Identifying the risks and opportunities associated with skill mix changes and labour substitution in pharmacy
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Identifying the risks and opportunities associated with skill mix changes and labour substitution in pharmacy

A CfWI report in collaboration with the University of Manchester to provide managers and workforce planners with evidence to inform their choices when addressing workforce challenges.

This briefing paper considers the evidence for using skill mix and labour substitution in pharmacy, to address a number of outcomes such as making efficiency savings.

Evidence related to two forms of labour substitution is reviewed:

  • Substitution consisting of inter-professional role substitution (such as pharmacists taking on the roles of doctors).
  • Substitution involving intra-professional role substitution (such as reconsidering the roles within the pharmacy team – technicians performing tasks previously performed by pharmacists).

The findings indicate that:

  • Pharmacists and technicians can undertake enhanced roles in an effective and safe way.
  • Substitution is acceptable both to users and providers of healthcare.
  • Training to provide enhanced roles may have resource implications.
  • There is very little evidence that labour substitution is cost effective.
  • The evidence that exists is based on small-scale, descriptive studies where the research design prevents generalisation to other settings.

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