The recruitment of pharmacists in Primary Care Networks (PCNs) has exacerbated a general shortage of pharmacists, says an independent review of Integrated Care Systems (ICSs) published today.
The review, Rt Hon Patricia Hewitt, set out to consider the oversight and governance of ICS in England and the NHS targets and priorities for which Integrated Care Boards (ICBs) are accountable, including those set out in the Government’s mandate to NHS England. As part of this work, Hewitt and her team engaged with a wide range of stakeholders representing various local health and social care settings, including LPCs.
In regards to unlocking the potential of primary care and its workforce, the report suggests that careful consideration is given to how national policies may impact on local needs. In particular, it highlights the impact that the Additional Roles Reimbursement Scheme (ARRS) roles for pharmacists are having on the community pharmacy sector:
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 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.
PSNC has been warning Government and NHS England about this issue for some time, including by co-signing a letter calling for the Government’s upcoming long-term NHS workforce plan to include the whole of pharmacy. With the continued pressures on services, it is more important than ever to support the pharmacy workforce so that the staff needed to deliver patient care now and into the future can be recruited, trained and retained.
Ms Hewitt, Chair of the Norfolk and Waveney ICS and a former Health Secretary under Labour, was commissioned in November 2022 to advise the Government on how to make sure the new ICBs operate efficiently. Following the publication of her report, it will now be for Government and the NHS to consider the recommendations made.
Responding to the report, PSNC Chief Executive Janet Morrison said:
“The Hewitt Review is an important report for the future of ICS and the commissioning of local healthcare services. For community pharmacy, the review recognises the damaging consequences that ARRS has had on the sector, exacerbating workforce issues, which has left many pharmacies forced to close their doors temporarily to patients. This is something that PSNC has been warning Government and NHS England about for some time, including calling for a stop to recruitment of pharmacists to PCNs or allowing the money to be spent funding collaboration with community pharmacies. The policy of solving one workforce problem by worsening another is absurd – it has increased vacancy rates and caused spiralling locum costs.
The report is clear that action should be taken to carefully consider the best use of the limited pharmacist workforce going forwards, and that the new ICS should be instrumental in this. However, local action will need to be joined up nationally, so it will be important for the Government to realise these issues, with solutions in their upcoming long-term NHS workforce plan by ensuring that it covers the entirety of the pharmacy workforce across the NHS, including community pharmacy. We would welcome the opportunity to discuss the issues in the Hewitt Review, as Government considers the recommendations.”