Increasing community pharmacy workloads in England: causes and consequences

Objective To explore English community pharmacists experiences of workload increases. Setting North West of England. Method Ninety-six women and 71 men replied (response rates = 40 and 31%, respectively). Thirty female pharmacists and 29 male pharmacists were interviewed between February 2005 and February 2008. The study involved semi-structured face-to-face interviews with theoretically sampled respondents. Interviews were recorded and transcribed verbatim and a thematic analysis conducted. Main outcome measures English community pharmacists’ opinions and experiences. This paper specifically considers the following themes, community pharmacists’ accounts of workload, role expansion, skill mix, management support, coping strategies, perceptions of patient safety, and impact on pharmacists health and well-being. Results Respondents reported escalating workloads in community pharmacy, which most respondents linked to increased stress and decreased job satisfaction. There were striking differences in the work patterns described by the male and female community pharmacists. Male interviewees commonly worked full time, in senior positions in community pharmacy. Female interviewees commonly worked part time as employees. This study suggests that interviewees perceived that skill mix initiatives were not currently helped pharmacists deal with rising workload demands. Additionally, this study found some evidence that work intensification resulted in decreased health and well-being and prompted concerns about patient safety. Community pharmacists are more vulnerable to work intensification than other health care professions. The demand-control-support model was applied to understand causes of work related stress. Interviews described using problem based coping strategies to combat stressful working environments. Conclusions Workloads have increased in community pharmacy and the work environment has become increasingly stressful. Consideration of the factors shaping community pharmacy point to continued workload increases. This is likely to have a negative impact on pharmacists and conceivably the services they provide. Skilled support staff, supportive management and appropriate resourcing are required to maintain high quality services.