For pharmacists who have come into general practice, morale seems good. Around 70% of practice pharmacists see themselves still being in general practice in five years’ time.
Pharmacists are popular hires for PCNs and the GPs that work with them. The latest data show that there are nearly 5,500 pharmacists recorded, although not confirmed, under the ARRS.
On the whole, practice managers and GP partners responding to our sister title – Management in Practice and Pulse – surveys have found pharmacists useful.
But there is debate around whether their introduction to general practice has had a destabilising effect on community pharmacy. One thing is certain – a significant number of pharmacists who are now in practice originally worked in the community.
The House of Commons Health and Social Care Committee’s report on pharmacy concluded there should be a review of the ARRS to explore flexibility on the funding criteria that could ‘reduce the drain of community pharmacists into primary care networks’.
Of the 137 practice pharmacists surveyed by sister title The Pharmacist, only 9% had never worked in community pharmacy, with 76% transferring to general practice completely and 17% working across both sectors.
The Pharmacist survey found that 58% of the 101 practice pharmacists who had left community pharmacy said they made the move because they preferred the work in general practice, while 42% said they wanted to develop their prescribing skills. From summer 2025, all newly qualified pharmacists will need to be able to prescribe.
Utilising skills was a major factor for those who made the move. Mayoor Kerai, a practice pharmacist in Kent says: ‘I had completed independent prescribing training in community pharmacy and I wanted to use this skill. I had also reached a glass ceiling in community pharmacy and was unable to progress any further. I chose the practice role to allow for this personal development along with better salary and work/life balance.’
Another practice pharmacist in Swindon says: ‘I worked in community pharmacy for many years and I really loved interacting with people. That’s something I knew I would miss when I left community pharmacy. But although I was learning new things from time to time, I didn’t feel I was learning enough. I wanted to have a more clinical role and I wanted to learn more in that area. Although there were new services being offered by community pharmacists, I did not feel we had enough support to deliver them.’
There are also those who say there were issues with workload in community pharmacy. One practice pharmacist in Staffordshire says they left due to ‘pressures in community, underfunded pharmacy contract resulting in fewer staff, with more stress and more services alongside a prescription factory system that didn’t make best use of clinical skills’.
Another based in southeast London says: ‘I work fewer hours and don’t have to stress for being late and finding a queue of angry patients or even angry staff on occasions. I have the flexibility of managing my own break times without feeling like being micromanaged. And of course not having to stand on my feet the whole day was the icing on the cake!’
There is also little dispute that community pharmacy is facing workforce problems. A Community Pharmacy England (CPE) survey representing 6,100 pharmacy premises in 2024 found that 58% of pharmacy owners said they were short of pharmacists, while almost two-thirds (62%) of pharmacy team members reported a reduced ability to offer services or advice to patients because of staffing shortages.
Indeed last year a net loss of 432 bricks and mortar pharmacies over the 2023/24 financial year, was revealed by the Company Chemists’ Association (CCA).
This equates to more than eight pharmacies permanently closing each week, the CCA said.
But there is some dispute over whether this is a direct result of the ARRS. CPE said the scheme had ‘led to the recruitment of over 5,000 pharmacists, primarily from community pharmacy, into GP surgeries and PCNs’, resulting in ‘shortages, temporary closures and rising costs’.
But President of the Primary Care Pharmacy Association Dr Graham Stretch says there should still be enough pharmacists to support both sectors.
He told the select committee in November 2023: ‘The actual numbers are very interesting. ARRS supports 4,689 pharmacists, of which, in July 2019 to September 2023, 3,047 have come from the community sector. That is a significant number and I am not pretending otherwise. In the same period, the General Pharmaceutical Council’s register has grown by 7,308, more than double the number of pharmacists moving from community into PCN.’
However, Dr Stretch did acknowledge that ‘that oversimplifies things, because we have portfolio roles’.
A qualitative study of the effect of ARRS found there were ‘unintended consequences at system-wide levels, including large numbers of staff moving from other services to work in the scheme, which left some services depleted of their workforce’.
Dr Zoe Anchors, a researcher at the University of the West of England and one of the authors of the study, says: ‘The three things that were coming up in terms of concerns around the destabilising of NHS services were: pharmacists being taken from hospitals and community pharmacy; paramedics moving from emergency care services; and the impact on wider mental health service providers of including them in the ARRS. All of these were impacting NHS services. Some people said we are “robbing Peter to pay Paul”.’