‘Direct funding’ needed for practice pharmacists, says report

GP practices should be given ‘ringfenced’ and direct funding to employ pharmacists and other general practice staff, a major new report has suggested.

A new white paper launched today by our publisher Cogora has called on the government to consider ‘central funding’ of all general practice staff, including pharmacists, as part of the next GP contract.

It suggested the money be given directly to practices in a move away from the current Additional Roles Reimbursement Scheme model – used by primary care networks (PCNs) to employ general practice staff.

The report, centred on general practice access and authored by Pulse editor-in-chief Jaimie Kaffash, suggested there were issues with the ARRS scheme which meant it ‘might not have improved all aspects of access’ for patients.

This included the structure of the scheme – where ARRS staff are often shared across practices – which the report said ‘could dilute any improvement of access’.

Salary bands used for the scheme had also caused problems, ‘being too high or too low for some roles’, the paper noted.

‘There is a strong feeling among primary care staff that the ARRS funding would be more effective if given directly to practices, rather than to PCNs,’ it added.

The paper, being launched today as part of the Labour Party Conference, said: ‘Funding is key to access.

‘The next GP contract should see staff costs ringfenced, with the money given directly to practices.’

It suggested this would enable ministers to increase funding to general practice ‘while removing the fear that this will be interpreted as a pay rise for individual GP partners’.

‘Larger groups of practices could still hire staff to work over a larger population, through PCNs or neighbourhoods,’ the paper added.

Based on a survey of more than 2,000 primary care professionals, including practice and community pharmacists, the report found that the majority of the measures around good access are predominantly depending on systemic issues, such as funding, recruitment, deprivation and patient demographics.

Cogora’s survey revealed that, of the most traditional roles included in the ARRS, ‘practice pharmacists were considered most helpful in terms of improving access’.

Examples of ARRS pharmacists benefiting patient access are cited within the report, including from a practice manager who described a pharmacist who dealt with minor illnesses to ‘free up GP time’.

Latest NHS workforce figures suggest ARRS pharmacists are still the most popular hire for PCNs but that levels of recruitment have started to slow.

Earlier this month, The Pharmacist reported a small increase which saw 12 more pharmacists employed by PCNs since June, bringing the total number of pharmacists to 5,472 (FTE) according to these figures. This was followed by pharmacy technicians, which had an increase of 11 roles.

But in recent months concerns have been raised around the potential consequences of GPs being added to the ARRS.

A survey carried out by our sister titles Pulse and Management in Practice in April, revealed more than a third (37%) of GP practices in England were considering or had already started replacing non-GP ARRS staff with GPs.

In May, president of the Primary Care Pharmacy Association (PCPA) Dr Graham Stretch said the situation was ‘unsettling’ for pharmacists employed under the ARRS, and encouraged peers to be ‘as visible and as effective in practice as possible’ to help protect their roles.

Changes to the GP contract for 2024/25 saw the previously ringfenced ARRS funding for GPs combined into the pot with all other roles, meaning PCNs are no longer capped on how many newly registered GPs they can recruit within the boundaries of the ARRS.

General practice nurses – both new and experienced – were also added to the list of roles that PCNs can employ under the ARRS.

In July, it was announced that funding had been given to PCNs to cover a 3.6% pay uplift for ARRS staff, including pharmacists.

Meanwhile, GP practices had also been asked to use additional funding from the government to cover a 4% pay rise for employed practice staff.

However, ARRS GPs are entitled to a 4% pay rise in line with the Review Body on Doctors’ and Dentists’ Remuneration (DDRB).

A separate Cogora white paper published at the start of the year revealed GP practices across England were struggling to recruit pharmacists because of local ‘competition’ and issues related to pay.