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Health think tank Public Policy Projects (PPP) has recommended that all integrated care systems (ICSs) should be mandated to appoint a chief pharmacist, estimating that only around half currently have one.
A report by PPP, which is chaired by former health secretary Stephen Dorrell — ‘Collaborating to deliver medicines optimisation opportunities‘, published on June 21 2024 — aims to address systemic and structural barriers to effective medicines optimisation.
Its recommendations include a proposal that NHS England should provide a template mandating integrated care boards (ICBs) to deploy a distributed leadership model across all ICSs, including the appointment of a chief pharmacist or similar senior leader from a pharmacy background.
“This would harness pharmacy as a strategic partner at system level and as a key voice in bringing industry partners to the table,” the report said, adding that this would also “enable the pharmacy voice to influence commissioning and contracting agreements, the better coordination of medicines teams and overall elevation of pharmacy as a profession in line with the other sectors of primary care”.
The report also recommended the implementation of a community pharmacy-dedicated Additional Roles Reimbursement Scheme (ARRS) to help address workforce shortages. It said that the existing ARRS had “created more competition for skilled staff between sectors” and left many pharmacies relying on locum staff.
But for this to be successful, the report said the sector would need similar levels of support — including in education and training — offered to implement ARRS roles in general practice.
Community pharmacy representative bodies have previously 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.
The Hewitt Report into ICSs, published in April 2023, identified that the ARRS had “on occasion exacerbated the problem of a general shortage of pharmacists”.
Other recommendations of the PPP report included: prioritising patient outcomes over cost savings in medicines optimisation; promoting greater cross-sector collaboration; and implementing infrastructure similar to the medical deanery model to enable joint posts and support for pharmacists’ professional development.
Commenting on the report, Tase Oputu, chair of the Royal Pharmaceutical Society (RPS) English Pharmacy Board, said: “Pharmaceutical expertise is required across the NHS and pharmacists recruited through ARRS continue to make a significant difference, something rightly recognised in both the ‘Long-term workforce plan’ and the ‘Primary care recovery plan’.
“However, both community pharmacies and GP practices require further investment to support their workforce of both pharmacists and pharmacy technicians. We need a strategic approach to workforce planning across the system, backed by the ongoing investment needed to deliver high-quality patient care.”
She added: “As the RPS put forward in our evidence to the House of Commons Health and Social Care Select Committee, we support calls for strong pharmacy leadership to ensure that medicines expertise is at the centre of ICB decision-making. This includes the appointment of a chief pharmacist in every system. Such an approach would further improve the coordination of medicines use and supply across each ICS.”
The RPS has previously advocated for mandatory chief pharmacist roles at hospitals and in similar settings.
The General Pharmaceutical Council (GPhC) published draft standards on the role of chief pharmacists in January 2024, following legislation removing the threat of criminal penalties for accidental or unintentional preparation and dispensing errors by pharmacy staff working in hospitals and similar settings.
Also commenting on the report, Alastair Buxton, director of NHS services at Community Pharmacy England, said: “The community pharmacy workforce is under great strain, following years of underfunding of the sector and with other factors at play. The impact on pharmacy teams has been enormous, adding to their already pressured workload.
“And for pharmacy owners workforce issues are adding to the already critical financial situation and, for some, they are making staffing their pharmacies a daily battle. Our four-point plan calls on the new government to commit to a plan to safeguard the pharmacy workforce, and we are open to exploring the best methods of achieving that with ministers and NHS England.
