Hospital pharmacy career pathways need reviewed

Hospital pharmacists

Senior hospital pharmacists have been telling us of the difficulty they face in recruiting staff at Bands 6 and 7; the training and junior grades in hospital pharmacy. However, newly registered pharmacists have told us that they were experiencing the opposite: jobs in hospital pharmacy were proving hard to find. Working with MSPs in the Scottish Parliament the Society has secured data on staffing and vacancy levels for pharmacists in the Scottish hospital sector to investigate further.

At first glance the data suggests that hospital pharmacy is quite healthy. There has been an overall increase in the number of pharmacists employed in the Scottish hospital sector over the last three years (Table 1). Looking closer however suggests that there are some deep seated problems. The expansion of overall numbers has come as a result of disproportionate growth in technician and senior pharmacist grades at the expense of Bands 6 and 7.

 

Table 1 - Numbers employed as pharmacists in Scottish hospitals, 2007 - 2010

 

Total number employed

Proportion of workforce (%)

Band

2010

2007

2010

2007

9

11

5

0.80

0.54

8d

22

19

1.60

2.04

8c

46

17

3.35

1.82

8b

186

107

13.56

11.47

8a

554

325

40.38

34.83

7

326

259

23.76

27.75

6

227

201

16.55

21.55

TOTAL

1372

933

100

100

Source: ISD Scotland

 

While there has been some growth in Band 6 posts, it has not kept pace with the growth seen at Band 8a and above. Indeed, as the table shows, 40% of hospital pharmacists are now employed at Band 8a, more than the number employed at the Band 6 and 7 combined. It is expected that many of the current 8a and 8b pharmacists will be in post until retirement. These are complex, responsible jobs with a great deal of autonomy. We welcome that the pharmacists in these posts are recognised for their professional expertise.  This grading structure creates a career bottleneck though and we need more Band 7 and 6 pharmacists to guarantee good succession planning. This point is reinforced when looking at data on vacancy rates in the sector (Table 2):

 

Table 2 - Vacancies in Scottish hospital pharmacy by Band, Sept 2010

Band         Total vacancies (%)

3 months + vacancies (%)

9

18.2

18.2%

8d

0

0

8c

3.1

3.1%

8b

2.0

2.0%

8a

4.1

3.6%

7

10.7

8.9%

6

11.6

4.1%

Source: ISD Scotland

 

While the level of vacancies at Band 9 looks high, it should be noted that there are in fact few of these posts in Scotland. The number of Band 8d and 8c posts are also very small, reflecting their seniority. The data on Bands 8a, 7 and 6 shows that there is an issue with workforce structure in Scottish hospital pharmacy. As things stand there is reduced opportunity for younger hospital pharmacists as there is little movement of staff on higher grades. Furthermore, there is the fear that some Band 7 and 6 posts may have been sacrificed to upgrade posts or assist with staff budgets where they have been over spent.

The re-grading introduced under Agenda for Change (AfC) in the early 2000s appears to be partly to blame. Pharmacists in some Health Board areas have complained of being poorly banded. It appears that this problem has been allowed to remain unresolved for a number of years, this has created uncertainty and is damaging morale.

The data we have received suggests that pharmacists at the beginning of a career in hospital pharmacy are facing two major challenges: a falling number of posts at Band 6 and 7 that will get their career started and a grading system that creates bottle-necks that reduce opportunities to make progress. The Royal Pharmaceutical Society in Scotland believes that Band 6 posts should be protected and increased in number as they provide the training posts for the hospital pharmacists and hospital specialists of the future. We also need a career structure that differentiates between those that develop clinical specialisms and those that take on management responsibilities.