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?
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:
Mobilise and retain your Clinical Pharmacist workforce the SMART way.
"We commissioned SMART for our pharmacy workforce in March 2020 recognising that we had ambitious plans to rapidly expand the workforce in the next two years and that we needed a structured framework to ensure standardised delivery of the clinical pharmacist and technician role across our 6 PCNs.
The support we commissioned, including 4D Accelerator sessions with our senior pharmacists, ensured a shared vision and agreed set of competencies as well as a delivery plan for the service. This enabled us to use the SMART platform to quickly create a map of baseline competencies and capabilities which highlighted and identified training and development needs. We now have a focused development plan and set of agreed service milestones, KPIs including DES deliverables like SMRs; best of all, we have visibility of all of these to share with our PCNs. Having expanded our team rapidly to already having 25 clinical pharmacists and 6 technicians, SMART has been vital in providing assurance to the PCNs about the quality of the pharmacy workforce and has given us all clarity of service deliverables and priorities. Because Soar Beyond also has the i2i Network, we have been delighted that we are now addressing one of our key development needs around managing frail older patients by implementing a federation-wide quality improvement (QI) initiative including training, upskilling and systematic review and management.
I feel the structure of the SMART platform and the wrap-around support of the Soar Beyond team has been instrumental in helping us to rapidly standardise and provide a quality service and would recommend this for services- both large and small."
Juliet Fletcher -Senior Meds Optimisation Pharmacist and Senior Lead Pharmacist for Sunderland GP Alliance
“We chose Soar Beyond to help us develop and implement our Pharmacy Activation Strategy because of their heritage and expertise in primary care pharmacy; they really understand the various pharmacy sectors and their relative importance for our portfolio of products. Not only have they helped us to map the entire patient journey and potential interventions, but they have supported us to identify the service and workforce development opportunities so that we have a clear short, medium, and long-term vision and matching value offer that will drive market access of our brands.”
Marketing Director, Top 10 Global Pharmaceutical Company
"Soar Beyond’s QI (Quality Improvement) pods are an innovative, interactive way of engaging an interested cohort of customers, galvanising their desire to make QI change and providing them with the structure and support to do this well. Through an expression of interest process, Soar Beyond has been facilitating these QI pods to help equip the frailty champions to drive the QI in their practices. We now have developed a frailty QI community through the pods which is really helping us to build relationships with these GP Clinical Pharmacists for us as a company and supporting patient and process QI implementation. Having the QI pods as a value offer to drive implementation has been a key part of our delivery and implementation strategy."
Hannah Harding, Senior Scientific Affairs Manager, Nutricia.
"Novo Nordisk has been working with Soar Beyond since 2016 to support NHS organisations, to optimise their pathways and clinical services, using the Soar Beyond proprietary 4D™ methodology in facilitated stakeholder meetings. This started with Soar Beyond’s consultancy and expertise in delivering 4D™ change programmes. Due to the success of this approach, we have now rolled out an intensive upskilling programme for our field based market access team, whereby they become accredited to apply the 4D™ methodology to support service optimisation. I’ve enjoyed the collaborative approach with Soar Beyond to create market access solutions to meet both our business and NHS customer needs"
Hasseena Winter, National Market Access Manager
"Having worked with Soar Beyond on a number of training and NHS partnering projects at different companies, I have found them to be very responsive to our needs and to ensure the subject matter is both relevant and informative. As they work at the cutting edge with the NHS directly, the additional offerings around tool kits to support healthcare professionals are forward thinking and absolutely in line with the NHS agenda. For example, the i2i toolkit which they have developed for our disease area focus has attracted huge interest from medicines management and primary care network pharmacists. This provides a platform on which we can act as peer level partners in the improved management of patients whilst provide us with commercial opportunities in line with this agenda. I would wholeheartedly recommend working with Shailen and his team."
Colin Smith, Head of Field Sales, Alliance Pharma