Introduction
The need to determine and manage appropriate staffing resource to be competitive and profitable has long been recognised in industry and commerce, and there is much for healthcare providers to learn from this. With a growing elderly population, increasing reliance on health services and limited resources, healthcare delivery is increasingly driven by cost containment and tight budgetary management. The challenge in terms of effective staff resource calculation to optimise productivity falls to all professions within healthcare and pharmacy is no exception.
The development of Clinical pharmacy services over the past 40 years has been largely based on the seminal paper by Hepler and Strand[1] on pharmacists’ responsibility to deliver ‘pharmaceutical care’. The objectives of these services have been clearly described as the management and prevention of medicines-related problems to achieve optimum health outcomes for individual patients, and the benefits of clinical pharmacy services have been demonstrated in terms of economic and patient safety outcomes[2-5]. However, much of the published literature on pharmacy staffing focuses on prioritisation of limited resources and productivity, mainly concentrating on dispensary services and supply functions, rather than the clinical aspects of pharmaceutical care[6,7]. Previous studies have determined hospital clinical pharmacy workforce requirements, based on tasks required for service delivery[8,9]. However, these estimates relied on a fixed number of 24 beds and an inpatient length of stay of 6 days, which limits their practical application to local scenarios with different patient throughput or service models.
In recent years there has been an increased focus on the Pharmacy workforce in the UK, particularly in reducing unwarranted variation, and identifying accurate baseline workforce requirements has become a priority [10]. It has been suggested that in order to be accepted into practice any healthcare workforce calculator tool needs to meet the four requirements of being simple to operate, adaptable to changing service delivery models, seen as valid by the healthcare practitioners and the outputs of it should be accepted and understood by non-clinicians[11]. The Clinical Pharmacy Workforce Calculator (CPWC) was initially developed from local time and motion studies of the tasks a group of senior pharmacists considered necessary for the delivery of care, the time the tasks routinely took pharmacists and the frequency with which local policy required them to be done. The resulting algorithm was simple to use since it required only the entry of bed numbers and average length of stay data to calculate the pharmacy staffing requirements of a ward-based service[12]. It was used to determine the pharmacist staffing needs of a series of new local service delivery initiatives and the CPWC output was accepted by senior hospital management. The next step then was for it to be validated by clinical pharmacists by more general application to other hospital pharmacy services, in different settings, which included considering its content validity and the reliability and consistency of its output[13]. The methodology adopted to do so is transferable to other settings and this report outlines a practical approach to addressing the issue of staffing levels for pharmacy practice.