(Members see page with links to view documents)
The career structure implementation is badly needed - pharmacists are working as specialists without the commensurate support and recognition. The path has been long and challenging, here is a road map of the journey.
As you can see from the timescale above the grades that hospital pharmacists are working to were last reviewed in 1978. They were fit for that time but things have moved on. Many things have changed in the last 40 years - ABBA and The Bee Gees no longer top the charts, Grease is no longer on at the cinema and similarly hospital practice has moved on!
This is the key driver for the HPAI - to bring a new supportive career structure that not only is fit for now but also fit for the future. The past work leading to the current negotiations give the best chance of change that we have had in those 40 years. This is why it is vital that if we are serious about laying the foundations for our future we support this initiative.
The Hospital Pharmacy Review (sometimes known as the Career Structure Review) was published in November 2011. The review aimed to create a structure for Hospital Pharmacy to best facilitate a consistent delivery of pharmacy services in line with best practice and recognised international standards. The current structures and grades, Basic, Senior, Chief II and Chief I were implemented in 1978 and in no way reflect the current complexity and specialist knowledge that is required to manage medicines in a modern hospital. In 1986 the HPAI notified Health Service Management of the need to conduct a new review in order to match changes in practice in European countries and further abroad.
The Review itself suffered much delay. In 1990 the PSI launched their “Commission of Inquiry into Pharmacy” which recommended a career structure overhaul. Unfortunately there was no restructuring after this report, however the 1990’s saw Hospital Pharmacists introduce specialisations that had a profoundly positive effect on patient safety and cost effectiveness. These specialisations included clinical pharmacy and aseptic compounding. In the next decade, specialisations were extended to include medication safety pharmacists and antimicrobial pharmacists. In the last decade, IT developments, cluster pharmacy services and automation projects, although isolated, emerged within hospital pharmacy and pointed to the next generation of creative developments.
A second review of structures within hospital pharmacy was approved by the Department of Health and Children in 2001. In 2005, the Department of Finance agreed to the finalisation of outstanding
reviews, such as that of hospital pharmacists, where service improvements were involved. Further delays were however incurred due to the establishment of the Health Service Executive (HSE) on January 1st 2005 and the commencement of the Pharmacy Act on the 22nd May 2007. In late 2009, Dr. Ambrose McLoughlin was appointed as Chair of the Review of Hospital Pharmacy.
In December 2011 the Hospital Pharmacy Review was signed off by the HSE and the HPAI and the expectation was that the Review would then proceed to implementation. However, despite the repeated efforts of the HPAI negotiation team, not a single aspect of the Review has yet been implemented.
The Hospital Pharmacy Review is available in the members section
In March 2018 a presentation was given to Heads of Department detailing the progress made up to that date it is available here
Brian Rattigan, Vice President (IR) describes below the background to the composite report which was finalised in 2017 and takes us up to the present status of negotiations with the HSE.
The Pharmacy Review was completed and agreed in November 2011. New job descriptions for the management and specialist grades were agreed 12 months later.
Despite repeated and sincere efforts by IMPACT/HPAI to initiate the implementation phase, the HSE did not engage in a
IMPACT issued a directive in May 2014 to all Hospital Pharmacist members of the union (note not limited to HPAI members)
Compliance with this directive by Hospital Pharmacists was effective in leading to a meeting in September 2016 with Liam Woods,
Interim Director, Acute Hospital Services, HSE . He approved the mechanism to establish a Steering Group to oversee the implementation of the Pharmacy Review in early 2017 .
The Steering group also created a Joint HSE/IMPACT Working Group and subsequently four Sub-groups. The Acute Hospital Drugs Management Programme were well represented on the management side. .
The Steering Group agreed the reports (the Composite Report) for the Implementation of the Pharmacy Review in August 2017 .
By agreement of both sides, a process was arranged for HPAI/IMPACT to lodge documentation which matched the job descriptions of the 4 new grades with higher salary scales. This meeting took place on October 11th 2017 at which the management side pledged to :
(a) Give by return their response within 3 weeks
(b) Give by return their draft initial business plan for DPER to validate the service improvements and cost savings achieved with Implementation of the Pharmacy Review.
(c) Invite IMPACT/HPAI to work with them to strengthen the submission to DPER and most likely to also attend at the submission.
At this meeting on October 11th 2017, the management side stated they already had provided financial space in the HSE financial estimates for 2018
HPAI /IMPACT lodged their documentation on October 13th.
The HSE did not honour any of their 3 commitments.
Hence in mid 2018 IMPACT (now called FORSA) sought the intervention of the Workplace Relations Commission .
Please note the Composite Report is finished and agreed. You are welcome to share the report with Hospital Pharmacist work colleagues who are not members of the HPAI if you wish.
The composite report is available here
Under the auspices of the WRC, FORSA reached an agreement with the HSE on an employer/union agreement in respect of the Hospital Pharmacy Career Structure in acute hospitals.
The 2020 agreement is available here with appendix here along with the WRC letter covering the proposal
FORSA balloted Hospital Pharmacist members on this proposal in September 2020. FORSA Explanatory note from Ballot here
The membership accepted the agreement and FORSA moved to seek immediate implementation.
After several months with no implementation (coinciding with the announcement of a national emergency due to covid 19) FORSA wrote to the HSE in January 2021 as it became apparent that the employer wished to direct the agreement into the Building Momentum Public sector pay agreement.
The January 2021 letter is available here
The employer replied in April 2021 with a letter confirming that the agreement could be funded outside of the 1% allowed under building momentum
Continued WRC meetings between HPAI/FORSA and the employer side made no meaningful progress leading up to November 2021.
At the November 2021 WRC meeting the employer side declared that they were not in a position to fund the agreement outside of the building momentum agreement.
In December 2021 FORSA issued a Directive instructing hospital pharmacist members to cease the provision of financial and other data.
A ballot for industrial action up to and including strike was planned for January 2022
A series of online briefings were held by the HPAI in conjunction with FORSA over the Christmas 2021 period.
Due to Covid restrictions FORSA held an online ballot of its members for industrial action up to and including strike.
HSE CERS issued a response to the directive (here)
On the 26th of January FORSA declared that the result of the ballot way a vote of 94.5%in favour (forsa release here).
Preparations for Industrial action were underway with a planned date of Wednesday February 16th, however communication came on the 11th of February that the case was to be brought to the Labour Court and therefore industrial action was deferred.
A meeting was held with representatives from the HSE, FORSA, HPAI, WRC at the workplace relations commission on March 16th. At this meeting both parties agreed to an urgent referral to the Labour Court.
A date in the Labour Court was scheduled for the 30th of June. In the session it emerged that during the national pay talks on an extension/successor to Building Momentum a credible solution for resolution was identified. FORSA issued a note to members explaining this. (here)
The public sector pay agreement contained a line covering the implementation under section 2.7 . For the agreement to be put into place a national ballot was required.
At this point our FORSA representatives Eamonn Donnelley and Catherine Keogh moved into alternate roles and were replaced By National Secretary Linda Kenny
An acceptance of the agreement was obtained from a ballot of public sector workers which then allowed for the consideration of implementation of the career structure agreement.
FORSA immediately wrote to the HSE seeking a meeting to discuss full implementation without delay. (here)
An initial implementation meeting was organised for the 10th of November with representation from the HSE, DoH, FORSA and HPAI. At this constructive meeting the first stage of implementation was secured covering the elements of the agreement that covered Basic grade Pharmacists and Heads of Department in Model 4,3&2 hospitals. A further meeting was arranged to discuss the next elements identified by the management side namely the Deputy Pharmacist executive manager roles and Advanced Pharmacist Specialist on the 12th of January. (FORSA updated members here)
In order to enact these changes official communication had to be sought in the form of Circulars, one from the DoH to the HSE and one from the HSE f or local implementation. The creation of new grade codes, salary scales and job specifications was required to produce these documents.
The first of these circulars was published in January 2023 (here)
Due to illness the second implementation meeting was rescheduled to the 2nd of February 2023.
About the association
The Hospital Pharmacists Association of Ireland (HPAI) is a voluntary organisation that represents it members on issues relevant to hospital pharmacists.
The Hospital Pharmacists Association of Ireland exists to:
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