PCN pharmacist recruitment has ‘unintended consequences’, warns Government report

Recruitment of clinical pharmacists to general practice is ‘compounding the problem’ of community pharmacy closures and delayed discharges from hospitals, a Government report has warned.

Earlier this week, former health secretary Patricia Hewitt’s review into the progress of integrated care systems, requested by the Government, concluded that national contracts – including the GP contract – present a a ‘significant barrier’ to local innovation.

And she went on to warn that ‘contracts with national requirements can have unintended consequences when applied to particular circumstances’.

‘For instance, the national requirements and funding of Additional Roles Reimbursement Scheme (ARRS) roles for community pharmacists within PCNs, has on occasion exacerbated the problem of a general shortage of pharmacists, with some now preferring to work within primary care rather than remain in community pharmacies or acute hospitals, compounding the problem of community pharmacy closures and delayed discharges,’ the report said.

In her report, she recommended that NHS England and the Department of Health should ‘as soon as possible’ convene a national partnership group to develop together a new framework for primary care contracts.

Since 1 April, ICBs have been handed delegated commissioning responsibilities also for pharmaceutical, general ophthalmic and dental (POD) services, in addition to general practice.

And, according to Ms Hewitt, this presents a ‘an opportunity’ to make better use of the existing pharmacist workforce.

‘The new responsibilities for ICBs provide an important opportunity, at place or system level, to integrate the whole primary care offer for communities, making the best use of both the staffing resource available and the premises,’ the report said.

She added: ‘Instead of each element of primary care being treated as a separate silo, ICBs now have the opportunity – and the responsibility – to work with all elements of primary care to achieve the accessible, high-quality and integrated services that residents and local communities need.’

In February, pharmacy leaders highlighted the same problem whilst criticising an NHS England ad campaign to redirect patients with minor illnesses from general practice to pharmacies.

The Hewitt Report also recommended that:

• a review group is set up to urgently review national primary care contracts including the GMS contract;
• centrally held buyout funds are set up, to take over GP contracts or premises where practices are ‘not delivering to a high enough standard’; and
• for QOF to be ‘updated with a more holistic approach that allows for variation’.

A version of this article was first published by Pulse’s sister title The Pharmacist