The NHS England primary care recovery plan, released yesterday focuses on increasing access to primary care – by freeing up GPs and making the most of other roles, such as practice and community pharmacists.

But Graham Stretch, president of the Primary Care Pharmacy Association (PCPA) and chief pharmacist and partner at Argyle Health Group, told The Pharmacist that the new plans are likely to make little day-to-day difference to pharmacists working in general practice and Primary Care Networks (PCNs).

Read on to find out what’s relevant from the plan for practice and PCN pharmacists – and how much of an impact it could have.

1. A key part of the NHSE plan is to offer appropriate care to patients and involves making the most of non-GP roles, such as practice pharmacists.

NHSE is planning a three-step national communications campaign to help patients understand who can help them, including practice and community pharmacists.

There is also ‘care navigator training’ to help practice teams signpost patients to the right clinician, and incentives for practices to track which members of the team are delivering appointments through General Practice Appointments Data (GPAD).

Well-trained care coordinators and telephony systems are already in place in many practices. Mr Stretch said that the plan could help those that do not have systems in place, and make GP receptionists ‘better able, better equipped and trained to recognise those patients that might be best managed by pharmacists and pharmacy technicians’ – although it could have ‘limited’ value, especially for patients uncomfortable talking to GP receptionists about their health.

Rachel Power, chief executive of the Patients Association, welcomed the plan to fund training of care navigators as 'excellent news'. 'We think this will really help patients’ timely access to appropriate care,' she said.

2. Primary Care Networks (PCNs) and the Additional Roles Reimbursement Scheme (ARRS) will be reviewed for ‘successes and lessons learned’, and to shape plans from 2024/25 onwards.

3. Patients will be encouraged to manage their own health at home, with the communications campaign to encourage self-care and funding to enable joined-up home monitoring of conditions like blood pressure.

To make home monitoring easier for patients and practices, NHSE announced that it would fund digital tools for patients to send their readings to their practice, which can then be reviewed by staff and added to the patient’s clinical record with ‘one click’, NHSE said in its plan.

‘Often getting those readings so that we can properly monitor [blood pressure] is tricky,’ said Mr Stretch, who welcomed plans for more joined-up systems including funding for community pharmacy to play a greater role in blood pressure management.

4. The plan proposes more services to be carried out in community pharmacy, with plans to increase the number of blood pressure checks carried out under the NHS Hypertension Case-Finding Service to a further 2.5 million in a year.

Funding announced yesterday will also go towards the Pharmacy Contraception Service, which allows community pharmacists to manage and eventually initiate oral contraception – and over time will include long-acting reversible contraception (LARC), excluding intrauterine systems (IUS) and intrauterine devices (IUD).

And Pharmacy First, a common ailments scheme allowing community pharmacists to treat seven conditions – sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women – will begin before the end of the year, NHSE said.

Under the scheme, community pharmacists will be able to supply prescription-only medications, including antibiotics and antivirals, under patient group directions (PGDs) where clinically appropriate and following a patient consultation.

Research will also be commissioned to understand the impact of the scheme on antimicrobial resistance.

Investment will also be made in community pharmacy and general practice IT systems to give community pharmacists access to relevant clinical information from patient records.

Thorrun Govind, England chair of the Royal Pharmaceutical Society (RPS) described the primary care plans as 'a real game-changer for patients', saying that they would 'provide better access to healthcare, helping to reduce the strain on other parts of the NHS and provide patients with the care they need, when they need it'.

Mr Stretch said that treating acute conditions was a small part of the work undertaken by practice pharmacists, but he welcomed the proposals for community pharmacies to do more. ‘Prevention is better than cure. A pharmacy is in every high street, it’s available, accessible, seems to be the obvious place to perform public health screenings’, including hypertension and a range of other conditions, he said.

And over time, community pharmacy would be the appropriate place to manage long-term conditions like high blood pressure. ‘That's the obvious end game. I don't see any reason why pharmacy can't play that role if they had access to clinical systems,’ he said.

But he expressed doubt about whether the service would be able to live up to the hype. ‘All of these things are absolutely commendable. But what should not happen is what is and what is really unhelpful is creating demand before structures are available universally for all the patients in England.’

He said that the announcement of the primary care plan was causing confusion and frustration among patients. ‘Any funding, of course is welcome. But what we must not be doing is raising expectations that some national level service is available. We shouldn't be announcing that to patients until a national level service is available.’

‘The hard work is training the prescribers. The hard work is negotiating the difficulties around access to notes to be able to do it safely,’ he said.

‘It’s positive, and the proposals are eminently reasonable. And we see schemes in Wales and Scotland where it’s working well. And there’s no reason why that can’t happen in England. What should not happen is they should not have done a huge news release and generated demand before the hard work on the details have been completed,’ he added.

5. And community pharmacy leaders have raised concerns that the £645m investment won’t be enough to plug the estimated £1.1bn funding shortfall faced by the community pharmacy sector, let alone investment in new services, such as the projected £350-£400m annual cost of Pharmacy First.

Just 4% of community pharmacists signed up to the Pharmacy Contraception Service within its first two days, citing capacity and funding constraints, and the Pharmaceutical Services Negotiating Committee (PSNC) said that until it knows how the new funding will affect the affordability of the service, its position – that due to stretched capacity within the sector more money would be needed to safely resource additional work– was ‘unchanged’.

Detailed discussions about how the £645m will be distributed are now beginning between the negotiator, the Department of Health and Social Care (DHSC) and NHSE, and while the community pharmacy sector has welcomed the ‘vote of confidence’ it seems cautious about the impact the funding will have until details are made clearer.

‘My feedback is, it's very, very welcome. And I think most colleagues would support the proposals. But most colleagues would also need time, and the contractual arrangements to be sorted and the notes access and communication aspects to be sorted before people go and announce grand schemes to the public,’ Mr Stretch told The Pharmacist.

Amanda Pritchard, NHS chief executive said that practice teams were 'working incredibly hard to deal with unprecedented demand for appointments'.

'But with an ageing population, we know we need to further expand and transform the way we provide care for our local communities and make these services fit for the future,' she added.

She said that the primary care plans were 'an ambitious package of measures to do just that – with pharmacies playing a central role in managing the nation’s health including providing lifesaving checks and medication for common conditions for the first time.'

'This blueprint will help us to free up millions of appointments for those who need them most, as well as supporting staff so that they can do less admin and spend more time with patients,' she said.

And health and social care secretary Steve Barclay said: 'This plan will make it easier for people to get GP appointments.

'By upgrading to digital telephone systems and the latest online tools, by transferring some treatment services to our incredibly capable community pharmacies and by cutting unnecessary paperwork we can free up GPs time and let them focus on delivering the care patients need.

'Together with further support to increase the workforce, this plan will provide faster and more convenient care.'