The recruitment of community pharmacists to primary care roles via the Additional Roles Reimbursement Scheme “has on occasion exacerbated the problem of a general shortage of pharmacists,” a report commissioned by health secretary Steve Barclay has acknowledged.

The independent review of Integrated Care Systems, which was published yesterday (April 4) and authored by former Labour health secretary Patricia Hewitt, says that although ICSs “represent the best opportunity in a generation” to transform health and social care, work must still be done to “align all partners, locally and nationally”.

Ms Hewitt speaks of the need to correct the “over-focus on treatment of illness or injury” and improve disease prevention efforts, and to pay closer attention to the “unintended consequences” of national contracts “when applied to particular circumstances”.

She writes: “For instance, the national requirements and funding of 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.

“National contracts present a significant barrier to local leaders wanting to work in innovative and transformational ways. I have recommended that work should be undertaken to design a new framework for General Practice (GP) primary care contracts, as well as a review into other primary care contracts.”

Ms Hewitt also cites the role pharmacies can play in ICS efforts to ensure digital pathways are accessible to those “least able to use” them due to factors such as frailty and disability. 

She writes: “From a high street pharmacy helping someone into a digital consultation booth and putting digital monitors on them for their remote outpatient consultation, to a dementia day centre supporting a carer to do a digital medicines assessment, digital patient engagement won’t be real until it works for the NHS’s most vulnerable users.”

Commenting on the report, PSNC chief Janet Morrison said the negotiator has been warning of the knock-on effects of ARRS recruitment “for some time,” including calls to either stop PCN pharmacist recruitment or allow community pharmacies to benefit from ARRS funding. 

Ms Morrison said the Hewitt report “is clear that action should be taken to carefully consider the best use of the limited pharmacist workforce going forwards,” but stressed that “local action will need to be joined up nationally” and that the Government must ensure its upcoming long-term NHS workforce plan “covers the entirety of the pharmacy workforce across the NHS, including community pharmacy”. 

National Pharmacy Association director of corporate affairs Gareth Jones described the “subsidised employment of pharmacists in general practice” as an “own goal” by the NHS and welcomed the report’s finding that this is “an example of silo thinking”.

Mr Jones said: "The NPA has suggested that there should be a workforce risk assessment at system level before any new recruitment via ARRS.

"We have also asked ICBs to think creatively about what more they can do to optimize community pharmacy staffing for the delivery of locally identified priorities.”