Workforce data gaps could hamper pharmacy's neighbourhood role, MPs told

The proposed shift to neighbourhood-based care under the 10-year plan for the NHS risks being undermined by a lack of comprehensive workforce data on where pharmacists are deployed and what skills they have, the Health and Social Care Committee has heard.

Amandeep Doll, director for England at the Royal Pharmaceutical Society (RPS), told the parliamentary committee that gaps in workforce information were hampering efforts to integrate pharmacy into the government's plans to shift care into the community.

She said that while NHS England data suggests there are adequate numbers of pharmacists overall, there is no complete picture of where they are working or what skills they have.

Ms Doll said the lack of data was particularly acute for pharmacist prescribers, who are seen as being crucial to delivering clinical services in community settings.

'We don't have information about where the prescribers are exactly working,' she told the committee. 'We know less than 10% of them are working in community pharmacy.'

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Ms Doll highlighted this as a potential problem for workforce planning as the NHS prepares to roll out neighbourhood health services under the 10-year health plan.

'If we want to have that shift from hospital into community pharmacy and community, we need to make sure that the skill mix is there to be able to help deliver these services,' she said.

Ms Doll said the absence of a unified dataset showing the distribution of pharmacists and their skill levels across hospital, primary care and community settings was hampering strategic workforce planning.

She said geographical variation also presented challenges, with shortages in coastal and rural areas similar to those affecting other professions.

'There is geographical variation, and when talking to employers and organisations, there are gaps, very similar in areas of coastal rural areas and perhaps where there's not the university towns,' she said.

Ms Doll called for a more comprehensive approach to workforce data collection that would enable planners to identify gaps and deploy pharmacists where they are most needed.

She also stressed the need to ensure that pharmacists are able to use their skills effectively.

'We need to make sure that there's actually prescribing services on offer in community pharmacy that are nationally commissioned to allow people to utilise their skills,' she said.

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She warned that without opportunities to use their prescribing qualifications, pharmacists would move to other settings where they could apply their clinical training.

In addition, Ms Doll raised concerns about a potential bottleneck in foundation training places for newly qualified pharmacists.

'Once the pharmacists graduate, they need to do a year in training, and there's a risk that there's actually not enough funded places for them to be able to be trained and then qualify and work as pharmacists in the practice areas that we need them to,' she said.

She said there was also a shortage of clinical supervisors available to support trainees in practice.

Reiterating concerns recently voiced by RPS England chair Tase Oputu, Ms Doll warned that cuts to integrated care board (ICB) medicines optimisation teams risked undermining the strategic management of pharmacy services at a time when pharmacists are being asked to take on expanded roles.

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'There is a real risk with the 50% cuts to ICBs that medicines optimisation is considered as an administrative role, and we're going to lose that skill set within the ICB,' she told the committee.

'Medicine is the biggest intervention to patient care, and it's one of the biggest spends. If we lose that expertise, it's not going to be strategically managed.'

The committee is examining workforce issues as part of its inquiry into delivering neighbourhood health services.