The appointment of practice pharmacists is becoming a more common arrangement, a trend unlikely to trail off as predicted shortfalls in the numbers of both GPs and practice nurses over the next decade bite. It’s a business model that seems to have an official stamp of approval from NHS England, which has more than doubled (to £31m) the cash available for a pilot project to part-fund new clinical pharmacist posts. However, there are several things to need to bear in mind when recruiting a practice pharmacist.
1. Be aware of, and budget for, the real cost of recruitment.
The cost of recruitment is always higher than you expect. As with any new employee, the cost of recruiting and training is high, and the cost of getting it wrong and having to go back to square one is even higher. The interview process is time consuming, after which a new employee will need support from other professionals within the practice.
2. Make time for your current team to support the new employees
Allocate time for your exiting staff to induct and support the new team members. Much of the workload will fall on the shoulders of the practice manager and so a key consideration is timing - when can he or she afford to invest the time needed to integrate a new person into the practice? There are peaks and troughs in practice management activity, so plan ahead. Remember, too, that anyone who has not worked in general practice before will need a structured induction programme and typically need training in anything from use of your computer systems to QOF and QIPP.
3. Beware the effect on cash flow
There are also peaks and troughs in practice income and it can be some time before you see a ‘return on investment’. If you are not able to generate some income by releasing locum staff immediately, that will have an effect on cash flow. There may also be external HR consultancy fees to find. I would therefore advise to look well ahead and involve your accountancy advisers. Yes, our key role is to advise on financial performance and cash flow management and how to optimise the flow of funds through the business, but we are also well aware that if the workflow isn’t right, and the longer terms plans are on the radar, then the cash flow never will be right either.
You should expect your accountant to have enough knowledge of the business of running your practice to be able to advise you on both timing and funding. Adding a whole new skill set to the practice is a planned process, not a distress purchase because someone just quit. Do it on your terms, in your time and get it right first time.
4. Have full and frank conversations with existing partners, salaried GPs and locums about their future plans
Make sure you are filling the right gap. It’s not just a case of finding the right person for the job, but also the right job for the practice. While your current needs might be for an entry-level candidate to manage and authorise repeat prescriptions, an advanced-level pharmacist can potentially take more workload from GPs with, for instance, carrying out face-to-face medication reviews. This might be a better option if you have a partner about to retire or are funding a GP locum whose skills are being underused.
For most practices, this will be the first time they have employed a pharmacist but the key practical considerations are not so different from the employment of practice nurses. So, this could be a good opportunity to give your HR and employment practices a health check as well.
5. Plan a career path for the pharmacist
Do bear in mind the many years of training and practical experience involved in gaining necessary pharmacy qualifications, and understand that potential new team members taking on the role of practice pharmacist are likely to be looking for a career path. Therefore, you have to have a roadmap in mind for how the role can develop or accept that you will need to manage relatively frequent turnover. Both options have operational and financial implications.
David Martin is a partner at accountants Knill James and heads the firm’s medical sector team.