1. Global pharmacy workforce and migration – recipient perspective Professor Karen Hassell EuroPharm Forum Bratislava, Slovakia 13 th October 2007

2. The GB pharmacy workforce Third largest professional group in the health care sector in GB: 47,692 registered pharmacists in 2007 estimated > 77,000 support workforce 23 schools of pharmacy (8 are new) 57% of practising pharmacists are female 2604 pharmacists joined the register in 2006 But 1932 left the register in 2006 Average 2% increase in number per year

3. Distribution of pharmacists in selected EU countries (2004 data) Data source: www.fip.org

4. But workforce shortages exist… Multiples taking up to 10 weeks to recruit Vacancy rate of 10% in large multiples 12% of hospital pharmacists posts vacant or occupied by a locum (2006 data) High turnover and exit from the hospital sector Geographical inequalities: rural & urban Not confined to qualified pharmacists

5. Impact of shortages? High(er) workload Non-store staff provide cover Reduction in leave/training Work longer hours (owners) Increased stress and dissatisfaction at work Closure of community pharmacies Cessation of current services Failure to take up new services

6. Why do these shortages exist? 1.Demand for pharmacists and pharmacy services increasing: Increase in dispensing volume More older people Client expectations (‘demanding consumer’) More OTC and P medicines available New national pharmacy contract (in 2005) Provision of enhanced and advanced services ‘Professionalisation’ agenda

7. 2.More ‘chain store’ pharmacies: 16% of the total in 1971; 57% in 2007 Open longer hours Provide more services 3.More employment markets for pharmacists: Eg, primary care Increases competition between sectors

8. 4.Behaviour and socio-demographic changes in the workforce: More women (and fewer men) Baby boomers versus Generation Y Changing expectations and attitudes to work High proportions not practising pharmacy at all 32% work part-time (2005 data) A substantial number migrate overseas

9. Emigration of GB trained pharmacists In 2007 4718 pharmacists on the GB register were domiciled outside GB Most (66%) were GB-trained (but not necessarily GB nationals) PULL: lifestyle, career opportunity, returning home, & partner’s job were main reasons for leaving GB; most are working in retail pharmacy; many have no intention of returning to GB in the short term.

10. 1.Expand student intake 2.Implement skill mix – ie, utilise technicians 3.Utilise technology/automation 4.Improve workforce satisfaction 5.Encourage leavers to return 6.Recruit foreign-trained pharmacists… Solutions to the shortages ?

11. Foreign-trained pharmacists in GB There were three (but now two) routes for overseas pharmacists to enter the register of pharmacists: ‘European’ ‘Adjudicating’ Reciprocity route abolished in 2006

12. Foreign trained pharmacists domiciled in GB, by entry route

13. Source countries Through EU route: Spain (and Poland) Through Reciprocity route: Australia and New Zealand Through the Adjudication route: ?

14. Distribution of pharmacists (2003/04 data) Data source: www.who.int/whosis/database

15. Issues for GB as a recipient Recognise that GB is a donor as well as a recipient Need some open debate: The good and bad of migration Should GB be taking pharmacists from countries with shortages of their own? The individual’s right to migrate?

16. What should GB be doing? Employer responsibilities: Awareness of situation in donor countries Guard against exploitation and poor work conditions Devise strategies for successful integration Responsibilities of policy makers: Raise awareness Meaningful HR planning Have a co-ordinated policy approach to the recruitment of foreign-trained pharmacists Sign up to an ethical code of recruitment

17. What should the professional body do? Continue to invest in ‘workforce research’ – but more needed on migration patterns; and more on monitoring movement Establish mechanisms to mitigate the adverse impact of migration on donor countries, eg: Assist donor countries to expand their capacity to train and retain staff Encourage ‘partnerships’ between countries of origin and GB

18. Thank you Please visit our website: The Centre for Pharmacy Workforce Studies www.manchester.ac.uk/cpws