‘Skewed’ funding arrangements mean that insufficient pharmacists are being employed by primary care networks (PCNs) in the most deprived areas of England, according to new research from the Health Foundation.
The report Doing More For Less said that areas with high deprivation were missing out because the greater health needs of their populations were not adequately taken into account by current funding arrangements.
Pharmacists were one of the roles with the biggest difference in staff numbers between the most and least deprived areas, once additional patient needs were taken into account.
Between March 2019 and June 2023, PCNs in the most deprived areas of England employed 10.73 full time equivalent (FTE) pharmacists per 100,000 needs-adjusted patients, compared to 11.97 in the least deprived areas.
The report also said that general practices in the poorest areas could benefit from an additional £18.6m a year if funding better accounted for deprivation.
One clinical director quoted in the report described the different issues facing PCNs in more deprived areas, highlighting that patients were unable to obtain prescriptions out-of-hours due to a lack of affordable and accessible transport.
And another said that practices wanted PCNs to fund staff with clinical skills, such as pharmacists, to help tackle the day-to-day pressures of core general practice.
But according to the report, some staff funded through the additional roles reimbursement scheme (ARRS), ‘especially in-demand roles like paramedics and pharmacists, left for better paid or less complex work in more affluent areas’, which it said that ‘a small number of interviewees’ had expressed frustration about.
Dr Rebecca Fisher, a GP and a senior policy fellow at the Health Foundation, said: ‘General practice in the poorest areas, where people have the greatest health needs, is missing out on much needed funding and additional staff.
‘Without this, the health of people in more deprived areas risks falling even further behind other parts of the country.’
The Health Foundation said the disparity between affluent and deprived areas was particularly concerning given that PCNs have been tasked with reducing health inequalities.
And it urged NHS England to reform its funding formulas to ensure PCNs in areas of high deprivation receive the funding they need.
Dr Fisher said the renegotiation of funding contracts for PCNs and GPs was ‘an opportunity to address this issue’.
The Health Foundation report said that those at the frontline believed PCNs had real potential for supporting patients in the most deprived areas providing there was improved support from commissioners and funding that properly accounts for population needs.
Nearly half (46%) of the £839m total ARRS funding between 2019 and 2022 was spent on recruiting of clinical pharmacists, then health minister Neil O’Brien revealed earlier this year.
A version of this article first appeared on our sister site Pulse PCN.