Background
Cancer Pharmacists undertake a broad range of activities unique to cancer services. To develop a sustainable cancer pharmacist workforce, contemporary workforce indicators are needed to inform clinical resourcing. Whilst workforce guidelines exist for cancer pharmacy services, feedback from staff indicated that these are not reflective of the resourcing required to provide comprehensive cancer pharmacy services in our state.
Aim
To develop a contemporary cancer pharmacy workforce model reflective of best practice care in a statewide pharmacy service.
Method
We utilised the World Health Organisation ‘Workload Indicators of Staffing Need (WISN)’ methodology. Cancer pharmacist workshops defined best practice workload components using the SHPA Oncology and Haematology Standards of Practice. Human resource data and prior pharmacist workforce surveys informed indirect patient care, administrative and leave components. Cancer pharmacists were surveyed to determine the duration and frequency of each activity. Additional activity data was sourced from coded hospital activity and electronic medical record reports.
Results
The survey response rate was 50%. Using this methodology, we established an optimal pharmacist to patient ratio in our cancer outpatient setting of 1:10. The time taken for standard clinical activities (eg. medication reconciliation) was consistent with non-cancer clinical areas. Cancer specific activities, such as protocol verification and governance activities, increased cancer pharmacist demand. Further modelling is required for inpatient and paediatric activity. There was broad support for optimising clinical pharmacy technicians in this workforce.
Discussion and Conclusion
We now understand cancer pharmacist workload indicators and required resourcing in our outpatient setting. This will inform resourcing allocations and provides a baseline to evaluate the impact of service changes on workforce needs. It also contributes to the evidence base for use by other cancer pharmacy services. Strategies to explore how pharmacy technicians can help provide top tier clinical services and prioritisation models are under development.