I am very optimistic about the formation of PCNs and the funding commitment to increase and upskill the workforce in this sector of pharmacy. This is despite NHS England’s persistent use of the term 'clinical pharmacist', and its apparent erasure of any reference to decades of work in general practice from established GP pharmacists like myself.
I have previously stated my views on the adoption of the ‘clinical’ label for pharmacists working in surgeries. I continue to believe that it is intentionally meant to be divisive, not only against the community sector, but also against existing GP pharmacists. However, the measured reaction from my PCN to the GP contract has filled me with optimism that the future is bright for all pharmacists in general practice, whether ‘clinical’ or not.
The practices in my network have made it very clear that their existing pharmacists are extremely valued and, while they see opportunity to increase capacity, have acknowledged that this can only be done with the support of the existing pharmacist team. It may be that as the ‘clinical’ pharmacist workforce grows, with an increasing emphasis on patient-facing activities, its roles and duties will change – or be different between pharmacists. But our unique position as the experts in medicines will be a common thread for all pharmacists.
The biggest challenge for the new pharmacists will be to demonstrate value over and above delivering the requirements of the PCN. Employers have already worked out that the ‘70%’ salary contribution towards a 'clinical' pharmacist from NHS England actually plays out in real terms as around 50%. This places a great onus on the new roles to provide additional tangible benefits to GPs and surgery teams that justifies the costs of their employment. My advice to the new recruits is to follow the lead from existing GP pharmacists who have been doing this work for decades.
I’m not as optimistic for the role of community pharmacy in all this and do worry that many who are talking up the extent to which they will be involved in PCNs have not done their sums.
The information from NHS England about PCNs is rather woolly, even with the recent announcements of the new community pharmacy contract. It has stated that PCNs and community pharmacy will be expected to collaborate, but has not provided detail on how or what funding will be available. There is indication that cardiovascular disease prevention and diagnosis may in part be delegated to community pharmacy. But, on the other hand, they have lost medicines use reviews to the new GP ‘clinical’ pharmacists.
Can community pharmacy leaders secure funded services from these networks? Will GP practices, already tasked with making a significant contribution to the new additional workforce within their PCNs, be easily convinced to further contribute to community pharmacy services? Even if collaboration with non-GP providers is intended to be a ‘requirement’ from April 2020, successfully realising this will very much depend on who is expected to foot the bill.
The GP Pharmacist is a former community pharmacist working in a general practice