Overview
The department conducted a scoping and planning project with a view to give pharmacy staff collective responsibility for improving the well-being of their workplace. The plan was shaped by the staff, for the staff, and best described how they wanted to experience workplace well-being day-to-day in the department.
The result was the ‘Work Well Strategy: Building a healthier and happier culture for our staff’. To bring this strategy to life for staff and embed well-being at a local level, the pharmacy department undertook a quality improvement project with the aim of operationalising the strategy into a local delivery plan. A project manager was recruited for a year to lead the project, with results assessed 12 months on.
Factors impacting workplace well-being in pharmacy
Some 87% of pharmacists and pharmacy technicians are at risk of burnout due to their job, with 61% considering leaving their current role or the profession altogether, survey data shows. The annual Workforce and Wellbeing Survey 2024[1] from charity Pharmacist Support, the Royal Pharmaceutical Society and APTUK surveyed 6,598 pharmacy professionals, students and trainees, finding that risk of burnout rose as high as 91% among those working in community pharmacy. In addition, over one-third (35%) of respondents said their mental health had been either ‘poor’ or ‘very poor’ over the last 12 months, with a further 33% citing theirs as ‘average’.
What’s more, just 21% of those questioned reported feeling as though their mental health and well-being was a priority within their work environment, with 41% saying they ‘rarely’ felt this was the case, and 18% reporting ‘never’ feeling this way.
Meanwhile, a study conducted by the University of Manchester[2] found over one-third (37%) of pharmacy technicians said it wouldn’t take much for them to change careers. Published in the journal Research in Social Administrative Pharmacy in November 2024 and funded by Health Education England – now part of NHS England – the survey attracted responses from 603 GP, hospital and community pharmacy technicians.
A total of 89 respondents (16% of those who answered the question) revealed they were actively looking to leave the profession. When asked about the factors contributing stress to their roles, staff shortages and medicines shortages were commonly cited, along with low pay and a lack of opportunities for career progression.
There’s strong indication that more needs to be done to address employee engagement and retention in pharmacy, with the ‘Work Well Strategy: Building a healthier and happier culture for our staff’ initiative aiming to address these issues.
Devising a workplace well-being strategy for pharmacists
The workplace well-being project implemented by the department set out to create a vision for staff well-being, with ownership at all levels. An operational plan would be required, along with key performance indicators (KPIs) to track the impact of the plan once implemented. But prior to this, research was required, in three key stages.
1. Gap analysis
Firstly, a gap analysis was completed to map what was already available in the department to the aspirations of the strategy. The findings were then grouped into three themes:
- Environment
- Culture
- Communication
The themes of culture and communication were taken forward for further investigation with the wider team.
2. Focus groups
To assess the concept of communication further, pharmacy staff were invited to take part in focus groups, which were structured in three parts:
- Reviewing communication preferences: staff were presented with a copy of the department’s meeting structure and asked to describe its robustness for providing effective lines of communication. The observations from these conversations provided key insights into how staff preferred to access information, and how they liked to be communicated with.
- Assessing wellbeing touchpoints: participants were then asked to describe the touchpoints for wellbeing that occurred throughout the meeting structure. A Red / Amber / Green status was used to capture the consensus opinion. This gave a temperature check of staff experience within the existing business-as-usual model.
- Ranking wellbeing tools: finally, staff were asked to consider a selection of wellbeing tools and rank them in order of preference. This proved to be a useful exercise, as it challenged assumptions held by the project leads.
To ensure the focus groups were inclusive for all staff, line managers were given advanced notice, so the time could be booked off in the rota for staff to attend.
3. Staff surveys
Thirdly, to investigate departmental culture, staff opinion about joy in work was captured using questions based on the “What Matters to You?” conversation guide[3] from the Institute for Healthcare Improvement. These questions were posted on whiteboards, displayed on digital canvases, and promoted through the sharing of QR codes. The questions were:
- What matters to you in daily work?
- What helps make a good day?
- What gets in the way of a good day?
- Rank the current staff culture as either sunny, cloudy or stormy
In addition, subjective surrogate indicators of the plan’s effectiveness were created from the dimensions of the Fair Work Framework[4] , taking the form of 8 ‘pulse’ surveys, with the intention of continually checking in with department staff following the plan’s implementation.
These surveys were themed around:
- Fair treatment: Our values are at the centre of all we do
- Reward: Do you feel appreciated for the work you do?
- Staff voice: I would feel able to talk openly with my line manager if I was feeling stressed
Creating the operational plan & developing KPIs
The operational plan was a one-page document, inclusive of three locally developed ‘work well’ objectives, presented alongside a list of deliverables. The information gathered from the ‘You said, we listened’ focus group exercises formed the recommendations in the operational well-being plan. Objective measures for evaluating the plan’s impact were categorised into five KPIs:
- Departmental vacancy rate
- Percentage of sickness absence
- Number of completed ‘stay conversations’
- Annual appraisal completion rate
- Instances of peer-to-peer recognition, appreciation or gratitude via the employee engagement platform
Implementing the pharmacy employee well-being strategy
Good management and leadership practices lead to better performance, including better retention, creating a positive work environment and meeting business objectives. Given the importance of effective management to workplace well-being and productivity, it was decided that training managers and empowering leaders should be the initial focus of the project’s implementation. This took the form of a series of workshops looking at knowledge, skills and behaviours, such as how to have meaningful management conversations.
The Chartered Management Institute[5] reports that 82% of managers who enter management positions have not had any formal management and leadership training – that they are ‘accidental managers’. Our workshops were complemented by the development of a training checklist, designed to support managers to identify and address any skills or knowledge gaps through their personal development plans – these would also be shared with aspiring managers for their development.
A role descriptor for department ‘Well-being Champions’ was also being developed using the Plan-Do-Study-Act (PDSA) cycle[6] and staff feedback. Leaning into the principle of collective responsibility, these champions would be responsible in part for leading on the delivery of the department’s operational wellbeing plan.
One year on: what was the impact of the pharmacy workplace wellbeing plan?
The first 12 months of the pharmacy workplace well-being project’s implementation impacted staff experience and workforce metrics, as ‘stay’ conversations and appraisals were conducted, and staff felt empowered to embrace peer-to-peer recognition. The results were as follows:
1. Departmental vacancy rate
To help staff contextualise their experience of their working conditions, two KPIs relating to headcount were reported each month: the pharmacy vacancy rate, and the staff sickness absence rate.
Also known as the ‘establishment gap’, the vacancy rate is the percentage difference between the total funded establishment for each month, compared to the total whole time equivalent of staff in post.
In the 12 months preceding the implementation of the well-being plan, the establishment gap was 6.2%. While it was hoped the impact of the plan would be to improve recruitment and retention, instead this percentage increased to 11.1% over the following 12 months. This could be attributed to the additional investment received by the department for middle grade posts, which have been traditionally challenging for the department to recruit to.
2. Sickness absence rate
However, the reverse was observed for the department’s sickness absence rate, where it met the Scottish government’s target[7] for NHS boards of 4% or less, by falling from 6.5% to 4%.
3. Number of completed ‘stay’ conversations
Stay conversations are one-to-one retention discussions. Guidance issued to the department recommended that line managers should have them with each of their team members at least every six months.
Despite this, only six out of a potential 128 (4.7%) stay conversations were recorded during the first 12 months of the well-being plan. The team at St John’s Hospital recognised that this was an area for improvement, and will be explored through the regular peer check-ins which have subsequently been scheduled for the department line managers.
In other settings, there is data showing the effectiveness of stay conversations, with a review from University Hospitals Leicester, reported in The Pharmaceutical Journal[8] , finding that 96% of respondents who took part in these discussions felt listened to afterwards. What’s more, 92% said they had felt confident raising concerns, with 88% finding the conversation useful, and 92% saying they’d like further stay conversations to take place in future.
4. Annual appraisal completion rate
Following the introduction of the pharmacy workplace well-being programme, the organisation’s 80% target for completing annual appraisals had been achieved and maintained, meeting this KPI.
5. Instances of peer-to-peer recognition and appreciation
According to the IHI Framework for Improving Joy in Work[9] by the Institute for Healthcare Improvement, camaraderie and teamwork is one of five fundamental human needs which must be met to improve joy in work. For this reason, instances of peer-to-peer recognition, appreciation or gratitude via the employee engagement platform were included as a KPI in the operational well-being plan.
The monthly count of these instances were recorded as declining; however, it is possible that staff were sending praise via one of the other digital promoted methods, for which data collection was not possible. Recommended methods included:
- GREAT-ix
- Microsoft Teams
- Awesome postcards[10]
Pharmacy workforce well-being: resources and initiatives
There are multiple schemes and resource libraries designed to provide pharmacists and pharmacy technicians with extra support, and to improve long-term staff retention. For example, the changing role of pharmacy technicians under Pharmacy First offers more autonomy, and more varied responsibilities, potentially improving staff satisfaction.
Meanwhile, the charity Pharmacist Support[11] has been helping pharmacy professionals for over 180 years with everything from mental health to achieving a better work-life balance. The General Pharmaceutical Council (GPhC)[12] outlines that all pharmacy leaders have a responsibility to:
- Provide staff with the supporting, training and resources necessary to perform their roles to a high standard
- Ensure staff have the opportunity to, and are encouraged to, raise any concerns
- Provide a safe working environment
- Provide facilities for breaks
These measures are designed to ensure that pharmacy professionals’ well-being is prioritised by leaders, and that everyone feels supported at work. Joining a pharmacy network, such as UKCPA, can also provide you with extra support throughout your career, from when you’re a trainee pharmacist, right through your time as a qualified pharmacist.
Join UKCPA for support throughout your pharmacy career
Become a member of UKCPA for less than £3 a week to join a supportive community that will provide you with a whole host of opportunities throughout your career. The benefits of joining UKCPA include:
- Find a community dedicated to your field of interest, from Community Health Services to Care of Older Peopleand from Infection to Emergency Care
- Get access to an extensive resource library, featuring research, papers, and useful documents submitted by your peers
- Keep on top of your training with ongoing, expert-led education
- Take part in forum discussions on everything from workplace well-being to medicines safety
- Connect with other pharmacy professionals in person or online at regular networking events
Acknowledgements
Parts of this article are based on an original piece by Lynne Merchant, Site Lead Pharmacist at St John’s Hospital in NHS Lothian.
