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International health worker migration: the case of GB-registered pharmacists

International health worker migration: the case of GB-registered pharmacists. Professor Karen Hassell Global health, Justice and the ‘Brain Drain’ Conference, Keele University 17 th September 2007. Acknowledgements. Liza Nichols – PhD Student Peter Noyce – other supervisor

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International health worker migration: the case of GB-registered pharmacists

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  1. International health worker migration: the case of GB-registeredpharmacists Professor Karen Hassell Global health, Justice and the ‘Brain Drain’ Conference, Keele University 17th September 2007

  2. Acknowledgements • Liza Nichols – PhD Student • Peter Noyce – other supervisor • RPSGB – funding • The pharmacists themselves For more information about our research please visit: www.manchester.ac.uk/cpws

  3. Presentation outline • Some background about the pharmacy profession • Data on the current stock of pharmacists • Migration in and out of the profession • Who emigrates and why • Implications

  4. Some facts about pharmacy • Degree entry profession from 1967 • Now a 4-year (MPharm) degree programme • 1 year pre-registration training before qualifying • 16 ‘established’ Schools of Pharmacy • Majority of pharmacists work outside the NHS • Large chains now dominate private sector • Changing professional role • The RPSGB (and PSNI) is currently the professional and regulatory body for the profession

  5. Number of GB registered pharmacists: selected years

  6. Number of pharmacists: 2002 to 2007

  7. Age groups by gender (2007) Data source: 2007 register (n = 47232)

  8. The pharmacy workforce in context • Not largest health care workforce in GB: • Smaller than nurses and doctors • But larger than dentists and physios • Size in comparison with other countries: • 249,642 (88/100k pop) in USA (2000 data) • 13,956 (72/100k pop) in Australia (2001 data) • 20,765 (67/100k pop) in Canada (2003 data)

  9. Distribution of pharmacists in selected EU countries (2004 data) Data source: www.fip.org

  10. Distribution of pharmacists elsewhere(2003/04 data) Data source: www.who.int/whosis/database

  11. Immigration of pharmacists:Students • How many? • UCAS data: 1741 (1996); 2237 (in 2001) • 19% & 16% respectively were from ‘overseas’ • In 2001 majority (53%) were non-EU • Trends? • Why study in the UK? • What happens after studying?

  12. Immigration of pharmacists: Practitioners • There were three (but now two) routes for overseas pharmacists to enter the register of pharmaceutical chemists: • ‘European’ • ‘Adjudicating’ • Reciprocity route abolished

  13. Number of foreign trained pharmacists domiciled in GB, 2002 - 2004, by entry route

  14. Immigration of pharmacists: Practitioners • Not a large number/proportion, but growing • Registration requirements vary • Source countries • Practitioner experience of working in GB? • Exploitation? • Work conditions? • Language problems? • Financial burden? • Pre-registration difficulties

  15. Pharmacist emigration

  16. Pharmacist emigration 45110 (100%) GB Register 40279 (89%) Home status (current address is GB based) 37317 (82.7%) GB 968 (2.1%) RECIP 1130 (2.5%) ADJ 864 (1.9%) EU Movement into Britain All overseas qualified = 6.5% 2003 data

  17. Pharmacist emigration 45110 (100%) GB Register 40279 (89%) Home status (current address is GB based) 4831 (11%) Overseas Status (current address is overseas based) 37317 (82.7%) GB 968 (2.1%) RECIP 1130 (2.5%) ADJ 864 (1.9%) EU 3562 (7.9%) GB 1008 (2.2%) RECIP 112 (0.3%) ADJ 149 (0.3%) EU Movement into Britain All overseas qualified = 6.5% Movement out of Britain All =11%; GB qualified = 8% 2003 data

  18. Pharmacist emigration: why study it? • Emigration thought to be exacerbating workforce shortages: • Demand for services increasing • More chain-store pharmacies • More elderly people • Higher levels of prescribing and use of OTCs • Movement out > than movement in • Dissatisfaction with their profession? • Will they return to GB?

  19. Pharmacist emigration: a research study • Literature review • Secondary analysis of existing data: • UCAS data on students • RPSGB pharmaceutical register data on pharmacists leaving and joining • Primary research about GB-trained pharmacists who reside overseas: • email ‘interviews’ • postal and email survey (Jun–Dec 2003) • 55% response rate (n=1947)

  20. Research questions • Who is leaving? • GB nationals? • Why are they going? • Where are they moving to? • What are they doing? • Will they return to GB practice?

  21. So who are they? • Men are over represented • Most (82%) are working • ‘Top’ destination countries: • USA, Australia, Ireland, Canada, Hong Kong, elsewhere in the UK; (Malaysia, New Zealand, Kenya). • Over a quarter (27%) are non-GB nationals • Reasons for leaving vary: push and pull factors feature, but ‘pull’ more prominent

  22. Why leave GB?

  23. What are they doing? • 18% is economically inactive: • includes retired, carer, travelling/education • 8% of ‘economically active’ work outside pharmacy • 29% of ‘pharmacy’ employed don’t work in a health care setting: • Over half (52%) of these work in industry, 12% in academia, and 10% in marketing • Industry work is more prominent among the emigrating pharmacists (14% cf 4%) • Most (49%) work in community (retail) pharmacy

  24. Future intentions of those who’ve emigrated

  25. Pharmacist emigrant: a possible typology Migration from GB: GB-qualified exits from Britain Retired migrant Travel/lifestyle migrant Returning home migrant Migrant partner Overseas nationals who qualify in GB - funded by their ‘home’ government Spouse trailing/ tied movers Career migrant Occupational achievement, career preferences, job mobility, opportunities

  26. Summary • Number of foreign-trained pharmacists in GB is not large, but it is increasing • A sizeable proportion of GB-trained pharmacists emigrating are non-GB nationals • Over half intend staying overseas permanently • Pull factors more prominent than push for emigrating pharmacists as drivers to leave • Emigration mainly driven by social & career factors • Most work in commercial healthcare setting

  27. What next? (1) • For policy? • System of recording and monitoring movement for workforce planning purposes and research • Should professional body assist developing countries to expand their capacity to train and retain staff? • Should the RPSGB consider not taking pharmacists from under served countries? • Liaise and learn from other health care regulators and professional bodies

  28. What next? (2) • For research? • Describe and understand migration into GB • Consider impact of movements on receiving countries and countries ‘losing’ pharmacists • For employers in GB? • Employer responsibilities? • Consider their role in inducing talent exit? • Retention or return to (GB) practice initiatives

  29. Thank you

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