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Revealed: Only half of PCNs recruited clinical pharmacists in 2019

EXCLUSIVE Only around half of primary care networks (PCNs) had recruited clinical pharmacists last year, with a similar proportion having managed to hire social prescribers, a Pulse investigation has revealed.

In some commissioning regions, not a single PCN in the area has managed to hire either of the roles, according to data supplied by CCGs to Pulse following freedom of information (FOI) requests.

The findings are backed up by interim results from a Pulse survey, which reveals 47% of the 193 GPs taking part said their network had experienced problems recruiting a pharmacist, while 31% had encountered difficulties employing social prescribers.

GPs told Pulse that candidates had been put off by uncertainties about the future of the roles, while competition between PCNs for the extra staff also meant networks had been unable to hire clinicians.

The BMA's GP Committee said the findings show networks need 'support and time to be able to build their teams'. 

In response, NHS England and Improvement pointed Pulse to its planning guidance from last month, which highlighted that PCNs are at various stages of maturity.

This news comes as the GPC is set to vote on the contract for 2020/21 on Thursday, which includes amendments to the PCN network specifications.

One of the biggest incentives of the five-year GP contract, agreed a year ago, was funding for GP practices who chose to join PCNs to hire additional clinical staff.

Networks have been able to receive reimbursement for 70% of the cost of clinical pharmacists and 100% of the funding for social prescribers since 1 July 2019.

At the time the contract was announced, it was expected that in 2019/20 this meant that a network serving around 50,000 patients would be eligible for £92,000.

Physiotherapists and physician associates will be funded from 2020, while paramedics will be funded from 2021.

NHS England and the BMA’s GP Committee, which negotiated the contract, said at the time that they chose the roles because they believed there was enough supply.

However, when Pulse asked CCGs in December how many of their PCNs had recruited the first two roles, 126 commissioners responded, saying that only 53% (494) out of the 932 networks they cover had managed to hire clinical pharmacists.

Meanwhile just 48% (448) of PCNs have recruited social prescribers, according to the 128 commissioners in England who responded.

A total of 16 CCGs did not have any PCNs with either of the roles in place – though some have since said they have managed to recruit.

Dr Beena Gohil, GP principal at Oldfield Family Practice in Ealing and co-clinical director of Greenwell PCN in west London, said: ‘We have had two rounds of interviews for a clinical pharmacist and even then had people cancelling on the day.

'When we did eventually appoint one, she resigned after two weeks, citing uncertainty around the job role as one of her reasons.’

She added: ‘We have had one round of interviews for a social prescriber. Again people cancelled on the day.'

Dr Gohil also said one of the business models NHS England suggested networks set up as - federations - was causing her PCN problems.

She said: ‘Because the federation does not have a PMS contract, we are unable to offer an NHS pension, making the job even less attractive.’

Berkshire GP Dr Robert Koefman told Pulse his PCN has also been unable to recruit any clinical pharmacists so far due to competition with other PCNs to hire the available pharmacists.

Dr Koefman, GP at Binfield Surgery in Bracknell, said: ‘It’s because they’re being paid more by other PCNs. They’re out there for the people who can pay them the most. They’re going to try and get as much money as they can so they’re going for the highest bidder.

‘I presume there’s not enough to go around but certainly I know that localities near us are offering more money.’

Dr Michelle Drage, chief executive of Londwide LMCs, said recruitment problems in London were down to high living costs in the city and the patient population often having complex needs due to high deprivation levels.

She added: 'There is also little resource in the PCN DES for on-boarding and training of these new roles, meaning our PCNs are all trying to recruit from the small pool of pharmacists who are ready to deliver services immediately, or trying to second-guess what skill mix will make for a relatively autonomous social prescriber.'

Dr Richard Vautrey, BMA GP Committee chair, said: ‘These figures echo the findings of our own clinical directors’ survey, which found that the majority of PCNs had not yet recruited social prescribers or clinical pharmacists.

‘Such findings highlight the challenges that networks are having and demonstrate why they need the support and time to be able to build their teams.'

NHS Warwickshire North CCG, which has not yet recruited any pharmacists or social prescribers, said it is working with the PCNs in the area to launch a recruitment campaign for the extra roles.

A spokesperson for NHS West London CCG, which has also been unable to recruit either of the roles, said it was also in the process of recruiting the additional roles.

The 16 CCGs where all of their networks have failed to hire both clinical pharmacists and social prescribers 

  • North Lincolnshire
  • Redbridge
  • Crawley
  • Knowsley
  • High Weald Lewes Havens
  • Warwickshire North
  • West London
  • Birmingham and Solihull
  • North Durham
  • Bath and North East Somerset
  • Trafford
  • Darlington

CCGs that have since confirmed to Pulse they have recruited some roles:

  • South Tyneside - Jo Farey, head of commissioning at NHS South Tyneside CCG, said: ‘Three social prescribers have now been recruited – with one in post already. We are currently recruiting for six clinical pharmacists, and expect to have these in post shortly.’
  • Northumberland -  A spokesperson for NHS Northumberland CCG said: 'To date, all primary care networks in Northumberland have recruited social prescribing link workers and are currently in the process of recruiting clinical pharmacists.'
  • Barnsley - A spokesperson for NHS Barnsley CCG said: 'Barnsley has had a fully integrated clinical pharmacy team working successfully in primary care for the past three years. 24 clinical pharmacists are working across the Barnsley PCN area, which has allowed the PCN to consider where the new posts can add most value to this embedded model. This is also the case with social prescribing.'
  • Luton - A spokesperson for NHS Luton CCG said: 'All five Luton PCNS have recruited social prescribing link workers. I don’t believe that there have been any problems with the recruitment of these roles. The CCG medicines optimisation [team] has been working with the networks to help with the recruitment of clinical pharmacists. Out of the five networks, two clinical pharmacists have been recruited with the third starting this month. The remaining two PCNs are actively recruiting to fill these roles.'

Source: FOI requests sent by Pulse to CCGs in England on 16 December 

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Readers' comments (6)

  • to say that all areas need the same solution is crazy. senior clinical decision makers are what is needed.

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  • Not sure there's any evidence the decision makers have any clinical knowledge (certainly no back bone to tell NHSE to **** off!)

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  • Trying to take on additional admin and business roles with uncertain funding and external restrictions is time consuming, stressful and a waste of clinical skills. I do not understand why this was ever thought a good idea by anyone in practice.

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  • @ watchdog | GP Partner/Principal05 Feb 2020 1:41pm

    ‘to say that all areas need the same solution is crazy’

    Just so and just one point. It’s the transferable value of a workers recompense for their labour that is important, not the number of currency units (you’ll get a lot more for the same pocket-full in Bradford compared to London). We live in a commercial and consumerist society and it’s time that medical service providers recognise this fact.

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  • Sadly our PCN has successfully recruited and inflicted Pharmacists on our Practice; it's damage limitation, trying to minimise the extra work they generate. If anyone out there wants one, you are very welcome to ours.

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  • More HR nightmares. Just what we need.

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