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Nearly half (46%) of Additional Roles Reimbursement Scheme (ARRS) funding between 2019 and 2022 was spent on the recruitment of clinical pharmacists, health minister Neil O’Brien has revealed.
In total, £839m was spent on ARRS roles between 2019 and 2022 – £387m of which was spent on clinical pharmacists.
The news comes within a written response by Mr O’Brien to a question tabled by Sir John Hayes, a Conservative MP for South Holland and The Deepings, last week.
Mr O’Brien added that the data on clinical pharmacist spend was based on reports by primary care networks and integrated care boards, and does not include spending on advanced practitioner pharmacists or pharmacy technicians.
And he said that data for ARRS for 2022/23 was currently not available.
He added that NHS England (NHSE) had committed to review the ARRS during this financial year, which would ‘cover the performance of the scheme to date and inform the government’s approach to any future support for additional clinical roles in general practice’.
Malcolm Harrison, chief executive of the Company Chemists Association (CCA), suggested that the ‘staggering amount of money’ spent on ARRS pharmacist recruitment ‘has directly led to the shortfall of community pharmacists in England’.
He added: ‘This money could have been invested in frontline pharmacy staff allowing pharmacists to provide even more vital patient-facing care.’
And he said that ‘robbing Peter to pay Paul’ was ‘a short-sighted strategy’.
‘The pharmacy network needs investment especially as we gear up to deliver the Pharmacy First common conditions service,’ Mr Harrison added.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp), said that ARRS had created a lack of a level playing field for community pharmacy with regard to workforce challenges.
And she queried why a funded scheme to encourage a multi-disciplinary team within community pharmacy settings was never considered, ‘given how accessible community pharmacies are’.
Nick Kaye, chair of the National Pharmacy Association (NPA) said that funding for extra pharmacists in community ‘could really shift the dial in terms of integration and patient access to NHS medicines advice’.
‘If I know I’ve got an extra pharmacist in my pharmacy for 40 hours a week, they can max out the NMS [New Medicines Service], hypertension, contraception, walk in consultations. Then in two years’ time, I have actually built up a funding stream that means they stay. At the moment, I just haven’t got the cash ﬂow to hire that person because I’m spending so much on increased medicines cost, but NHS England could help us get there,’ he said.
But Dr Graham Stretch, president of the Primary Care Pharmacy Association (PCPA), suggested that factors other than ARRS could be responsible for workforce issues in community pharmacy.
According to Dr Stretch: ‘Some 2,420 community pharmacists moved into PCNs funded by ARRS between 2019-March 2023. In the same period 5,846 pharmacists joined the register in England, twice the number moving to PCNs under ARRS.
‘To suggest ARRS is the cause of workforce issues in community pharmacy is to ignore findings from surveys identifying [that the] top factors causing poor mental health and wellbeing were inadequate staffing, lack of work/life balance, lack of training and lack of colleague/senior support.’
And he added: ‘Instead of futile sectoral arguments between pharmacists, we need to advocate for adequate resources and fair contracts in all fields of practice and work together in partnership between GP surgery and community pharmacy, towards our shared goal, to improve our patients health and well-being.’
More than 31,000 staff – including pharmacists, mental health practitioners and social prescribers – have been recruited to work in general practice under ARRS since 2019, NHSE revealed last week.
In its workforce plan, published in June, NHSE said that it would seek to extend the ARRS by increasing the number of non-GP direct patient care staff by around 15,000 by 2036/37.
But it said that the expansion would be ‘carefully managed’, taking into account additional training of pharmacists, to ensure sustainable workforce growth and in consideration of the additional capacity required to staff roles across primary care.
Dr Stretch told The Pharmacist at the time that he anticipated a slowing down in recruitment of pharmacy professionals.
This story first appeared on our sister title, The Pharmacist