Clinical governance issues arising from the Mental Health and Learning Disabilities Pharmacy Workforce Survey (England) 2006.

Objectives: In the last 10 years changes in the Government's agenda for medicines management and improved patient safety have resulted in unprecedented calls for the provision of mental health pharmacy services. This has not been reflected in pharmacy workforce planning or budgets. We aim to ascertain pharmacy staffing levels in Mental Health Trusts and whether supply of medicines and delivery of clinical pharmacy services are at an appropriate level.

Methods: All Chief/Lead Pharmacists for Mental Health Trusts in England were sent a questionnaire. Follow-up was done twice by e-mail at 2-week intervals.

Key Findings: The response rate was 48% (n = 38 usable questionnaires), and results showed that many Trusts were providing little more than a basic supply service. Pharmacy services equating with risk-management were often provided on an ad hoc basis. Staffing levels were reported as insufficient, with mainly part-time staff. A basic pharmacy ward visit was only offered by 60.8% (n = 14/23; not all participants answered all questions) of respondents, at the 100% level (i.e. a daily service). Six of 31 respondents receiving pharmaceutical services from external organisations reported no formal signed agreements with the external provider.

Conclusions: The increasing emphasis on community-based mental health teams, while still retaining on-site provision and Department of Health initiatives to improve patient safety via medicines management, has placed great strain on mental health pharmacy services. The resultant pharmaceutical input from external drivers is not reflected in appropriate pharmacy staffing levels. The results raise some serious governance issues.