Workforce planning must recognise pharmacy's place in the NHS family
When will the government stop treating community pharmacy like the NHS’s poor relation, asks NPA vice chair Nick Kaye
Earlier this month marked the 74th anniversary of the NHS. As usual, many community pharmacists took part in the celebrations, rightly regarding themselves as part of the NHS family.
Yet just a few days earlier, a government health minister made a statement in the House of Lords that hinted to the contrary. Lord Kamall suggested that, because in community pharmacy, the employers are often “commercial organisations” they have “a clear role and responsibility in staff recruitment and retention”.
This is at one level absolutely true. But in the context of the debate that day, it seemed like the government had less of an interest in the community pharmacy workforce than it did other parts of the healthcare workforce; while we are all family, some are more family than others.
This when the system is crying out for a holistic and integrated approach to workforce planning. I am personally convinced of that, given that I work in a community pharmacy for part of the week and a GP practice, too.
We need to plan in a way that allows pharmacists to use their skills wherever they are practicing. Many pharmacists now work across different sectors and it is the shackles of the contract that puts limits on our scope of practice rather than our clinical skill set. All pharmacists are clinical and workforce planning should reflect this. Thorough workforce planning also requires the system to understand the need in a geographic area.
Lord Kamall pointed to data from Health Education England, which showed there are now an additional 4,122 pharmacists employed in the community compared with five years ago, with the number of registered pharmacists increasing year-on-year.
However, I believe these headline figures fail to take into account the context of increased demand and a real-term drop in income for pharmacies in this period. A modest rise in the overall number of full-time equivalent (FTE) pharmacists in our sector does not mean there is adequate coverage for vital tasks.
Ministers have repeatedly stated their ambition for community pharmacy to provide more clinical services – an ambition shared by England’s new chief pharmaceutical officer, David Webb – but this will be an uphill struggle unless staffing challenges are properly addressed.
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All of us on the ground in community pharmacy know the issues the sector has in recruiting and retaining colleagues. The Community Pharmacy Workforce Development Group, of which I am vice chair, published a report last year that included a survey of contractors in England.
The survey found a 9% FTE pharmacist vacancy rate across the country.
One factor among several is the Additional Roles Reimbursement Scheme (ARRS), through which GP surgeries have been incentivised to employ pharmacists and pharmacy technicians. This has encouraged the migration of staff from community pharmacy, leading to unfilled vacancies.
Before any further recruitment into ARRS, primary care networks should be required formally to calculate the impact on other parts of the local NHS, including pharmacy contractors, and their ability to deliver patient care objectives.
Better still, let’s try ARRS in community pharmacy and see what a pharmacy could do with more than one pharmacist per pharmacy or an expanded pharmacy technician role. Why not have social prescribers working in and for community pharmacies, given how accessible we are and the expanse of our combined estate?
That would be a tangible sign that the NHS does indeed recognise we community pharmacists as a valuable part of the family.
Nick Kaye is vice chair of the National Pharmacy Association