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NHS England has said that primary care networks (PCNs) must work with community pharmacy providers “in the best interests of patient care”.
The ‘Network contract directed enhanced service (DES)’ specification, which sets out PCN “requirements and entitlements”, published on 1 April 2024, says that PCNs “must work with other PCNs, local community services providers, mental health providers, community pharmacy providers and other relevant health and social care delivery partners in the best interests of patient care”.
It adds: “This includes developing and fostering strong relationships with other clinical leaders and commissioners to successfully manage the health and care needs of the populations they serve.”
Graham Stretch, president of the Primary Care Pharmacy Association, welcomed the guidance for PCNs to collaborate more closely with community pharmacy, which he said would “leverage further integration”.
“Pharmacist expertise — whether in community, general practice, PCNs or hospitals — improves safety and ensures that patients get the best out of their medicines. This reduces pressures, not just on GPs, but on the whole healthcare system,” Stretch told The Pharmaceutical Journal.
The DES specification also sets out arrangements for the ‘Additional roles reimbursement scheme’ (ARRS) to run in the financial year 2024/2025.
Under the scheme, which was initially announced in January 2019 as part of the five-year GP contract, PCNs are able to claim reimbursement for the salaries of 17 roles, including pharmacists and pharmacy technicians, as well as physiotherapists, paramedics and podiatrists.
It was initially planned to run for five years, but the arrangements for the GP contract in 2024/2025, published on 28 February 2024, set out that it would run for this financial year.
In the ‘NHS Long Term Workforce Plan’, published in June 2023, NHS England said that it would “seek to extend the success” of ARRS.
The workforce plan sets out an ambition to increase the number of non-GP direct patient care staff by around 15,000 by 2036/2037, adding that the expansion “would be carefully managed taking into account additional training of pharmacists, to ensure the growth in workforce is sustainable, and considers the additional capacity required to staff roles across primary care”.
Community pharmacy representative bodies have raised concerns that a rapid expansion of clinical pharmacists and pharmacy technicians working in primary care networks has created a shortage of pharmacists in community pharmacies.
A joint statement from the National Pharmacy Association and the Company Chemists’ Association, published in June 2023, following the publication of the NHS Long Term Workforce Plan, said that the organisations were “doubtful about the decision to continue funding” ARRS, adding that “it only makes sense if it is adding capacity to the primary care system, not stripping capacity from other community and secondary care settings”.
A spokesperson for the Association of Independent Multiple Pharmacies told The Pharmaceutical Journal on 3 March 2024 that the ARRS scheme had “created a lack of level playing field for community pharmacies and led to an imbalance of workforce” in the sector.
Malcolm Harrison, chief executive of the Company Chemists’ Association, told The Pharmaceutical Journal: “Whilst the recent ‘NHS long term workforce plan’ recognised that the expansion of ARRS needed to be ‘carefully managed’ to account for the additional training of pharmacists, we are still awaiting details of how this will be undertaken in practice.”
- This article was updated on 4 April 2024 to add a comment from Malcolm Harrison, chief executive of the Company Chemists’ Association
