The staffing crisis in New Zealand pharmacies continues unabated and whilst it might feel like no one is listening, I hear your cries for help and I’m advocating the need for industry change.
Advocating for industry change
In my role as New Zealand’s pharmacy recruitment specialist, I experience frustration from both sides of the fence.
Pharmacy owners need more pharmacists but there simply aren’t enough registered and suitably qualified pharmacists available to meet the current demand.
I’m talking to several qualified pharmacists who are keen to work in New Zealand but they’re bogged down by bureaucratic red tape, high costs of entry, lengthy training, or their qualifications aren’t recognised here.
Let’s take a look at some of the employment barriers prospective pharmacists and dispensary staff are facing and what I think we could do to remove these and speed up the employment process.
Who are the best people for the job?
There’s a long-held belief in New Zealand, that Kiwis are always the best people for the job. I don’t share this belief, as I consider it a handbrake on our sector's growth. Regardless of beliefs, the reality of the situation is that there just aren’t enough Kiwis wanting the work.
It’s time to create a new narrative
New Zealand is in the grip of a labour market squeeze, which is slowing business growth. Employers are stubbornly resisting the demand for increased pay rates, so Kiwi pharmacists are leaving the profession, going offshore in search of better pay, taking time out to raise children, or changing career paths completely for a better work/life balance.
We need to change our outdated outlook and create a fresh perspective.
Surely the best people for the job are those who have a pharmacy degree or related qualification and valuable pharmacy experience - wherever they come from, who have the desire to live and work in New Zealand.
These will fit into one of four categories:
New Zealand residents with a pharmacy degree and industry experience
New NZ graduates seeking an internship to gain experience in New Zealand pharmacy.
Overseas pharmacists with a pharmacy degree and experience, who want to live in New Zealand.
Certified Technicians
Let’s take a look at each of these and consider the barriers these groups are currently facing and what could be done to help them.
1. New Zealand residents with a pharmacy degree and experience
My recommendations regarding the need to address the short and long-term consequences of pharmacy mental health is well documented in my blog “Why NZ pharmacy is facing a staffing landslide”. If we want to stem the exodus of staff from the profession, we need to:
Revise the community pharmacy funding model
Reduce stress levels and prevent burnout (which will come when more vacancies are filled)
Listen to staff and offer greater flexibility
Introduce incentives, increase pay rates and make them feel valued again
Be generous with praise, show your appreciation and improve employee motivation
Revise the way pharmacists are paid and consider commission to those pharmacists providing more services (as we are now seeing in Australia), or consider grading pharmacists according to accredited skills and expereince and using a pay scale.
The ‘disappearance’ of the minimal hours practicing pharmacists'
I’ve found that a high percentage of female pharmacists remove themselves from the practicing register when having children. I’m told they do this to eliminate the time commitments expected of them (450 hours per three years minimum) and the disproportionately high annual fees involved. We need to incentivise these valued professionals to stay on the register and continue to practice to ‘keep their hand in’. They are the “fat” in our staffing numbers and we need to acknowledge them.
Incentivising part-timers and /or locums to be available for work
Despite being on a lower or more variable income, part-timers and locums are still expected to pay the same annual registration fees and PSNZ fees as full-time pharmacists, who also benefit from having their ACC fees paid by their employer if permanent.
We could do so much more to remove these barriers and incentivise those working part-time or having children, to remain on the practice register and continue to be available to work:
Could we introduce a lower tier, pro-rata registration fee for part-time pharmacists, encouraging them to remain registered and available for work? That way they won’t be as tempted to leave the profession and will endeavour to maintain their skills.
Remove the need to submit a signed declaration of hours worked. I suspect these are not always accurate reflections.
Remove the requirement for a specified number of work hours in a given period. This could free up and encourage parents and locums to be available to cover staff leave or work ad hoc days as required.
2. New NZ graduates seeking an internship to gain experience in New Zealand pharmacy
Every year New Zealand produces more than 120 pharmacy graduates all of whom need to undertake a year’s internship under the guidance of a preceptor. As a condition of their degree, they’re generally required to complete that internship within 12 months of their final exams. The theory is that they make an immediate contribution, sharing their knowledge and expertise with our teams.
The main barriers affecting this group are onerous costs, poor hourly pay rates, and an inflexible internship intake date.
Although many businesses pay for their EVOLVE internship programme, other interns struggle to find the $5,400 cost. Could the PSNZ invoice this in quarterly installments to spread the financial burden for these interns?
Some contributing employers are then reducing the already poor hourly rate of pay to just $23 an hour. A rate that incidentally hasn’t changed in over 20 years when I did my internship. Come on - we need to do better than that.
$23 an hour is not a competitive rate to start with and is well below the starting salary for other professional graduates. This is causing our interns to feel devalued and generates dissatisfaction and disappointment - which isn’t a great start to a young person’s career in our profession.
Why do we still have only one intake for EVOLVE each year? Could the EVOLVE programme have two intakes per annum, 6 months apart? This would be particularly popular with overseas registered pharmacists where the January timing isn’t always compatible with their immigration timing.
3. Overseas pharmacists with a pharmacy degree and experience who want to live in New Zealand
It frustrates me that there are so many qualified pharmacists desperate to come to New Zealand to work. I currently have 12 overseas candidates in my recruitment pipeline and I don’t understand why we are making it so difficult for them.
If our archaic policies and slow processing times aren’t enough to put candidates off, Immigration New Zealand isn’t exactly rolling out the welcome mat.
We urgently need Immigration New Zealand to add pharmacists to the critical skills shortage list now.
The Pharmacy Council needs to be more open-minded and recognise the degrees of more overseas pharmacists especially when they have already been working in a country we reciprocate with.
I fully appreciate the need for professional education standards, but under the current circumstances, could our requirements be softened? Countries like Australia, Canada, Ireland, and the UK are already taking this approach and are securing the lion’s share of migrating pharmacists whilst New Zealand misses out.
The current training requirements, costs, and time to undertake them are overly burdensome. Council and PSNZ need to remove all unnecessary rules and regulations and introduce a new fast-track system to help speed up the process. In my opinion, this needs a full review.
The current delay between passing KAPs and starting the Law and Ethics course can be up to 8 months. We need to increase the frequency of the NZ law course and the EVOLVE intake annually so that the three components can be undertaken consecutively within a single 12-14 month period.
We need to review the upfront training fees for the law & ethics course currently $2,400 and allow experienced international pharmacists to hit the ground running when they arrive, instead of coming in as overqualified technicians, with the drop in income associated with that.
We need to put an end to discriminatory hourly rates and be willing to pay off-shore and on-shore interns the same generous hourly rate of pay. This will make them equally attractive to employers.
PSNZ could introduce a single training fee for all candidates wanting to undertake the EVOLVE intern programme, instead of charging internationals $3,000 more than on-shore interns to do the same course.
4. Certified Technicians
We need to break down the ludicrous belief that a pharmacy technician "needs" to be NZ-trained. Yes we have different laws and international technicians may need a review of these but the skill set is identical.
Certified PACT technicians can be relied upon to undertake the final accuracy check on dispensed items in our pharmacies. This is a particularly valuable role given the current shortage of qualified pharmacists and this additional responsibility can be achieved with minimal red tape.
I encourage you to incentivise and support more of your pharmacy technicians to undertake this training programme now, encouraging employee development and career progression from within your existing teams.
I’d also like to see the following PACT technician progression barriers under review:
Could the length of post-level 5 qualification experience be reduced from 2 years down to 12 months?
Could we remove the stipulation regarding 6 months at their current site?
Could we allow a PACT technician to use their certification as a locum across different pharmacies - a practice currently restricted?
Could intern preceptors have the option of managing a PACT at the same time and be funded and rewarded individually to do so?
Could experienced PACTs be authorised to serve as a preceptor for new PACTs and be funded to do so, freeing up intern preceptors or allowing more PACTs to be managed at one time in a single pharmacy?
I’d welcome the opportunity to address these barriers in an industry-wide, solution-focused forum and invite expressions of interest via email to amelia@pharmacyrecruit.co.nz
Feel free to add your comments below.
Amelia
