P95 Recommendations for UK hepatology pharmacy staffing standards for adult services

<h3>Introduction</h3> The fundamental objective of adult hepatology pharmacy services is to provide effective pharmaceutical care (direct and indirect), to promote and deliver medicines optimisation, supporting people with liver disease and post liver transplant to get the best healthcare outcomes from their medicines. Prior to this survey, little was known about the UK hepatology pharmacy workforce. To understand the current workforce in terms of staffing levels, skill mix, roles and risks, a working group was established to create a workforce survey, with the intention to subsequently make recommendations for UK hepatology pharmacy staffing standards. <h3>Methods</h3> A request for volunteers to be part of the workforce working group was sent via the British Hepatology Pharmacy Group, British Liver Transplant Group and the Solid Organ Transplant Pharmacy Association. Five pharmacists and one pharmacy technician formed this group. In addition two paediatric pharmacists were invited to contribute to the development of the workforce survey. The survey was drafted using existing surveys from the Renal Pharmacy and Dietician teams who have published their workforce survey results. This was piloted at 3 sites and subsequently amended. The final survey was disseminated in 2023 to all UK pharmacy teams providing pharmacy hepatology services. <h3>Results</h3> Seventeen centres responded to the survey of which 5 (29%) were based at District General Hospitals, 2 (12%) based at centres providing secondary and tertiary level hepatology services, 3 (18%) at secondary care centres and 7 (41%) were based at centres providing tertiary level care. Figure 1 showed the spread of pharmacy staff members, with a greater number and higher levels of banding in tertiary level centres. In addition to inpatient care, pharmacists and pharmacy technicians are increasingly involved in providing outpatient care. Per week, on average 18 patients with viral hepatitis, 5 patients with autoimmune liver diseass, 15 transplant patients, 15 surgical pre-assessment patients and 6 patients with advanced chronic liver disease were reviewed in pharmacy led clinics. When asked about safety concerns of current staffing levels the following were raised: ‘Unable to develop/expand service, drive innovation’ ‘Reduced opportunities for MDT working’ ‘Poor health at work’ (stress or sickness, working unpaid/paid overtime) <h3>Conclusions</h3> The findings from the survey show the pharmacy team are integral members of the hepatology multi-professional team. However, this is not consistent across the UK and recognition and investment is key in order to ensure this workforce remains sustainable given the increasing incidence of liver disease in the UK.