Cross-sector working the ‘way forward’ for pharmacy

Training and upskilling pharmacists to work across different settings will improve patient care, avoid workforce competition and must be ‘the way forward’ for the profession, a conference has heard.

A panel of pharmacy leaders came together during The Pharmacist’s inaugural GP Pharmacy conference last month to discuss how the landscape of practice pharmacy has changed in recent years and what the future might look like.

Among the panel was Yinka Kuye, head of pharmacy primary care transformation medicines optimisation at Frimley Health and Care Integrated Care System, who argued that a ‘split, rotational’ way of working for pharmacy professionals was ‘the future’ of the profession.

She said it was realistic to believe that having pharmacists working across practices, community and hospitals could become ‘the norm’ and that this could help avoid workforce competition among sectors.

Recognising this was already happening in some areas, Ms Kuye said having rotational posts was ‘not about [being] a general practice pharmacist or a community pharmacist – you are just a pharmacist that's able to work across the different sectors’.

‘I think we've already got examples of where that's working really well, and that is the future,’ she said.

‘The future is that we are going to be training and upskilling our pharmacy professionals be able to work across a system as a whole.’

By doing this, pharmacists would have an ‘understanding of each other’s worlds’.

‘We talk at the moment in my system around spending time in each other's shoes to understand the pains and the challenges of the world in which your colleagues work in,’ she said.

‘When you are actually already working in that field, you understand it firsthand, and it just means that the care that you're able to provide, the interaction, the communication, is going to be so much more seamless for that patient, and therefore the patient experience will be that much better.’

This way of working is ‘going to continue to only become better and stronger’, she said, but funding is ‘a big factor’.

‘We've got to make sure that the funding is followed through to enable this to happen. There is always a challenge around contracts and who holds the contract and things like that. We need to iron out. But this is the way forward,’ added Ms Kuye.

In December 2024, NHS England announced that plans to introduce mandatory multi-sector placements for trainee pharmacists in 2026/27 had been delayed by a year amid ‘barriers and challenges’ around creating appropriate placement opportunities.

More widely, Ms Kuye suggested that practice pharmacists played a ‘pivotal role to bridge the gap across the primary care system’.

And she pointed to Pharmacy First as an area of successful integration.

‘It’s been about that integration, about those relationships, about that connection between primary between general practice and community pharmacy, and having really seamless, clear pathways of care for our patients, helping to reduce that duplication, freeing up GP practices – all the things that we know happens,’ said Ms Kuye.

‘If we get that unification right – unification, rather than division – and that co-designing of care pathways, I think that's the space where magic will really happen.’

Also on the panel was Vishal Mashru, head of medicines and research, Leicester, Leicestershire and Rutland ICB clinical lead – medicines optimisation, Cross Counties Primary Care Network, who discussed how community pharmacy, general practice and secondary care was changing.

‘I think community pharmacy is going to become an extension of extension of general practice,’ he suggested.

And with more complex care being directed outside of hospitals, Mr Mashru said GP practices could become an ‘extension of secondary care trusts’.

His comments came ahead of the publication of the government’s 10-year plan for the NHS, which also pointed towards this direction of travel and to a ‘neighbourhood’ way of working.

The practice pharmacist workforce landscape

It was recognised during the panel discussion that there had been an ‘explosion’ of pharmacists working in general practice in recent years, with workforce numbers climbing from the hundreds to several thousands over the last decade.

But funding changes to the Additional Roles Reimbursement Scheme – which now allows the recruitment of nurses and GPs under the scheme – means the role of pharmacists seems less protected, it was suggested.

President of the Primary Care Pharmacy Association and a practice pharmacist partner, Dr Graham Stretch, said: ‘The protection we enjoyed under ARRS has been diluted now by the 20 or so different roles within that including, crucially, GPs and nurses.

‘Pharmacists and pharmacy technicians are having to therefore prove their worth on that playing field.’

He had previously given a similar warning to The Pharmacist after exclusive data suggested more than a third of GP practices in England were considering replacing non-ARRS staff with GPs.

Meanwhile, fellow panel member Zafran Azam, head of pharmacy – implementation and place, NHS Derby and Derbyshire Integrated Care Board/Joined Up Care Derbyshire, said he felt it was ‘a really interesting time to be within primary care’.

‘Over the last three, four years, we've really seen a huge use of the pharmacy team. We have an absolute explosion of pharmacy pharmacists and technicians within the primary care networks and general practice itself,’ he said.

The free-to-attend GP Pharmacy event was held on Tuesday 24 June and also heard about the opportunity for practice pharmacists to expand their clinical role in managing ADHD, particularly through SMRs and shared care.

The event also heard a warning from a consultant pharmacist about the risks to patients when obtaining weight loss jabs online and about the need for practice pharmacists to build deprescribing into routine care.