6 7


Recent focus on the pharmacy workforce in Australia, Canada, Great Britain, and the USA [11-18]; the 2006 and 2009 FIP Global Pharmacy Workforce reports [19,20]; and a systematic review of the literature [21] add to our understanding of the complex issues that countries face. It is not just a simple case of supply and demand. There is also a need for countries to model their workforce needs based on predicted future provision of services and care, roles and responsibilities of the pharmacy support workforce, increased use of technology, the advancement of biotechnology and personalised medicine, demographic changes, and future patterns of working all while ensuring there is a sustainable academic workforce to maintain the supply of suitably trained pharmacists.

2.2 Systematic review of the literature on the pharmacy workforce

A systematic review of the literature from January 2006 to March 2012 was undertaken that focuses upon the issues facing the expansion of the global pharmacy workforce. Contemporary issues surrounding the global pharmacy workforce and, more specifically, the published methods used to expand the workforce were systematically identified and reviewed. One hundred and nine studies were included in the review, to be published separately. Findings from the review (in press) are summarised below.

Working conditions and job satisfaction

The level of job satisfaction among pharmacy personnel is an important indicator of staff turnover and retention. The primary determinants of job satisfaction were intrinsic aspects of the job; that is, factors that make people satisfied are the work that they do or the way in which they are used. A number of studies found female pharmacists hold high levels of job satisfaction compared with their male counterparts. Job position was consistently found to be a significant predictor of job satisfaction. Other factors identified as increasing pharmacist retention were good remuneration, good relationships with co-workers, and flexible schedules. Factors increasing staff turnover included high stress, insufficient or unqualified staff, and poor salary. Further, job stress and excessive workload negatively affect job satisfaction. Evidence also suggests that pharmacists engaged in shift work might present unique characteristics, which has implications for labour supply and pharmacy services delivery.

Workforce development: education, training, and leadership

Continuing professional development (CPD) has the potential to be useful in pharmacy workforce revalidation. Time, finan- cial costs, resource issues, understanding of CPD, facilitation


and support for CPD, motivation and interest in CPD, attitudes towards compulsory CPD, system constraints, and technical problems were identified as key barriers to CPD. Pharmacy professionals on the whole agreed with the principle of engaging with CPD, but there was little evidence to suggest widespreadand wholehearted acceptance and uptake of CPD, essential for revalidation. Direct experience of effective CPD in the absence of perceived barriers could impact personal and professional development and patient benefit, thus strengthening personal beliefs in the value of CPD.

Supply and demand issues: Current status and future directions

Increased demand and limited supply of pharmacists constrains the ability of the workforce to expand. Many different supply and demand factors that influence the pharmacy profession were identified, the majority of which were common to most countries. The most common factors increasing demand for pharmacists were increased feminisation, increased clinical governance measures through continually reviewing and improving the quality of patient care, increased numbers of prescriptions, and increased complexity of medication therapy. The most common factors mitigating demand for pharmacists included increased use of technology, expansion in the numbers and roles of pharmacy technicians, and increased numbers of pharmacy graduates.

Pharmacy workforce migration

There is greater migration from less-developed countries to more-developed countries. The pharmacist workforce from African and Asian countries was disproportionately affected by migration. A significant number of pharmacists from developing countries migrate to the developed world; however, the extent of such migration was not properly captured. Postulated reasons for migration include better remuneration, joining or supporting family, political and social instability, poor living conditions, poor working conditions and management, unsafe environment, further training and qualifications, and job opportunities and satisfaction.

2.3 Conclusion

This systematic review updates and builds a better understanding of the current challenges affecting the global pharmacy workforce in ensuring equitable access and responsible use of safe, effective and quality medicines. This review complements findings from the 2012 Global Pharmacy Workforce Survey on workforce composition and expands on findings from the 2006 and 2009 workforce reports.



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