Pharmacists ‘underappreciated’ for their work in primary care networks, report says

Pharmacists working in primary care networks (PCNs) in England are “undervalued” by GPs and are often given tasks below their level of competence, according to a report commissioned by the government.

The report – published by independent think tank The King’s Fund on March 4, 2022 and commissioned by the Department of Health and Social Care – reviewed the implementation of four PCN roles funded by the Additional Roles Reimbursement Scheme (ARRS), including pharmacists.

The ARRS, which was first announced in the GP contract for England in January 2019, allows each NCP to claim funding for hiring from a selection of 14 different healthcare roles.

This includes the ability claim at least £57,318 for hiring an additional pharmacist. The GP contract in 2019 set a target for NCPs to hire six clinical pharmacists by 2023/2024.

However, following interviews with 48 people working in PCNs, including 15 pharmacists, the King’s Fund report found that PCNs “lack a clear and shared overarching purpose and strategy” for the roles of the ARRS.

“The potential contribution of additional roles to general practice is not universally understood, despite copious amounts of written guidance, job descriptions and roadmaps, which may even have added to the confusion,” the report states.

For pharmacists, the report revealed ‘a strong feeling that they were not being given tasks that matched their skills’.

“Many felt that GPs underestimated their abilities or wanted them to focus on check-off tasks and medication reviews,” he added.

“Pharmacists often felt isolated, especially if they had left the hospital setting where team structures were in place. There was a strong consensus that it was important to have a critical mass of pharmacists and technicians, with management support.

In response to the findings, The King’s Fund recommended that NCPs and firms “carefully plan their strategy for integrating ARRS roles, considering the implications for staff working in network-wide roles or across multiple firms that have individual systems, cultures and practices”.

Commenting on the report, Nick Kaye, vice president of the National Pharmacy Association, said: “I recognize from first-hand experience many of the issues highlighted in this report, including confusion around the roles of PCN pharmacists.

“It is time for the NHS to think flexibly about allowing NCPs to use ARRS funding to commission community pharmacy colleagues to deliver services locally.

“We also reiterate our call for mandatory local impact assessments before any new recruitment of pharmacists into NCP pharmacist roles.

“These assessments should consider the impact on the ability of all healthcare providers in the region – including community pharmacies – to achieve their goals on behalf of the NHS.”

Graham Stretch, chief pharmacist at Argyle Health Group and clinical director at Brentworth PCN, said the report was welcome as it “highlights the issues we know our colleagues are having” across the country.

“It’s great to have the staff, but if you don’t have the sense of direction and more importantly the mentorship that staff need, and the influence to make sure they get to both the domain – so an office with a room where they can see patients – and the right workload delegation, you find that you have people who are rudderless,” he said.

“If you add that to the very considerable pressures on the general practice and primary care networks, and the availability of proper tutoring and mentoring, you end up with a situation where you have pharmacists who are very willing to continue but do not. t find themselves properly mentored to do the kind of work that may be too advanced for new people on the job.

Read more: Everything you need to know about primary care networks

Maria D. Ervin