More than a third (37%) of GP practices in England are considering or have already started replacing non-GP Additional Roles Reimbursement Scheme (ARRS) staff – which includes pharmacists – with GPs, a survey has shown.

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 primary care networks (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.

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In a survey carried out by our sister titles Pulse and Management in Practice, GP partners and practice managers across 501 GP practices were asked whether their PCN was considering replacing non-GP ARRS staff with GPs.

Some 24% of respondents said they had ‘discussed’ this while 8% said they had ‘started taking action to do so’. A further 5% said they had ‘done so already’.

Latest data shows that pharmacists remain the top hire for PCNs through the ARRS, though it seems recruitment has slowed recently.

One survey respondent said: ‘Our PCN is split about this and there is a real risk that the working relationship will break down.

‘We have decided that we wish to decide what roles are best for us, have them work directly for us and be part of our team, and choose who we have for those roles.’

Another said the work of non-GP staff had been of high value and had helped ‘take work away from GPs’.

‘It is more likely we will invest in more non-GP ARRS roles than the other way round,’ they said.

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However, Dr Stretch of the PCPA said he was aware of some ‘isolated cases’ where practice pharmacists were being replaced – including one example of a ‘whole pharmacy team being dismissed and replaced by nurses’.

He suggested pharmacists were ‘unsettled’ because of the inclusion of both GPs and nurses into what was a previously protected pool of ARRS money.

Dr Stretch urged those among the profession to make themselves ‘indispensable’ in their practices.

‘I would urge all of pharmacists to be as visible and as effective as possible in their practices, so that when the meeting happens that decides who they need and who they don't, pharmacists will be the first to be protected, because they do brilliant job.

‘My recommendation to peers is to ensure that you're doing as visible and as active a job in practices and make yourself indispensable in your practice and you should be safe.’

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Tase Oputu, Royal Pharmaceutical Society (RPS) England Board chair commented: ‘Pharmacists recruited through this scheme continue to make a huge difference for patients, delivering structured medication reviews at scale, and this was rightly recognised in the primary care recovery plan.

‘With continued pressures on the health service, we need a strategic approach to workforce planning across the system, and for all professions. This must be backed by the ongoing investment needed to deliver high-quality patient care.’