Clinical pharmacist recruitment in primary care networks (PCNs) is ‘compounding the problem’ of community pharmacy closures and delayed discharges from hospitals, The Hewitt Review has claimed.
The review, lead by former Labour health secretary and chair of Norfolk and Waveney integrated care board (ICB), Patricia Hewitt, suggests that contracts with national requirements ‘can have unintended consequences’.
‘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, published on Tuesday, says.
But Ms Hewitt also recognises the opportunities available following the switch of delegated commissioning responsibilities for pharmaceutical, general ophthalmic and dental services to ICBs from 1 April 2023.
‘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,’ says Ms Hewitt.
She adds: ‘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.’
Responding to the report, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Janet Morrison, highlights how 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,’ she says.
Director of corporate affairs at the National Pharmacy Association (NPA), Gareth Jones, says: ‘The NPA has repeatedly highlighted that it is an own goal for the NHS to subsidise the employment of pharmacists in general practice at the expense of denuding the community pharmacy workforce.
‘Hewitt has called this out as an example of silo thinking and we urge system leaders to respond accordingly by reviewing the wider workforce impact on their patch.’
James Davies, director for England at the Royal Pharmaceutical Society, comments that: ‘The report acknowledges significant pressures on the pharmacy workforce.’
Mr Davies says an incoming NHS workforce plan for England must consider ‘the whole of pharmacy’ and ‘support a future pipeline of pharmacists backed by investment in education and training’.
The review also recommends an increase in funding for prevention work and changes to the GP contract.
A version of this article was first published by Healthcare Leader’s sister title The Pharmacist