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Health education chiefs have pulled back from much deeper cuts to salary support for preregistration placements because they were concerned over the risk of disruption to the pharmacy workforce, reveals a document obtained by The Pharmaceutical Journal.
The report, which was addressed to The Executive of Health Education England (HEE), in November 2018, reveals that the original proposal was to “harmonise” salary support to 50% of existing levels from September 2020.
The document — obtained under a Freedom of Information (FOI) Act request — reveals that the eventual decision to level down salary support to 75% instead was taken owing to concerns over the time available and the expansion in the role of pharmacy set out in the ‘NHS Long-Term Plan’.
HEE announced these cuts in January 2019, but weeks later they were “paused” until September 2021 after chief pharmacists and the Royal Pharmaceutical Society dubbed them “incoherent”.
HEE said it would listen to “key stakeholders”, and a round table event to discuss the future of preregistration funding was held on 14 March 2019.
The HEE paper, written by a senior policy manager whose name was redacted before it was given to The Pharmaceutical Journal, says: “Originally, we proposed to reduce and harmonise salary support to 50% of a Band 5 AfC. However, in the context of the [‘NHS Long-Term Plan’], the drive for more clinically trained pharmacists, the comprehensive spending review and the fact that we are entering the recruitment cycle (which means we would need to communicate any changes within the next four weeks), we recommend reforming salary support incrementally across the regions; by levelling out salary support to the lowest common denominator.
“This allows us to signal to the system that we are reforming salary support, whilst mitigating the risk of disruption to the workforce (particularly as we know numbers have decreased). We can further monitor any impacts through a gradual reduction.”
The paper also says that the promised reinvestment of the “efficiencies” in training — originally promised in HEE’s orignal letter to chief pharmacists — may not be permanent.
“The executive is asked to approve reinvesting the efficiencies made into the education and training infrastructure of each profession at a level commiserate of the non-medical placement tariff (£3,122) as a time limited policy while we work with the Department of Health and Social Care to align wider policy on salary support, tariff and currency,” it says.
HEE confirmed as part of the FOI request that an impact assessment of the changes to 75% of preregistration salary support “has not yet been undertaken”, but that it will do so in future.
The Pharmaceutical Journal also asked HEE if its policy remained to move to a 50% cut in preregistration funding salary support and whether all savings would be reinvested, but HEE said “no final decision had been made”.
A spokesperson for HEE said: “HEE has agreed to work with colleagues further across the health system to agree a way forward that ensures the best possible use of resources to support pharmacy and its key role in the delivery of patient care now and in the future and to ensure plans fit in with the vision for pharmacy as set out in the [‘NHS Long-Term Plan’].
“The output from the engagement, including a review of the impact assessment, will be considered before any further decisions are made.”
