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Pharmacy’s recruitment crisis needs urgent tackling
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‘Plans’, ‘Visions’ and ‘Views’: They will all come to nought if the workforce issue keeps stalling, writes Malcolm Harrison
With the government’s 10-year plan for the NHS expected in the spring, there has been considerable debate about what the plan should contain, and more importantly whether it will be backed by the funding required for transformation.
In meetings convened across the country to discuss what the 10-year plan should contain, many have observed that there is little new to discover about what is wrong with the NHS. Indeed, people already know what is needed to fix things.
It is widely acknowledged that the system faces the same issues today that the Five Year Forward View (2014), the Next Steps on the NHS Five Year Forward View (2017), and indeed the NHS Long Term Plan (2019) all attempted to address. I must admit that it is with exasperation that I wonder what another ‘plan’ will achieve.
Delivering the vision
My recommendation to Wes Streeting is once he has his plan on 1 April 2025, he must place all his energy and focus into its execution. Having an ambition or vision (which let’s face it, is all these grand plans ever turn out to be) is pointless unless there is a proper plan for delivery underpinning them.
A case in point is last year’s NHS Long-Term Workforce Plan – remember that one? The other crisis currently facing the sector is one of its workforce. A decade of underfunding, married with the deleterious Additional Roles Reimbursement Scheme (ARRS) has left the community pharmacy workforce in a perilous position.
The Company Chemists’ Association (CCA) has spent many years highlighting the issues facing the sector’s workforce. We’re proud to have played a key part in ensuring policymakers recognised the devastating impact of ARRS. We were also pleased that the pharmacy workforce did indeed feature in the NHS’s Long-Term Workforce Plan, after much speculation that it might not.
If the government and the NHS are serious about moving care out of hospitals and into the community, there is no question that they must invest in the community pharmacy workforce.
A decade of flat funding has forced pharmacy businesses to make huge efficiency savings. Meanwhile, the demands placed on pharmacies has done anything but diminish. Pharmacy teams are not only dispensing more medicines than ever, but they have also been tasked with delivering a raft of new NHS clinical services.
The NHS Long-Term Workforce Plan committed to increase Foundation Year training places by 29 per cent, or to 4,300, by 2028/29. The plan said that this would help meet the expected demand of 34,000-36,000 FTE community pharmacists by 2036/37.
More than a year on, we have yet to hear of any details as to how these ambitions will be delivered. Instead, a new workforce plan is expected this summer – two years on from the previous one. To add insult to injury, ARRS recruitment continues – even though the plan committed to ensure this would be ‘managed’ carefully.
We know the General Pharmaceutical Council’s register of pharmacists is growing. But despite this, the NHS’s own data proves that the community pharmacy workforce is shrinking.
Data from the Community Pharmacy Workforce Survey, shows a reduction of 2,823 full-time equivalents from 2021 to 2023. Even when we compare 2023 data to the data from 2017, it is evident that the current NHS Workforce Plan is stuck in reverse gear!
To be clear, we fully support the ambition in the plan. However, it is ambition without a plan for execution. The ambition is simply not deliverable without renewed focus and accountability. Further delay in turning the ship around risks the sector going through another period of consolidation and eking out further efficiencies when most of the sector is in a perilous position.
An immediate increase to funding is needed to secure the network’s future – without which this is all moot. But what does the sector’s workforce need in the short term, to achieve a turnaround?
what the sector needs
Firstly, NHS England must publish further detail on how it intends to increase the supply of pharmacists to meet the projected demand, as laid out in its own workforce plan. This will need to involve sitting down with higher education institutions and employers to ensure there is an appropriate pipeline of pharmacy students coming down the track.
Second, it must pause ARRS recruitment of pharmacists and technicians. The ARRS scheme has been a wrecking ball to the sector. The NHS needs to outline how it will ‘carefully manage’ any future ARRS recruitment, without adversely impacting the community pharmacy sector.
Third, rather than moving pharmacists to different settings, local systems must consider how pharmacies could be harnessed to deliver specific ‘packages of care’ on behalf of PCNs. This would better utilise the pharmacy network, build patient access to care, and minimise unnecessary disruption to the NHS.
As a profession, there is a lot to be positive about if the funding and workforce crises are addressed. But it’s very difficult to look beyond these two crises right now. We certainly don’t want to fast forward a few months only to find further inaction and delay.
Malcolm Harrison is chief executive of the Company Chemists’ Assocation.