NHS England publishes guidance on how pharmacists could work across sectors

Guidance on how pharmacists can work across primary care networks (PCNs) and community pharmacy, or across a PCN and a hospital trust, has been published by NHS England in an effort to “improve recruitment and retention” within the profession.

NHS England said the guidance, ‘Shared workforce model for pharmacists: optional guidance for employers‘, published on 28 November 2023, is also aimed to allow for the sharing of independent prescribing supervision resources and maintain access to community pharmacies.

It added that the benefits for pharmacists include improved job satisfaction; professional development opportunities; job variety from portfolio working; and a way to maintain skills across different pharmacy settings.

The guidance comes after the government said in April 2023 that NHS England would develop guidance on sharing the pharmacy workforce between PCNs and other pharmacy employers, in response to recommendations from MPs for a workforce plan for pharmacy.

A workforce plan was called for to address concerns around the recruitment of pharmacists into primary care, which Keith Ridge, former chief pharmaceutical officer for England, said in September 2021 was “causing some challenges” for the workforce.

Under a section entitled ‘Delivering general practice services from a community pharmacy’, the NHS England guidance says: “Shared employment models support staff to take on varied roles, help employers and systems manage local workforce needs and enable closer integration of providers.

“They can also include staff working in a range of settings in the delivery of their role. For example, pharmacists may work part of their time in PCNs, and part in community pharmacies.

“Clinics may be delivered in either setting to make best use of the pharmacist’s time and the available estate.

“If pharmacists are delivering general practice services from a community pharmacy setting, they are unlikely to be able to contemporaneously deliver pharmaceutical services in the ‘Community pharmacy contractual framework’ (CPCF). They should therefore not normally be the responsible pharmacist.”

The number of pharmacists being recruited by PCNs increased rapidly under the ‘Additional roles reimbursement scheme’ (ARRS), which was announced in January 2019, as part of the five-year GP contract.

In October 2022, Janet Morrison, chief executive of Community Pharmacy England, called for this recruitment of pharmacists into primary care to be stopped.

The guidance outlines a three-step process to set up a shared workforce model, suggesting that integrated care boards initially bringing together employers from community pharmacy, hospital and general practice “to discuss how best to meet the needs of local systems, employers, pharmacists and patients”.

All parties would then agree workforce models before implementing them.

The guidance sets out four models for ways that pharmacists could work across sectors.

A “service provider model” would involve pharmacists being employed by one organisation, which would then agree to provide pharmacist services to another organisation “ordinarily in exchange for payment”.

Under a “secondment model” the organisation that employs a pharmacist would second them to another organisation under a specific agreement, which may or may not be on a paid-for basis.

A “joint employment model” would involve a pharmacist being employed by more than one organisation, with a joint contract of employment held between the pharmacist and the relevant employers.

Under a “concurrent employment model”, a pharmacist would have separate contracts with each organisation they work for; for example, two 0.5 whole-time equivalent contracts across two organisations.

Commenting on the guidance, Graham Stretch, president of the Primary Care Pharmacy Association, warned that ARRS funding is strictly ringfenced to pay pharmacists’ salaries and pensions, and could not be used to fund any other element of a service provided for a PCN from community pharmacy.

But he added: “In terms of recruitment and retention, this is positive because it lays out examples of portfolio working that I’m sure many pharmacists would welcome.”