The PDA wants to thank those who participated, whilst at the same time encouraging even more locum members to engage in future surveys. Respondents mainly practiced in community pharmacy settings where, without doubt, the key identified issue is that rates have reduced in actual and real terms.
Reduced rates of pay
One anonymous respondent was recorded saying, “Rates have gone down drastically. Now you will have to learn more things at your own time and be able to have the skills to provide services (EHC, pharmacy first…) at a lower/similar rate.”
Another respondent had documentary evidence of how severe some reductions in rates have been, sharing that, “I have invoices in my loft for prior to 2008 where the locum rate was 23/hr, today the same company is paying 21/hr.”
The PDA emphasises that the equivalent value of £23 in 2008 is around £37 and therefore, in real terms, this is a reduction in rates of more than 40%.
Other pharmacists who have been practicing as locums for decades shared similar perspectives, with some respondents stating, “I have been doing locum work for 32 years; on average, I get paid £1 per hour more than I did 32 years ago.”
“As a community pharmacist who registered 20 years ago, I received £25-£30 per hour plus full travel and paid accommodation if I worked away from home. It’s nothing short of a professional scandal that Locums are being paid as low as £25-£26 today, which is a massive real terms cut considering inflation and the cost-of-living crisis. I am unaware of any other profession where such rate stagnation has occurred.”
and
“Locum rates are now extremely low, some less than a technician’s wage!”
What has changed
While some examples above highlight decreases in rates compared to previous periods, several survey respondents noted that it is in recent years that rates have reduced significantly, noting, “The way the rates have decreased since Covid-19 has been shocking.”
Contractor behaviour
The PDA recognises that since the Covid-19 pandemic, some pharmacy contractors were choosing to close pharmacies rather than pay locums market rates, and unfortunately, the survey revealed this practice continues post-pandemic, with some survey respondents stating, “Companies seem to think accepting no locum at all and closing their branch for the day is more acceptable than paying a locum a fair rate and remaining open.”
“Several companies have non-negotiable rates and allow pharmacies to close as opposed to paying a slightly higher rate.”
“Multiple companies are staying closed rather than booking a locum. Denying patients access to their medications in favour of profits. Zero accountability- getting away without any repercussions.”
and
“…companies closing stores for half a day to share a pharmacist and pharmacists are almost coerced into doing this for them. Also, some pharmacies just close for a full Saturday without consulting the health board. They are not afraid of the repercussions because there doesn’t tend to be any for them.”
The PDA has continued to raise concerns over the impact of this practice on patients and communities, as well as the reputation of the profession and sector, yet site closures are not an isolated issue with employers. Other questionable behaviours have included contractors cancelling bookings without fair notice to secure a different pharmacist at a lower rate. One respondent said, “I’ve had a number of shifts cancelled without notice, only for them to be advertised again a couple days later, without offering them back to me when I’d already been booked for them prior.”
However, as one respondent said, there is clearly a perception that, “…owners can do whatever they want without any consequences from GPhC. GPhC only threatens individual locums, but they never do anything about unscrupulous owners, even including those who are pharmacists themselves. There’s a two-tier justice system when there’s two different standards governing owners and individuals.”
Supply and Demand
Some respondents highlighted the impact of newly qualified locums and those who have moved away from employed roles to locum. One experienced locum highlighted the impact of an “…influx of [locum] pharmacists who are either new or were previously in permanent positions…” and who may be “scared of walking away from low paying shifts and having unplanned days off. So, they just click and book via terrible platforms …at ridiculous rates.”
The impact of LloydsPharmacy leaving the market, Boots and other multiples reducing their number of pharmacies over recent years and other changes in the ownership, and the closures of community pharmacies, have simultaneously seemed to have impacted the demand for locums. One comment from the survey stated that, “The amount of work available has been hugely impacted by the collapse of Lloyds. Independent pharmacists are doing most of the work themselves or have brought in people known to them.”
The net effect of the combined behaviours of some pharmacy businesses and of the locum agencies they use, was also a significant topic of discussion in responses. The removal of locums’ ability to negotiate rates was seen as highly restrictive, and seemingly having the single consideration of securing a responsible pharmacist (RP) at the lowest possible rate, was recognised as a questionable practice. One respondent noted, “It seems bizarre to be so focused on one solitary deciding factor when securing the services of a healthcare professional. How would those behind these tactics feel if the NHS used similar tactics to secure the services of a surgeon for the lifesaving operation a relative was about to have performed on them?”
The impact reported by respondents
The survey responses showed a significant negative impact both financially and mentally, with many concerning comments including, “We have bills to pay. If I’d have known they would be this bad I wouldn’t have trained to be a pharmacist I would’ve used my skills elsewhere for better pay and morale”
“This makes me question whether continuing in the profession is sustainable.”
“I am trying to step away from pharmacy as the rates for locum are so bad, it is not worth the added stress coupled with the fact they are increasing workload, so more stress, more extra learning, more pressure to do services and then less pay.”
“I earn more per day doing my freelance website building work (which required minimal training) than I do ‘locuming’.”
“I am seriously considering changing career as the rates do not reflect the work and responsibilities I now have!”
What action is needed for pharmacists
The PDA is already negotiating rates of pay for some employed pharmacists via union recognition agreements, as well as being part of the NHS Staff Side structures for those employed in roles covered by Agenda for Change. If there were a negotiating structure for locum rates, the PDA is positioned and prepared to be able to represent the collective interests of locums, and this is something the PDA has already taken specialist legal advice upon.
However, no such structures exist yet, and therefore, alternative actions are required. Some actions, such as highlighting the temporary closures of pharmacies to avoid paying locum rates are already underway, and the PDA will continue to do this until the regulators, or the governments (in their role as commissioner for the pharmacy contract in each nation) take the necessary steps to prevent more pharmacies being affected.
Other measures can also benefit from the PDA’s reach as the largest pharmacist membership body in the UK. Due to this survey and those that follow, the PDA is committed to exploring any opportunities that present themselves to improve the practice and working conditions for all locums.
Further analysis of the survey results, and the PDA’s response will follow in future updates.
In the meantime, locum members with thoughts on this subject can email: [email protected]
Not yet a PDA member?
If you have not yet joined the PDA, we encourage you to join today and ask your colleagues to do the same.
Membership is FREE to pharmacy students, trainee pharmacists and for the first three months of being newly qualified.
Read about our key member benefits here.