New level, new devil – Clinical Pharmacists in Primary Care Networks (PCNs)

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What is the status quo?

Since their conception in July 2019, PCNs across England have been utilising the Additional Roles Reimbursement Scheme (ARRS) to recruit Clinical Pharmacists. By September 2020, 1,076 Clinical Pharmacists were in post, and by March 2021, there were 2,181 Clinical Pharmacists in post across 1,253 PCNs in England. We estimate there are or will be about 3,500 by the end of 2021 as the recruitment is so rapid, of all the ARRS roles, the clinical pharmacist is the most familiar and best-placed to displace most of the GP workload. With this recruitment frenzy well underway, and with the NHS Long Term Plan vision to expand the number of PCN Clinical Pharmacists to around 7,000 by 2023/24, where are these pharmacists coming from? And how will PCNs develop their clinical pharmacy teams, fulfil their potential and ultimately retain this expanding and relatively new breed of primary care clinicians?

Recruitment and Retention—the ever-increasing challenge

The addition of pharmacists to the government’s shortage occupation list earlier this year is a clear indication that this scarcity of pharmacists is due to a decline in the number of pharmacy graduates and increasing demand for their services. Of all the sectors affected, community pharmacy continues to lose experienced practitioners to PCNs. Yet, the rapid growth in the number of PCN Clinical Pharmacists over the past two years is evidence that recruiting into these roles is no longer the major challenge facing PCNs at present. Retention of this workforce is arguably the biggest workforce threat that PCNs face, especially once these pharmacists have completed the 18-month Primary Care Pharmacy Education Pathway and additional training to become Independent Prescribers. Imagine then the frustration and disappointment for PCNs and practices that will have provided supervision, line management, support and released pharmacists to participate in this development support to find that they jump ship to a neighbouring organisation.

So far, PCNs remain a somewhat nebulous entity and vary in maturity; this poses numerous organisational and operational uncertainties when thinking about the pharmacists’ sense of belonging:

·      Do these pharmacists belong to a cluster of practices?

·      Who are they working for?

·      Will they be spread too thin?

·      Should they deliver services across the PCN or per practice?

·      What should be expected from them?

·      Is the growth, development and succession plan clear?

·      How well-supported are the new Senior Pharmacists who have often been catapulted into their roles of managing teams and delivering to the PCN DES agenda, having been clinical pharmacists themselves but a few months ago?

With all this uncertainty, is it going to be long before these new recruits start looking elsewhere?

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What can PCNs do to retain and grow their pharmacist workforce?

Providing clarity  regarding the role for now and the future, understanding the competencies and having a clear development plan is critical to ensure staff feel valued and the organisation understands the full potential of the role. With this in place, practices are then able to align to deliverables required for the PCN.

Soar Beyond is commissioned by over 500 practices, at individual, PCN and federation level to support them with their clinical pharmacy teams to provide clarity and scope of the role through our SMART platform.

Soar Beyond’s advice to PCNs is to consider doing the following:

  • Aligning member practice expectations and developing a joint vision for the Pharmacy workforce including technicians. We do this with our facilitated 4D structured workshops led by two directors who will help you develop a road map for your team
  • Supporting your teams to assess their individual competencies using a structured framework. We do this using our SMART Platform and can help you customise your requirements and map your workforce as a collective
  • Growing your team infrastructure, peer support and development planning – we have built this on our SMART platform that can set your personal development plans. We also provide team and individual ACCELERATOR coaching sessions with a Soar Beyond senior pharmacist.

Mobilise and retain your Clinical Pharmacist workforce the SMART way.

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