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.