NHS England will seek to extend the Additional Roles Reimbursement Scheme (ARRS) by increasing the number of non-GP direct patient care staff by around 15,000 by 2036/37, it has announced in its workforce plan published today.
But it said that the expansion would be ‘carefully managed’, taking into account additional training of pharmacists, to ensure sustainable workforce growth and in consideration of the additional capacity required to staff roles across primary care.
The National Pharmacy Association (NPA) and the Company Chemists’ Association (CCA) said in a joint statement that they were ‘doubtful’ about the decision to continue funding ARRS.
‘ARRS only makes sense if it is adding capacity to the primary care system, not stripping capacity from other community and secondary care settings,’ said Mark Lyonette, NPA chief executive, and Malcolm Harrison, CCA chief executive.
‘However, the plan does at least recognise the need to “carefully manage” the expansion of ARRS and consider the additional capacity required to staff roles across primary care. We have consistently called for the impact on community pharmacies to be mitigated and we now look forward to further details,’ they added.
And they said that any action must be coordinated at a national as well as integrated care board (ICB) level, if it is to be truly effective, and to prevent systems competing against each other for resources.
Alastair Buxton, director of NHS services at Community Pharmacy England, agreed that the success or failure of the workforce plan ‘will depend on its implementation’.
He said: ‘NHS England must not repeat previous mistakes – the failure to plan properly for the impact of the ARRS scheme on community pharmacies has been disastrous for many pharmacy owners – and we need assurance that pharmacy will not fall through the gaps as systems take on responsibility for workforce planning, including the need for them to work with Local Pharmaceutical Committees in England.’
But general practice pharmacist and president of the Primary Care Pharmacy Association Graham Stretch told The Pharmacist he anticipated that any extra ARRS recruitment would predominately be for newly designated ARRS roles, such as mental health nurses, and that he expected a slowing down in recruitment of pharmacy professionals.
‘I rely on my community pharmacy colleagues, we work hand in glove with them every day. That’s how it should be. And naturally any plan needs to take into account the needs of the wider workforce,’ he said.
He added: ‘I’m pleased that there is a recognition within this that those pharmacists completing the ARRS pathway [including the primary care pharmacy education pathway and independent prescribing (IP) training] will potentially find investment in their ongoing training.’
But he said that the commitments outlined in the plan did not address issues of retention within general practice and community pharmacy.
For instance, he cited work-life balance and time for training and development as key reasons why pharmacy staff might leave the community sector.
And he commented that even though general practice had received a funding uplift of 2.1% , this ‘doesn’t come close to what I feel personally is a fair settlement’, as it would not enable employers to match likely Agenda for Change pay increases, while ARRS employers had not been funded to match Agenda for Change pay increases, forcing some employers to choose between reimbursement, retention and new recruitment.