Human resources are the present focus of attention in health systems strengthening and public health policies.[1-3] Strategic planning is essential to assess efficiency of human resources and health services, being an effective tool to address innovative solutions within health systems.[4-6] Although the organizational environment is recognised as an important factor in health services functioning and development, external environment continuous modifications challenge decision makers and practitioners. For health professionals, this environment could be described by a constant technological evolution, a growing search for patient-focused care and empowerment of citizens, ...view middle of the document...
Undertaking a strategic thinking approach allows for the analysis of different possibilities, without excluding those that seem unlikely. Recent approaches to the issue of pharmacists’ future have focused on workforce supply and demand,[14-16] while others have proposed scenarios to depict what the profession could be in the future, from the perspective of interviewed experts.[17, 18] This last case inspired our work since a flexible approach is used and a creative attitude is promoted towards a future vision reflection on the pharmacist profession.
Community pharmacists’ new role
The movement towards a more patient-centred orientation has become a new paradigm of pharmacy practice, leading to the development of patient information services, pharmaceutical care services, and the development of a clinical role for community pharmacists.[19, 20] The work of Hepler and Strand in the early nineties was a milestone in this change, pointing out to the delivery of longitudinal advanced medication-related services, the rise of professionals’ level of responsibility and the development of cooperative relationships with other health care professionals, as essential features to this new role. However, this movement toward patient-centred care in community pharmacy has been taking longer than one would expect back in the 1990s, much influenced by inner organizational barriers as well as several external factors (Table 1).
Community pharmacists’ workforce in Portugal
Portuguese community pharmacists have followed the global trend for a new role and an extended practice. They represent almost two thirds of the total pharmacists mandatorily registered in the Pharmaceutical Society. By the end of 2012 there were 7716 registered community pharmacists. These are mostly young professionals (67% less than 45 years old), 80% of which are women. The total number of community pharmacists has increased 74% between 2000 and 2009, with an annual average of 340 newcomers.[24, 25] This sharp rise was a direct consequence of the increase in the number of pharmacy courses offered both in private and public universities. For instance, in 2010 there were more than 1100 new students enrolled, a 6.5% increase when compared with 2008 admissions. In the same period, the number of pharmacy technicians working in community pharmacy dropped 25%.[24, 25] The ratio of pharmacists per pharmacy has increased during the last decade, with an average above 2 since 2005, leading to 68 pharmacists per 100.000 inhabitants.[25, 27] This can be considered a homogenous geographical distribution, but with a higher concentration in the urbanised regions of Lisbon’s and Porto’s metropolitan areas.[24, 25, 28, 29]
The number of pharmacies has increased 9.5% since the turn of the century, with an average of 24 new pharmacies per year. From 2007 onwards, changes in legislation allowed for non-pharmacist ownership, a decrease in the population base, from 4000 to 3500...