1) Getting Started.
It is desirable that you have some community experience. If not, approach large city centre pharmacies, they often employ two or more pharmacists and several technicians. You will be the second pharmacist and carrying out clinical and final checks. If you are outgoing, they will be pleased if you are the 'front' man/woman dealing with customer queries and handing out completed scripts.
If you have some experience, simply create a CV and a card and walk around local pharmacies to introduce yourself. Give dates available and remember that they will want someone for Weekends/Bank Holidays for starters.
2) First time at a new pharmacy.
If possible, ask to visit during 'quiet' time to see the dispensary layout and PMR system. Always 'phone the day before to confirm and ask re parking, hours, lunchtime closure etc. Would be good to obtain seniors home 'phone or mobile and give your own. Useful if stuck on the motorway.
3) Information exchange.
Ask for notes to be left. Even if they say the dispenser will be there, she could be away ill that day. Leave notes for your successor (In diary is best). Nothing more annoying than the patient coming in and say something was promised and you know nothing about it. Phone the following day to resolve any queries. If something permanent ie the flavour of Gaviscon put a note into PMR.
4) Be punctual.
I was usually the first to arrive. Remember to sign in as RS. With regard to SOPs, many companies have these available as PDFs and will email them to you on request (could be 6mb or more).
You cannot expect to have detailed knowledge of SOPs, but check critical areas: Eg: Handling of CDs. Owings, 'loans', emergency supplies. Generally, fall in with 'custom and practice' unless you consider there is a danger.
5) Get accredited in the various CCGs.
These will usually mean studying a CPP course and attendance at a CCG organised meeting. I have had to stay away on some occasions. All training costs such as mileage and accommodation can be claimed against tax. List any accreditation in your letters eg:
PCT Accreditations:
Cambridgeshire: Smartcard, MUR, EHC PGD, Impetigo PGD, Smoking Cessation
Suffolk: Smartcard, MUR, Smoking Cessation.
Norfolk: Smartcard, MUR.
6) Locum co-ordinators etc
These can be obtained by 'phoning the local pharmacy and asking for details.
Write an introductory letter with details of experience etc, accreditations etc.
List available dates for three months ahead and each month confirm existing bookings and give dates available on a rolling three-month basis. Most coordinators like to communicate by email. Keep two diaries, one personal and one desk-sized to be the master diary. Reconcile at least once a week.
7) Average Pharmacy Locum Wages.
Many companies have standard rates for locums, however, you should set your own standard wage and use that as default.
Eg,
Monday to Friday 8-7 £23/hour
Saturday £26/hour
Sundays/Bank Holidays Rota £43.50 for the first hour
£29/hour
Christmas, Easter, New Year's Day £59 for the first hour, Sunday rate thereafter.
You could negotiate your own rate for emergencies, ie booked on the day.
Mileage is usually paid after 40 miles total. Ie 44 miles, you can claim for 4 miles. As this constitutes part of your fee, you will be taxed and therefore the total mileage ie 44 can be claimed against tax (currently allowance is 40p/mile).
Some companies require you to fill in an invoice on a form, others on the computer. Issue an internal invoice for your accounting. For a good locum, form go to www.pharmacysop.com
7) Taxation and Accounts
You can start your financial year at any time. However, I was advised to start on May 1st. This meant I had the best part of two years to prepare accounts. I would strongly advise the use of an accountant. One advertises on this and other forums, another advertises specifically to locums in the PJ. The PDA has just started offering accountancy. If you are a full-time locum, consider becoming a limited company and pay yourself the minimum wage and take the rest as dividends which carry a lower tax rate.
Tax is paid twice a year, July and January. Make sure payment is on time. You should set aside approximately 25% income to cover the tax. This can be deposited in a fixed interest account, I put mine into Premium Bonds.
If your wife/husband/partner is not working, then pay them to look after the diary/phone and maybe do some bookkeeping.
8) Records
It is essential to keep your personal money completely separate. I originally had a business account at the bank but found charges excessive. I then changed to a NationWide Business Account and they make no charges and pay interest. However, you will need £5,000 as an initial deposit. Most of this can be drawn out when the account opened. You will receive a bank statement each month and it is vital that your records match this exactly. I maintain three accounts inside Sage: Cash payments, Bank payments and Bank receipts. Inside each account are various nominal acts and each payment or receipt can be allocated to a specific nominal code ie Petrol is 7300.
9) Accountants
As said before, the advice is essential. Accountants advertise in the forum and in the PJ. Some will accept Sage accts, others want figures set out on Excel spreadsheet. Once you have your master set, fairly easy to present as your accountant requires. Remember that you could be investigated at any time by IR. Accounts should be preserved for six years. Use of an accountant will mean that investigation risk is minimised, they have their reputations to safeguard.
10) Pharmacy Cross-Platform Accreditation
There are many different types of PMR systems. Often when starting it can be quite confusing and difficult to adjust. We have created a course that is recognized by all major locuming firms which train you to use all the different major PMR systems. Click the link below to join up or follow this link to learn more about the Pharmacy Cross-Platform Accreditation.
A few more locum pharmacist tips...
"ACT's (aka cheap labour)"
"Inherently flawed/ rotten to the core, our profession"
"Never underestimate the stupidity of the public"
It is very easy to fall into a pessimistic attitude once you become a pharmacist. If you get bogged down in the monotony of getting a box of a shelf, printing labels, sticking them on boxes and giving them to patients you will inevitably turn into one of the many scornful pharmacists who seem to inhabit so many articles in the Journal and online forums.
Realistically, this is unfortunately the core of our profession. To accurately dispense medicines against little green bits of paper, signed by someone who is constantly telling you what to do is hard. No doubt, to be a lackey of doctors, bending to their every whim is extremely arduous. But is it? As pharmacists do we not have the choice in what we do? Do we not have options?
When I get fed up of blistered fingers from putting labels on boxes or being sneezed on by "front line contact" patients I thank the heavens I am not a doctor. The responsibility, the liability, the workload of it all, is horrendous. As a pharmacist I am free to do as I please, the liquidity of the labour market is such that I can easily find work in another pharmacy as quickly as it is to speak on the phone to one of the many locum agencies begging for pharmacists.
The greatest aspect of the pharmacy profession is flexibility, to have options to do as you wish. You are not tied down to a regimen of appointments and rely solely on thoroughfare, it gives you periods of quiet where you can do as you wish. If this is to do marketing to generate more business, online pharmacy, import-export, medical journalism, CPD, talking to patients the options are infinite.
I honestly think pharmacists have it good in comparison, not only to doctors but to the vast array of professions out there. What other profession can you enter where you immediately gain a wage nearly twice of your peers of a similar age? Understandably, this wage does not, as in many other professions increase as you progress. But the compensation is increased flexibility, free time, and the ability and opportunity to explore other avenues to generate income.
Make the most of it.
Locum Checklist:
Once you have become a fully qualified pharmacist and embark on the freelancing world, the learning does not stop there...
Have a look at our example CVs. There are a few attributes that every good locum has on their CV. Remember large multiples sometimes do not allow post pre-reg unqualified pharmacists to work for them:
1. Computer skills with proficiency in:
Rx systems
Link 1/2
Pharmasys - online via M3
Pharmacy Manager
Eclipse - closed down 2009.
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Compass
Mediphase - Nexphase
Park
Positive Solutions
Smart Script |
2. CPD via CPPE (look at http://www.cppe.manchester.ac.uk/):
Substance misuse certification
Repeat dispensing.
MUR certified - a must with some of the big chains. Check this link.
Up to date Continual Professional Development Diary (look at www.uptodate.org.uk)
3. CCG specific services, these can include:
| Smoking cessation - supplying NRT, some PCT are reluctant to train staff due to high costs. |
Vaccinations (specificaly flu) - this can be very popular in later months of the year. |
Minor Ailments - you need to have signed the PGD to supply chloramphenicol. |
Chlamydia screening - a relatively new service where the patient submits a urine sample. |
| Bowel cancer screening - involves giving cards that can hold a faeces sample. |
Cardiovascular risk assessment - a series of tests that measures cholesterol and other factors to gauge whether patients are at risk. |
EHC PGD - this means "the morning after pill" can be supplied free of charge to selected groups of people ie under 18's. |
EHC OTC - this means the "morning after pill" can be sold over the counter. |
| BMI Check - calculate their height (m) and weight (kg), square their height and divide by their weight. |
Palliative Care - specially commissioned service. |
Concordance Service
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Keep Well Program
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| Needle Exchange - helping those addicted to injectable drugs do so safely. |
Methameasure competence - a type of methadone measuring device. |
Alcohol screening
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Suboxone Supervision
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| Pregnancy Testing
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Intervention Screening
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TB Screening - sometimes commissioned in densely populated immigration areas. |
BP Monitoring
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| Alli Training
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C Card Condoms
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Eye Care Scheme
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Sexual Health Scheme
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