Clinical pharmacist shortage threatens health care, claims A.P.E.S.
The Laval News
Martin C. Barry
A provincial association representing pharmacists working in public health care institutions across Quebec is suggesting that a decline in the number of staff pharmacists in Laval and other areas of the province is compromising health care and requires action by the government in order to avoid passing the consequences on to service users and patients.
Vacancies at CISSS
The Association de pharmaciens des établissements de santé (A.P.E.S.) du Québec says that the results of a survey it recently completed indicate there is a 12 per cent job vacancy rate in the Laval region for pharmacists working within public health care establishments.
The A.P.E.S. says that as of April 1 last year, five equivalent full-time pharmacist positions remained unfilled out of a total of 43 positions for pharmacists at the Centre intégré de santé et de services sociaux (CISSS) de Laval.
Impact felt, says A.P.E.S.
Across Quebec, according to the association, one in-house pharmacist position out of five (19 per cent) was vacant. The 2020 survey found 286 full-time health care system pharmacist positions remained unfilled across the province.
The A.P.E.S. says the COVID-19 pandemic very possibly worsened the situation, although the association was unable to compile corroborating data given the restrictions from the pandemic.
“We have come to a point where the shortage is impacting how well the pharmaceutical needs of hospitalized and ambulatory patients as well as patients living in CHSLDs can be covered,” said A.P.E.S. president François Paradis.
“So, taking into account the aging of the population and an explosion of acute and chronic health problems, a health establishment must be able to count on a sufficient number of pharmacists. As experts in pharmaceuticals, they must systematically be part of the care teams in an interdisciplinary fashion.”
The A.P.E.S. estimates that the shortage of pharmacists could result in any or all of the following consequences:
Greater risk of errors committed while filling prescriptions;
Unnecessarily lengthy hospital stays;
Heightened risk of secondary pharmaceutical side effects;
Relapses and rehospitalizations (revolving door syndrome);
Reduced quality of life for patients;
Higher costs overall for the health care system.
A working agreement between the pharmacists who are members of the association and the Quebec government expired at the end of March 2020 and is still up for renewal. Among the more outstanding of the A.P.E.S.’s unresolved issues is the hiring of new pharmacists in the province’s hospitals and long-term care facilities.
The group says that from 20 to 50 per cent of the remuneration paid to its pharmacists is based on “temporary” clauses in the agreement, which the A.P.E.S wants to see made permanent in order to do away with uncertainty that surfaces each time agreements are renewed.
Remuneration at issue
“In the past 10 years, we have graduated on average 62 pharmacists per year from the master’s program in advanced pharmacotherapy, which is preparation for working in a hospital environment,” Paradis continued. “As much as we are seeing a noticeable increase in admissions to the program, there has to be more incentive to get into this profession. And this can only be established through a more reliable system of remuneration.”
The temporary measures in question included extending the work week by approximately 10 per cent, thus adding 130 full-time staff pharmacists to the provincial network. The measures also included additional recognition of the pharmacists’ assistance in helping to train advanced pharmacotherapy students. And the measures took into account difficulties encountered in being able to recruit new pharmacists in certain regions of the province.
“It’s now more than 10 years that these measures have been in place,” said A.P.E.S. executive-director Linda Vaillant, who is a professional pharmacist. “There’s no longer anything temporary about them except for the name.
“The Ministry of Health and Social Services and the A.P.E.S. have unanimously recognized, in a joint report tabled in the fall of 2019, the efficiency and the pertinence of these measures,” she added. “Their report, the result of work completed in a committee over a period of 18 months, recommends the renewal. What more is needed to convince the government?”
The A.P.E.S. maintains that neglect of the remuneration issue is the main reason for the loss of staff pharmacists in the province’s public health care system since the year 2000. They predict the number of vacancies will only grow if the issue remains unresolved by the government.