Primary care networks will only be required to deliver structured medication reviews in line with the capacity of their clinical pharmacists under new, cut-back service specifications that have been agreed as part of the 2020/21 GP contract.

Changes to the Additional Roles Reimbursement Scheme (ARRS) means PCNs will now be able to recruit pharmacy technicians in addition to clinical pharmacists, social precribers and other staff categories.

GPs rejected the first draft service specifications for PCNs put out for consultation in mid-December, saying they were undeliverable.

A “significantly revised approach” has now been agreed between GPC England and NHSE. The final requirements for three of the service specifications for 2020/21 have been rewritten and are significantly shorter. It has been agreed that:

• The volume of structured medication reviews undertaken will be determined and limited by the clinical pharmacist capacity of the PCN
• The proposed requirement for fortnightly face-to-face medical input to the care homes is replaced with a requirement for medical input to be ‘appropriate and consistent’ but with the frequency and form to be based on local clinical judgement by the PCN
• It is explicitly written into the Directed Enhanced Services that PCNs cannot be contractually responsible for any failure by community service providers for non-delivery of their part of the service.

The personalised care and anticipatory care specifications have been postponed until April 2021 and will be part of next year's GP contract negotiations. The service on supporting early cancer diagnosis will be introduced from April.

In addition, PCNs will now receive 100 per cent funding for any roles recruited via the ARRS - previously only social prescribers were funded at 100 per cent and all other roles received 70 per cent funding.

The ARRS will also extend to cover new roles. Along with clinical pharmacists, PCNs will now be able to recruit pharmacy technicians along with five other new categories of staff. Mental health professionals will be added to the scheme from April 2021.

To cover these changes, the agreement sees substantial increases to the ARRS funding pot on top of the funding agreed last year.