The locum pharmacy sector in the UK has undergone significant changes over the past year, as revealed by the Pharmacist Cooperative's annual surveys. Comparing the 2023 and 2024 reports provides valuable insights into the shifting landscape and highlights concerning trends that affect locum pharmacists nationwide. This analysis examines key developments in the market, their impact on locum pharmacists, and practical strategies for improving hourly rates and working conditions amidst these challenges.

Market Dynamics: A Worsening Situation

The comparison between the 2023 and 2024 surveys reveals a deteriorating market for locum pharmacists in several key areas:

Finding Work: Increasingly Difficult

The percentage of locums reporting difficulty in finding bookings has increased dramatically from 55.6% in 2023 to 70.4% in 2024. This represents a 14.8 percentage point increase in just one year, indicating a significant contraction in available work or increased competition.

More concerning is the rise in pharmacists unable to secure work despite being available. In 2023, 24.8% of locums reported no days without bookings when available, but by 2024, only 17.8% could say the same. The proportion of locums experiencing more than 20 days per month without work despite availability has risen from 11.7% to 17.8%.

Downward Pressure on Rates: More Pronounced

The hourly rate distribution shows a clear downward shift:

2023 Hourly Rates:

• £40-£44: 27.7%
• £35-£39: 25.5%
• £30-£34: 17.4%
• Below £30: 4.6%

2024 Hourly Rates:

• £40-£44: 13.5% (down 14.2 percentage points)
• £35-£39: 29.8% (up 4.3 percentage points)
• £30-£34: 33.7% (up 16.3 percentage points)
• Below £30: 14.0% (up 9.4 percentage points)

This shift demonstrates a clear compression of rates toward the lower end of the scale, with far fewer locums commanding premium rates and significantly more accepting rates below £30 per hour.

Rate Pressure and Intimidation: Worsening

The pressure to accept lower rates has intensified:

• 2023: 87.8% of locums reported facing pressure (61.5% definitely, 26.4% sometimes)
• 2024: 86.5% reported facing pressure (63.1% definitely, 23.4% sometimes)

While the overall pressure remains high, there has been a slight shift toward more definitive pressure. More alarming is the increase in intimidation tactics, with reports of threats or intimidation rising from 19.2% in 2023 to 25.3% in 2024.

Agency Performance: Consistently Poor

Both reports highlight significant dissatisfaction with locum agencies, with Locate a Locum consistently rated the worst. The 2024 survey reveals that this platform is now perceived as actively driving down rates by removing negotiation options, representing a systemic shift in how bookings are managed.

Impact on the Profession: Increased Uncertainty and Career Shifts

The deteriorating market conditions have had profound effects on locum pharmacists:

Financial Insecurity

The combination of lower rates and fewer available shifts has created serious financial pressure for many locums. The surveys indicate that even experienced professionals are struggling to maintain their income levels from previous years, with many reporting rate reductions of £5-10 per hour.

Professional Devaluation

Responses across both surveys highlight a growing sentiment that the profession is being devalued, with pharmacists increasingly treated as interchangeable resources rather than healthcare professionals deserving of appropriate compensation for their expertise and responsibilities.

Career Redirection

Perhaps the most significant impact is the evident shift toward alternative career paths:

• Independent Prescribing (IP) qualifications have risen from 15.8% of respondents in 2023 to 25.9% in 2024.
• Interest in pursuing IP among non-qualified pharmacists remains high at 58.8% in 2024 (compared to 69.7% in 2023).
• There's an increased focus on upskilling to move away from traditional community pharmacy roles, with 54.2% of 2024 respondents either currently undertaking or seriously considering additional qualifications.

Strategies for Locum Pharmacists: Navigating the New Landscape

Despite the challenging environment, there are several approaches locum pharmacists can consider to improve their position:

1. Professional Differentiation Through Qualifications

The survey data clearly shows that diversifying skills is essential:

• Independent Prescribing: With a growing percentage of locums qualifying as IPs, this credential is increasingly becoming an essential differentiator. The ability to work across community pharmacy, hospitals, GP practices, and PCNs creates multiple income streams and reduces dependency on traditional locum work.

• Specialisation: Consider focused training in high-demand areas like diabetes management, dermatology, or travel medicine. The 2024 survey indicates that locums with specialised skills are better positioned to command higher rates or secure positions in more stable environments.

2. Strategic Booking Approaches

With agencies receiving poor ratings and driving down rates, alternative booking strategies are worth exploring:

• Direct Relationships: Both surveys indicate that direct bookings generally result in better rates. Invest time in building relationships with pharmacy managers rather than relying exclusively on agencies or platforms.

• Collaborative Networks: Consider joining the Pharmacist Cooperative Telegram network and Syrkle.net where pharmacists can share past rates, booking information and support each other in maintaining professional standards and avoid bad employers, agencies and branches.

• Geographic Flexibility: The data shows that most locums travel significant distances (65.9% travelling 10-50 miles in 2023; 61.6% travelling 30-50 miles in 2024). Being willing to travel can significantly increase booking opportunities, though this should be factored into rate calculations.

3. Rate Negotiation Strategies

Both reports highlight the challenges of rate negotiation, but several approaches may help:

• Value-Based Negotiation: When negotiating rates, emphasise specific skills, specialisations, and reliability rather than simply asking for higher pay.

• Advance Booking Premiums: Consider offering slight discounts for guaranteed long-term bookings while maintaining premium rates for short-notice work.

• Transparent Rate Structure: Develop a clear rate card that accounts for travel distance, notice period, and services provided. This professionalises the negotiation process.

4. Collective Action

Individual strategies alone may not be sufficient to counter the systemic pressures in the market:

• Professional Advocacy: Support efforts to establish minimum standards, similar to those for other self employed healthcare professionals.

• Information Sharing: Participate in forums and professional networks where rate information is shared to increase transparency, e.g. Syrkle.net and TPC Telegram network.

• Formal Reporting: Report intimidation or coercive practices to professional bodies such as the GPhC or the Competition and Markets Authority where appropriate.

Looking Ahead: The Future of Locum Pharmacy

The comparison between the 2023 and 2024 surveys suggests that the traditional locum community pharmacy model is under significant pressure. Several trends are likely to continue:

1. Polarisation of Rates: We may see further division between lower-paid, basic dispensing roles and premium rates for those with advanced qualifications or specialisations.

2. Shift to Primary Care: The interest in IP qualifications indicates a continued movement of pharmacists toward primary care, potentially reducing the pool of community pharmacy locums and eventually creating upward pressure on rates.

3. Platform Dominance: Unless challenged, booking platforms may continue to reshape the market dynamics, potentially further reducing negotiating power for individual locums.

4. New Service Opportunities: The introduction of Pharmacy First and other enhanced services may create new opportunities for appropriately qualified locums to command higher rates.

Adaptation is Essential

The comparison between the 2023 and 2024 Pharmacist Cooperative surveys reveals a locum pharmacy sector under significant pressure. Rates are declining, finding work is becoming more difficult, and intimidation tactics appear to be on the rise. However, the data also points to potential pathways for locum pharmacists to navigate these challenges.

By focusing on professional development, strategic booking approaches, effective negotiation, and collective action, locum pharmacists can work to improve their position in this challenging market. The surveys suggest that the future of locuming may look very different, with traditional community pharmacy roles potentially offering diminishing returns while new opportunities emerge for those with advanced qualifications and specialisations.

For locum pharmacists, the message is clear: adaptation and professional development are no longer optional but essential strategies for thriving in the evolving healthcare landscape.