Pharmacists employed under the Additional Roles Reimbursement Scheme (ARRS) should have access to supervision that evolves throughout their career, with time for this enshrined in their job description, a thinktank has suggested.

The Nuffield Trust reviewed guidance and academic literature and held a roundtable of experts to understand the landscape of ARRS staff supervision.

The thinktank said it had found 'huge variability in the amount and quality of support being offered to ARRS clinicians in practice, with variation in capacity, training and motivation of supervisors'.

It said primary care networks (PCNs) should be accountable to integrated care boards (ICBs) for providing standardised induction and supervision for ARRS roles.

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And it proposed a 'fluid ARRS supervision model for different career stages at “entry point”, “transition” (when role scope changes) and “steady state” (when staff are competent and confident in their role)'.

'Fluid' model of supervision throughout career

At entry level, or when they are new to general practice, clinicians need access to practice supervision at all times, as well as ring-fenced time with a named supervisor, the Nuffield Trust suggested.

This should focus on assurance of core skills and assessment of judgement.

Regular ring-fenced supervision time should continue when they reach a steady state and are confident and competent in their role.

At this point, the focus should be on professional development.

And they should still be able to access practice support when needed.

As clinicians' roles change and expand throughout their career, additional supervision needs should be identified, along with reassessment of their role description and assurance of capabilities.

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NHS England supervision guidance for PCN multidisciplinary teams suggests pharmacists, senior pharmacists and pharmacy technicians should all have access to monthly supervision.

ARRS funding should be used to fund supervisors

To ensure that senior clinicians have capacity to supervise ARRS roles, the thinktank proposed that the rules on the use of ARRS funding be changed, so that it could be used to pay for supervisors' time.

And it suggested that all clinical staff supervising ARRS clinicians should receive specific training for their supervisory role.

But where clinical capacity allows, senior clinicians should have the opportunity to opt out of supervising ARRS-funded clinicians, the Nuffield Trust said.

And it suggested 'a process to deliver consistent and high-quality ARRS supervision' should be included in the development of neighbourhood teams.

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A campaign by the Guild of Healthcare Pharmacists (GHP) is also seeking to standardise protected learning time for pharmacists working in PCNs and GP practices.

Pharmacists should be given 10% of their hours as protected learning time, the GHP has proposed.