King's Fund report prompts NPA to call for re-think of PCN pharmacist roles

The recent report by the King’s Fund has led the National Pharmacy Association (NPA) to renew its call for a re-think of PCN pharmacist roles.

The report pointed out problems with, among others, Additional Roles Reimbursement Scheme (ARRS) and highlighted a lack of shared understanding about the purpose of the roles, combined with an overall ambiguity about what multidisciplinary working means for GPs.

"I recognise from direct experience many of the issues highlighted in this report including the confusion around the PCN pharmacist roles," NPA vice chair Nick Kaye said.

“It’s time for the NHS to think flexibly about allowing PCNs to utilise ARRS funding to commission community pharmacy colleagues to deliver services locally.”

NPA is also re-issuing its call for mandatory local impact assessments before any further recruitment of pharmacists into PCN pharmacist roles.

Kaye said: "These assessments should consider the impact on the ability of all healthcare providers in the area – including community pharmacies - to deliver their objectives on behalf of the NHS.

"It seems that a lack of an adequate General Practice estate is fast becoming an issue in terms of accommodating ARRS staff. That’s ironic, given that so many pharmacists have been pulled away from the established network of community pharmacy premises, contributing to shortages there.

"By investing in connecting existing community pharmacy resources and innovating across the interface between community pharmacy and PCNs, we could realise more effective patient care."

The King’s Fund’s report states that ARRS roles are very often deployed across practices that have different cultures, systems and processes. The report added that ‘subcontracted employment models’ may also have the potential to provide some of the clinical supervision, managerial and HR support that’s required for these roles.

In relation to clinical pharmacists, there was a strong sense that they were not being given tasks appropriate to their competencies; many GPs underappreciated their abilities or wanted them to focus on ‘tick-box’ tasks and medication reviews.

NHS England and NHS Improvement now reimburse 100 per cent of the salary costs and on-costs for the range of additional roles, and the number of staff funded under the scheme will increase to 26,000 by 2023/24.

Commenting on the issue, Dr Leyla Hannbeck, chief executive at Association of Independent Multiple Pharmacies, said: “With the current rate of pharmacy closures because of what is a 60 per cent pay cut negotiated with PSNC, further cost increases such as these and the continuous and deliberate lack of level playing field for community pharmacy leading to decimation of our workforce by PCN's, the question must be asked is there still an objective in the NHS to force 3000 pharmacies into random, unplanned closures."

Hannbeck also called for an exemption of business rates for pharmacies.

"Volatility to CAT M caused by supply challenges impacts the ongoing profitability disrupting  working capital presents a more sinister threat than (business) rates. It is often forgotten that independent community pharmacies typically derive over 90 per cent of their remuneration from NHS activity. As such we believe that they should be exempted from business rates moving forward," she said.