How effective deployment of pharmacy technicians could free up GPs time

Increasing patient demand, workforce shortages and the increasing complexity of medicines optimisation continue to place considerable pressure on general practice^​1​. The ‘NHS long-term workforce plan’ advocates greater use of multidisciplinary teams to improve patient access and release GP capacity^​2​. However, a 2022 National Institute for Health and Care Research (NIHR) evaluation found limited evidence that multidisciplinary workforce expansion alone consistently reduced GP workload or NHS expenditure, emphasising that clearer role definition, targeted training and effective integration are essential to maximise the benefits of emerging professional roles^​3​. Conversely, a growing body of evidence demonstrates that pharmacists embedded within general practice improve medicines optimisation, prescribing safety and management of long-term conditions, while reducing medicines management workload^​4–7​.

Pharmacy technicians are integral members of the pharmacy workforce and were incorporated into the NHS ‘Additional roles reimbursement scheme’ (ARRS) in 2019^​8​. Their expertise in medicines management has the potential to release GP time for direct patient care, yet comparatively little has been published regarding their contribution to workforce optimisation or the economic value of their role^​8–11​.

A previously reported service evaluation explored the perceptions of 84 GPs shortly after pharmacy technicians were introduced into primary care networks^​10​. Respondents reported spending a mean of 6.5 hours each week managing medication-related queries and a further 10.15 hours undertaking prescription-signing activities. Most believed that appropriately trained pharmacy technicians could undertake a substantial proportion of these responsibilities, particularly medication queries (87%), prescribing audits (75%), electronic repeat dispensing (68%) and medication reviews (65%). The evaluation estimated that about 10.75 hours of GP time could be released each week through effective deployment of pharmacy technicians^​10​. These observations are consistent with the wider literature demonstrating that pharmacists enhance medicines optimisation and prescribing governance, while enabling GPs to focus on more complex clinical cases^​4–7​.

The original service evaluation included an illustrative workforce substitution costing, estimating a workforce value of about £677 per GP per week by comparing GP and pharmacy technician salary costs^​10​. While appropriate as an initial estimate, this approach reflected only direct employment costs and therefore underestimated the wider opportunity cost of GP clinical time.

Revisiting the illustrative workforce substitution costing using the Personal Social Services Research Unit (PSSRU) ‘Unit Costs of Health and Social Care’ provides a more comprehensive estimate of workforce value than the original salary based analysis. The PSSRU estimates the cost of GP patient-contact time at £268 per hour, incorporating salary, employer on-costs, qualifications, practice overheads and non-patient-facing activities^​12​. An equivalent PSSRU unit cost is not available for pharmacy technicians working in primary care.

Consequently, pharmacy technician costs were estimated using the nationally published ARRS employer reimbursement value for a band 5 pharmacy technician (about £20.60 per hour), representing the reimbursable employment cost for primary care networks⁸. Although these costing approaches are not directly equivalent, they represent the most appropriate nationally available estimates for each professional group. Accordingly, the analysis should be interpreted as an illustrative workforce substitution costing, demonstrating the potential value of releasing GP clinical capacity rather than a formal economic evaluation.

Applying these nationally recognised estimates to the previously reported release of 10.75 GP hours per week puts an estimated value on the released time of £2,881 per GP per week. If a pharmacy technician costs £20.60 per hour, then 10.75 hours of their time per week costs £221.45. This means that replacing GP time with pharmacy technician time — where appropriate — saves around £2,659.55 per week. Although this estimate will vary according to local staffing costs and the extent to which pharmacy technicians undertake medicines management activities, it demonstrates that applying standard NHS economic costing methods substantially increases the estimated value of released GP capacity compared with salary based calculations.

The analysis should be interpreted in the context of the investment required to integrate pharmacy technicians into primary care. Although the NHS England-funded Centre for Pharmacy Postgraduate Education (CPPE) Primary Care Pharmacy Education Pathway is provided without direct tuition costs to ARRS-employed pharmacy technicians, employers incur indirect costs through protected learning time, educational and clinical supervision, and workplace support during the approximately 15-month programme^​13,14​. These implementation costs represent opportunity costs associated with workforce development rather than additional salary expenditure, and are integral to safe and effective role integration. However, they are likely to be accommodated within existing workforce development and supervision arrangements across primary care networks. They are therefore unlikely to materially alter the longer-term workforce value associated with releasing GP clinical capacity.

Importantly, this revised illustrative workforce substitution costing does not show the original analysis was incorrect. Rather, it highlights how the choice of costing methodology influences economic conclusions. The original salary based analysis underestimated the opportunity cost of GP clinical time because it excluded employer on-costs, infrastructure costs and the indirect value of clinical capacity captured within the PSSRU methodology. Consequently, the revised analysis provides a more comprehensive estimate of the workforce value associated with integrating pharmacy technicians into the multidisciplinary teams.

As pharmacy integration into general practice continues to evolve, pharmacy technicians are well positioned to support medicines optimisation, prescribing safety and workforce sustainability. Evaluations should take up standardised NHS costing methodologies and prospective workforce outcome measures to determine whether the release of GP clinical time translates into improved patient access, prescribing quality and clinical outcomes — thereby providing stronger evidence to inform future policy on the expansion of pharmacy workforce within general practice.