies such as Lloydspharmacy blaming their recruitment and retention issues leading to branch closures on the alleged pharmacist shortage. This has been picked up by a number of local and national news outlets where they essentially acted as a mouthpiece for the multiples without questioning whether there is a genuine shortage or not. We have also seen the RPS and certain board members push this narrative. 

There is now a push to increase the number of places in pharmacy schools, import pharmacists from abroad, stop pharmacists joining primary care and send those already in primary care back into community pharmacy - this would flood the market with the consequence of reducing salaries and Locum rates. In our opinion, this would be an intended consequence brought about by those who seek to put profit and shareholders above patient care and staff welfare.

For well over a decade we have seen a constant reduction in pharmacist salary and locum rates. During the last 5 years hundreds of pharmacies have closed and the number of pharmacists have increased. Yet we’re being asked to believe that just because a couple of thousand pharmacists have moved into primary care roles there are not enough pharmacists to work in the community. What the media and employer representative organisations don’t seem to mention is why is it that only certain employers are having to close branches? Why are companies who pay their pharmacists a fair salary and give them a good working environment don’t seem to have problems keeping their branches open? Why is it since locums have started demanding fairer rates and safer working conditions that companies are all of a sudden demanding an increase in the number of pharmacists. 

There are 56,943 pharmacists on the GPhC register (2021) and an estimated 70% work in community pharmacy. There are currently 13,957 registered pharmacies in the UK which means there are ~ 3 pharmacists for every community pharmacy - a staggering 39860 pharmacists! Even if 7000 pharmacists decide to move completely to primary care that would still leave 32860 available to cover 13957 individual pharmacies. There are around 13,000 pharmacists registered as locums and the rest are employed. If around 27,000 pharmacists are employed to work in 13957 pharmacies with another 13,000 working as locums then how can anyone in their right mind claim there is a pharmacist shortage? Where is the evidence of pharmacist shortage? Has any large scale workforce studies been done to verify this claim? Who profits from an oversupply of pharmacists? What will happen to pharmacist salary and locum rates if the market is flooded with pharmacists?

Is it really a shortage if no one wants to work for you? Should we continue to give money to a professional leadership organisation which clearly has no interest in the profession? More importantly, is it time to create a new professional leadership organisation by pharmacists for pharmacists only and not for private equity funds with deep pockets?

Paul Day, PDA director

“I’m sorry I couldn’t attend interactively tonight. I hope the debate goes well.

“The PDA is the largest pharmacists’ membership organisation in the UK, and as the only independent trade union exclusively for pharmacists, workforce levels are of course something our members are concerned about as it impacts their practice and working lives. I hope this contribution adds to the discussion and it covers some of the points I would have made if I had been able to join you.

“Although the government were persuaded to return ‘pharmacist’ to the ‘shortage occupation list’, and some community pharmacy branches temporarily close with the company/contractor claiming this is due to a shortage of pharmacists, it would be naive to take just that as evidence that there is in fact a real shortage of pharmacists. 

“We need to see what is actually happening too, but first let’s dispel the myth that the increase of a few thousand extra GP practice roles have caused a shortage. The numbers just don’t support that claim, because due to steady growth, which outpaces the growth in GP practice roles, the number of pharmacists registered with the General Pharmaceutical Council (GPhC) is at record levels: well over 60,000 pharmacists.  See also the information we published today: https://www.the-pda.org/workforce-impact-gp-pharmacist-roles/

“At the PDA we do a lot of research. We survey members, we see evidence from the thousands of instances of casework and member support we provide each year, and we hear constantly from employed and locum pharmacists about what they experience. For example, we are currently analysing the results of our annual safer pharmacies survey and a survey about stress and wellbeing in workplaces, which utilises questions developed by the Health and Safety Executive (HSE). That survey focuses on three of the multiples and the results will be published soon.

“The attractiveness of a working environment, including culture, values, resources and stress levels, as well as physical conditions, are significant factors in where someone is prepared to work. Some pharmacists are very frank that they will not work for some chains due to their view of those factors.

“The PDA has submitted freedom-of-information (FOI) requests on community pharmacy closures." (see C+D’s story from earlier this week: https://www.chemistanddruggist.co.uk/CD135780/Temporary-closures-Scottish-health-boards-should-take-over-failing-pharmacies-PDA-suggests)

“We ask if these closures are due to a national shortage of pharmacists, how can a shortage only materially impact some employers to the point they close branches, but not others to the same extent?

“That said, we’ve also seen email exchanges between individual locums who have offered to work in specific branches, but the company has decided to close a branch anyway, perhaps still claiming a shortage of pharmacists even though they have had explicit discussions with at least one locum who was available and offering to cover the shift. Here we ask, how can it be a shortage when there was a professional available?

“That perhaps takes us to ‘money’.  A basic rule of supply and demand is that when demand exceeds supply (i.e a genuine shortage) prices will rise. So that means if there is a shortage of pharmacists then the rates of pay should increase. Yet we continue to see the purchasing power of employed pharmacists’ salaries reduce. Pay increases fail to keep up with inflation, hence the standard of living for many community pharmacists has declined. However, we also note that shareholder dividends at some companies continue to increase.  At Boots, there is now a possibility of an industrial action ballot being held for the first time by pharmacists. How can it be that pay in community pharmacy defies the laws of economics?

“We strongly believe patient safety must remain paramount and attempts to reduce the need for a pharmacist in each pharmacy, through technology, by seeking to change regulations or other factors need to be seriously examined and scrutinised. Equally, any employers that choose to proclaim a ‘workforce crisis’, but then suggest that only others, i.e regulators and educators, need to take action to change the situation, are also missing the point.

“To persuade those already on the register to spend more hours working in community pharmacy, smart employers need to demonstrate the value of the roles they offer. At this point, can I emphasise the PDA recognises that not all pharmacy employers are the same. There are already some great pharmacy employers out there, but sadly they struggle to widely communicate the difference of employment in their pharmacies in a market which is dominated by others and where experience of conditions at a few employers seems to taint the impression of an entire sector.

“Many pharmacists tell us that they want to see an offer of professional autonomy to practice in a workplace that is considered, and managed, as a healthcare setting, not just a retail one. This includes: a focus on patient safety, including safe staffing levels and rest breaks; zero tolerance of violence; competent and fair line management; and yes, of course, salaries that move living standards back towards the real-term values pharmacists previously earned. 

“Deliver that, and then let’s see if the ‘shortage’ still exists.

“Enjoy the debate.”

 

Good evening! C+D's editor Beth Kennedy kicking off the Big Debate this evening. Thank you to @Tohidul Islam for kicking us off with our first live comment. Please note that we have pre-prepared statements from Ravina Barrett, senior lecturer in pharmacy practice at the University of Brighton, as well as one from PDA Director Paul Day to come shortly.

Tonight, we're debating about whether there is a shortage of community pharmacists. Pharmacists have been added to the government's shortage occupation list - but not everyone is convinced that they need to be on that list.

We'll be hearing from a range of speakers, from locum representatives and union leaders to AIMp representatives. Please note that C+D contacted the CCA to join in tonight's discussion, but had not heard back in time for tonight's debate.

Now let's hear from @Paul Mason, who is Superintendent Pharmacist at Lo's Pharmacy Group, representing AIMp.

@Tohidul Islam, what impact do you think locum rates and demand have had on recruitment and retention in community pharmacy?

    The truth is the shortage of pharmacist is due to the certain organisation not giving community pharmacists the value they deserve. The migration of pharmacist out of community is not just a case of economics but also the community pharmacist realising their professional value and the benefits of their acquired skills not just as community pharmacist but also to the wider market. 

    After years of being the last to be considered for change and due to the neglect experience by most community pharmacist during the pandemic is there any wonder why they would look else where. Closure of pharmacy premises has very little to do with a 'lack' of pharmacist but everything to do with what value you are willing to attach to your community pharmacist. We are healthcare professional and being treated as a shopkeeper just clearly does not sit well with us. Give pharmacist the autonomy and value deserved  and there will not be a shortage.

    Pharmacy has a very real problem with the apparent availability of pharmacists to work in community pharmacies, for both employed and locum pharmacist posts.

    The problem is not total numbers of pharmacists, rather that the increasingly pharmacists are attracted to work for NHS organisations, with PCN posts being the fashionable workplace at the moment.

    Community pharmacy by its very nature is a different working environment and is at a disadvantage to PCNs because we cannot provide the same perks, such as working from home, working behind a desk, shorter working hours, working from an appointment list, or tax-payer funded NHS pensions. 

    AIMp members as independent pharmacy groups offer great places to work in and are friendly, supportive employers.  There is a strong desire to employ pharmacists in a variety of positions, and to innovate to drive community pharmacy forward.  They are however held back by the limitations of the current 5 year funding deal, meaning they have suffered flat funding from NHS for a number of years now.

    AIMp has always maintained our position that the lack of a level playing field is at the core of the reasons community pharmacy struggles to recruit and retain pharmacists, not a lack of interest in recruiting and developing pharmacists and finding innovative ways of work.

    @Paul Mason you make an interesting point about the move of some pharmacists into PCNs. I know this has been put forward as a problem by some other organisations, including Community Pharmacy Scotland. To what extent do you think this is causing the problem here in community pharmacy?


    On the flipside, @Tohidul Islam, your opening statement would suggest that you disagree with Paul on this issue. Could you elaborate?

    I think its part, a very significant part, of the problem we face at the moment.  As well as new PCN/GP roles, there also seems to have been a drift towards part-time working which has had a negative impact as well.  Takes working days out of the system, whereas the focus is often solely on “head count”.

    Pharmacist availability has always been very dependent on geography and many areas have always had problems with pharmacist numbers at the same time other areas seem flush.  Opening new schools of pharmacy to deal with this has failed.  This seems to have nothing to do with salaries or nature of pharmacy owners, it’s a simple fact that doesn’t ever seem to change much.  We all draw on personal experience and some will say there are loads of pharmacists, which for their locale may be correct.  I can say without doubt that is not the case in my area, pharmacist availability for locum and employed work is as low as it has ever been.

    It’s hard to say if COVID has made things worse, or just come at the same time as other pressures.  Certainly it seems the drift towards part time working has become more prevalent during the pandemic, and it has precipitated a number early retirements to my observation.

    Locate a Locum recently completed a rates study and rates have nearly doubled since 2020. This is completely down to supply and demand.  I agree with the comments on the total amount of pharmacists however they are simply not choosing to work in community pharmacy. 

    Increasingly pharmacists seem to want to try out PCN work, all for a variety of reasons, but at the heart of it working behind a desk with an appointment list, and taking advantages of the perks of employment such as NHS pensions and shorter working days have been quoted to me as reasons, as much as the desire to do more clinical work has been.

    AIMp members have found that PCN recruitment seems to have particularly drawn away the talented pharmacists we would look to for quality leadership in pharmacies and to drive innovation in the sector.

    These kinds of roles are usually either fully or partly funded centrally by NHS organisations and not by GP/PCN themselves, and benefit from tax-payer funded benefits.  This has left community pharmacy employers at a massive financial disadvantage at a time when they are part way through a 5 year deal of flat funding, essentially a 5 year pay cut when inflation is taken into account.

    Interesting point about pharmacy schools. I remember a point a few years ago when the sector was very angry that the government refused to cap pharmacy school places - the thinking being that rising numbers of pharmacists would drive wages and locum rates down.

    @Beth Kennedy locum rates hasn't affected demand. Demand is dependent on how many employed pharmacists employers are able to retain. Over the last decade or so a lot of employers have been applying unrealistic commercial pressure on their employed pharmacists and pharmacy team leading to recruitment and retention issues. The rate has been steadily going up since 2016 when the Pharmacist Cooperative started to educate pharmacists about rate negotiations and rates in their locality. Recently the rates have gone up because pharmacists are tired of being over worked and underpaid so we're now demanding same rate as 20 years ago in line with inflation. The problem is employers are only happy with the profession as long as we're happy to work for free and bur ourselves out. The RPS has been utterly incompetent at dealing with this issue and are largely to blame for allowing pharmacist to be abused this way by employers. 

    If you want to know about retention issues just ask employed pharmacists, locums and pharmacists in primary care. We did and the result isn't suprising at all. We have been saying for a long time that the only way to resolve the retention issue is to create a good working environment. Pharmacists are literally leaving community pharmacies and working in primary care for lower wage. That should tell you a lot! We're not going to burn out and lose our sanity so private investors can dodge tax and buy a new yacht or mansion. We deserve a fair pay and safe working condition. 

    Some of those new schools have dramatically reduced their cohort size in order to get maintain the standard of student on the course.  That's simply not helping the geographical shortages that they were intended to resolve.

    Please note that the views I express in this debate are my own.

    The shortage narrative is being spun by those who have an interest in ensuring that salaries and Locum rates stay artificially deflated. Looking at the Bank of England tool which gives the value of money between a range of years, my £14.50 per hour in 1997 would now be £36 per hour in 2020. We have companies still spinning the narrative that £20 per hour is still the going rate for a pharmacist or even £19 per hour.

    There may be a shortage of pharmacists who are willing to work for sub par salaries / hourly rates and there may be a shortage of pharmacists willing to work in an understaffed pharmacy while trying to keep the upper management happy by chasing impossible KPIs designed to subdue those trying to achieve them. Pharmacy closures have been blamed on a shortage of pharmacists but where is the data to support this? For each pharmacy that has closed due to this shortage, how many pharmacists have applied for the shift but have been told no or even worse their request was not not even acknowledged? Will those who have closed pharmacies release this data? Of course they won't. They risk being called out.

    If you look at the raw numbers there has been an increase in registrants on the register since 2015. Based on this, there is no shortage of pharmacists. 

    I support the position of TPC. We need the data to support this apparent shortage of pharmacists. 

    A common thread here from everyone seems to be that an increasing number of pharmacists are choosing to move away from community pharmacy. So what could be done to attract more pharmacists into the community? 

    @Paul Mason with due respect the only companies that are finding it difficult to get locum cover are the ones who think we're still stuck in 2005! pharmacists are n't going to primary care for perks they are literally running away from CP because of unrealistic commercial targets, poor staffing, unsafe working conditions and poor pay. If you have a shift anywhere in the country I can guarantee we can get it covered on our network. Its completely free. Send me the branch address and booking date and I will get you a locum. That's a guarantee. There is absolutely no shortage of pharmacists in the country. 

    @Beth Kennedy  As locums rates are increasing, at Locate a Locum we are finding a number of pharmacists considering moving from permanent employment to flexible employment as a locum. This matches key workforce trend reports  which have stated 50% of the workforce will be freelance within the next ten years  https://www.forbes.com/sites/elainepofeldt/2017/10/17/are-we-ready-for-a-workforce-that-is-50-freelance/?sh=549ffc8f3f82

    @Paul Mason The attraction to PCN and NHS organisation is not just fashionable, It is a shift in the culture of how pharmacists see themselves. Can I just ask, what is actually stopping community pharmacists offering similar incentives in order to improve retention. It is clear this pandemic has lead many people to re-access their work live balance and as suck working over 50hours a week does not offer the same value as it did 5years ago. Would it not be better for contractor to consider schemes such as sharing working hours or pairing up with PCNs to offer part time role or shared role. Increasing pension contributions and generally looking to the well being of their pharmacists?

    Community pharmacy is treated poorly by Government and NHS.  Rarely are the warm words converted into anything tangible, other than more work for less (or the same) income. 

    The 5 year funding deal has done community pharmacy few favours on balance and has instead given the Government cover to freeze our income, over a period of time where all pharmacy costs are going up, including all staffing costs.  Unless your pharmacy makes a lot of money from selling shampoo and sandwiches, the NHS is your principle source of income, and that to large extent dictates rates of pay because that is what the Government value pharmacists at.  Its hard to pay pharmacists twice the amount at which their funding is predicated on.

    Many pharmacies are struggling financially as a result, if they are forced out of business, there will be fewer places for pharmacists to seek employment, maybe that is what the Government want, but it is not what anyone inside profession wants.

    @Tohidul Islam I disagree, as you know Locate a Locum works across the whole market ( we currently serve over 10k pharmacies and have over 30k pharmacists registered. We are hearing the same anecdotally from all pharmacies, they are struggling for locum cover 

    A common thread here from everyone seems to be that an increasing number of pharmacists are choosing to move away from community pharmacy. So what could be done to attract more pharmacists into the community? 

    Hi @Beth Kennedy the solution is really simple and what I don't understand is why are so many people pretending its some kind of conundrum wrapped up in an enigma. All we're simply asking is to give us a safer working environment, a fair salary/locum rate thats in line with inflation and staffing level that reflects the workload. Its not a lot to ask for. We love working in community pharmacy but we're literally being driven away by corporate greed. 

    @Jonathon Clarke Locate a locum has a poor reputation among locums and is one of the lowest rates agencies on Pharmacy Revu. Excuse while I take your agencies views with heap of salt. I have seen the rates on offer. I can assure you they're not struggling because of a lack of pharmacists. As I said I can get locum cover for any pharmacy anywhere in the country. Just send me the date and location and I'll find you a locum willing to cover it, unless your Lloydspharmacy in which case I'll need to perform miracles before I can get any locums in their right mind to cover one of their shifts. 

    So what's the solution?

    We have one opinion saying flat funding, increasing costs, more work for less.

    We have another opinion saying better conditions, more support staff, flexible working, development opportunities.

    Perhaps we need a ARRS for community?

    'The government has cut our budget' this line is getting really old. The change in contract offers community pharmacy a chance the change and be more of a clinical environment instead of just a supply sector. There is money to be made in the new contract if only contractors will give pharmacist autonomy and accept the inevitable change that is here.

    Great point @Darren Powell. What does the ARRS look like in hospital pharmacy? Do you think it would be possible to introduce in community pharmacy with the current funding mechanism or would that need to change?

    There was a time where pharmacies were extremely profitable, unfortunately that's not been the case for some time since the price in the Drug Tariff have been driven down so that a fair amount of what we supply is close to cost or even less than buying prices.

    The financial model the Treasury use is clearly broken and is predicated on cheap labour and endless scope for efficiency.  That's clearly not reasonable nor sustainable.

    Owners need to balance income against expenditure in order to stay in business, so raising pay and staffing levels beyond that which the Government will pay for is a recipe for insolvency.

    AIM pharmacies are independently owned and operated, often family businesses, so to tar them with the same brush as the corporate behemoths who are vertically integrated, have huge sources of retail driven income is not fair not accurate.

    If pharmacies are operating at a loss, they will close.  That is not in any our interests, never mind the needs of patients.

    @Nana Ofori-Atta yes the contract hold opportunity, but the total funding is still the same.  Money for services is diverted from dispensing income.

    Flat funding is flat funding.  Its a fact.

    @Darren Powell no ones going to burn out for someone else business. Its really simple as that. The government has given certain level of funding but its also for the individual businesses to develop new revenue streams. What we should be doing instead of cutting wages and staffing levels is ensuring staff are well looked after so they can work with the employers to develop and run new services. By cutting salary and staffing all your doing is pushing people out. The current situation din't happen by accident. It happened because employers have spent the last 15 years maintaining their profit margins by taking it from their staffs wages. We have been keeping them in business and we're no longer going to do that so now we're painted as greedy for wanting fair wages and working conditions. Sorry not going to happen any longer. Employers need to work on better business models. I know a lot of independents that are doing very well by running private services. Only ones I see struggling are the those still focused on volume. 

    @Tohidul Islam I beg to differ. I take Pharmacy Revu as a pinch of salt as it's an embedded google form with a lack of user authentication.  Again your rates surveys are based on opinion and not actual booked shift data.  Interested to hear you can get locum cover anywhere in the country- perhaps you should start your own agency? However, I can also see on companies house you started and closed an agency a number of years previously

    Sadly, pharmacy is not united. There are so many pharmacy representative organisations.  I think this is a contributing factor as to why these issues are extremely difficult to resolve. Compare to GP's, where they have one strong voice. 

    Let's keep the conversation focussed on the issue. How do we encourage the pharmacists out there that community is a career to invest their time and honest labour in to?

    How do we get the public to pay for the services which might replace the reducing margins on dispensing?

    Plus, what do we do with that volume, if it's not providing the return, where does it go?

    Large online hubs?

    I'd like to remind everyone that we're here to debate the topic at hand, and while we're all for a spirited debate, let's refrain from talking one another down, please.

    Here's a link to our guiding principles for a reminder of the standards we promote here on this platform.

    A united voice for pharmacy would be a good start. Second, strong independent pharmacy leaders who want to and can represent the majority of the profession's interests. 

    @Jonathon Clarke take as much salt as you like but the reviews left by locums are not opinions. Unless you think hundreds of locums all dreamt up random locum rates? We're not an agency we're a free to use platform open to all pharmacy owners. I can see why that would be a threat to your business model but we're non-profit organisation and we are happy to work with reputable agencies and employers.

    I looked at developing a different agency model almost a decade ago where employers would have a choice of paying locums based on their level of experience but unfortunately every large employer we spoke to only wanted us to send them the cheapest locums and help them reduce their locum cost by 10% year on year. I wasn't comfortable with this business model and this demand to reduce rates year on year so we decided to not pursue the idea further and closed the company down. I prefer to put my profession and ethics before profit, unlike some agencies. 

    There are examples of pharmacies out there who have embraced changed and innovated their service to produce a profitable model. These are not the giants, these are very much independent pharmacies who have embraced the use of IPs and service provision within their community and have not had to convince patients to pay for their service. The truth is people will pay for convenience which is something we can provide in abundance over any other health service.

    @Darren Powell Hubs and mail order pharmacies present an interesting conundrum.  They may form part of the solution but presently don't seem viable ventures, and a very large proportion of our patient groups still want the face-to-face interaction with their pharmacy, something hub arrangements seem to interfere with

    @Tohidul Islam  The C&D ran this as a news item only a few days ago and seems to back up what you said earlier.

    Data from Healthboards in Scotland showed patterns in pharmacy closures. The data clearly showed that only some companies were closing their pharmacies repeatedly. Other pharmacies (different type of owners) in the same Healthboards had no such issues. 

    Why are these so called "shortages" only affecting certain types of pharmacy owners ?

    And can this then be termed a "shortage" ?

    Temporary closures: Scottish health boards should take over ‘failing pharmacies’, PDA suggests | Chemist+Druggist :: C+D (chemistanddruggist.co.uk)

    And that's the end of our 'live' debate this evening! However, this thread will remain open, so please continue to debate for as long as you like. Thank you to everyone who joined us here this evening, or who provided statements.

    This is one debate that's sure to rage on. One thing I think we can all agree on, though, is that something has got to give. And I think a question posed by @Darren Powell is a fitting one to end on: How do we encourage the pharmacists out there that community is a career to invest their time and honest labour in to?

    Goodnight.

    @bharat nathwani We've been gathering pharmacy closure reports for over a year and its always the same companies. When you look the reviews left on Pharmacy Revu about these companies you can why they can't hire locums. There is no mystery here. 

    In terms of investing in your workforce, I'm aware of one independent multiple is offering its pharmacists the opportunity to undertake IP training.
    Now people might say they are shooting themselves in the foot, but the optimist in me says they are preparing their workforce for future developments in the pharmacy contract. 

    Portfolio careers will be a HUGE thing in the future also. For example, I work one day in GP practice and rest in community pharmacy. I have found these roles to be extremely attractive to pharmacists 

    Struggling to add things up. Read through the comments. If you have quoted figures, taken them at face value. " my £14.50 per hour in 1997 would now be £36 per hour in 2020". "Locate a Locum recently completed a rates study and rates have nearly doubled since 2020. Saw something, very recently on Social Media that average locum rates are £37. Revu, I believe. So, are the locum rates £20 or £37?

    Apparently there are 3 pharmacists for every pharmacy. How does this constitute a shortage? A couple of thousand moving to a different sector cannot be attributed to this perceived shortage, can it?

    To combat this shortage, we are going to open more schools, get them from abroad, stop them working elsewhere, get them back from elsewhere. "  this would flood the market with the consequence of reducing salaries and Locum rates."

    See the problem? If there are 3 pharmacists to every pharmacy, and they are getting £37ph? Only way to explain this is Locum unity never seen through the ages. So x thousand have come together, though some will tell you, pharmacists are disjointed, and flatly refused to work, unless, for fair remuneration. However, if you add a "couple of thousand" new pharmacists, the whole dynamic will go to pot. It will be every man/woman for themselves. We will now have oversupply, because 3 per pharmacy is not oversupply, 3 and a bit is.