EXCLUSIVE Seven in 10 pharmacists working in general practice or primary care networks (PCNs) see themselves working in the sector in five years' time, our snapshot survey has suggested.

Almost 250 pharmacists working in general practice or community settings were asked about their career intentions in the coming years, as part of a survey carried out by The Pharmacist late last year.

Of the 128 general practice respondents, 72% of pharmacists currently working in general practice said they planned to stay there.

In comparison, just 31% of community pharmacist respondents plan to stay in their sector – either in a salaried or contractor role.

The findings align with a recent Qualitas survey of 100 pharmacy team members across 173 GP surgeries.

Jay Badenhorst, director of pharmacy at the Pharmacists' Defence Association (PDA), said the 'stark contrast' between the two sectors 'highlights the urgent need to address the systemic pressures' driving an 'exodus' from community pharmacy.

And the Company Chemists' Association (CCA) highlighted the need to develop and commission prescribing services in community pharmacy.

Prescribing 'significant driver' to GP and PCN work

Komal George, a pharmacist business coach, told The Pharmacist that as well as pressures within community pharmacy, prescribing opportunities were a 'significant driver' to taking a job in general practice.

She said that 'more and more pharmacists' saw prescribing skills 'as a necessity', especially given education changes coming in next year that will see all newly registered pharmacists qualified as independent prescribers.

However, she suggested that in community pharmacy, pharmacists qualified as independent prescribers 'struggle to prescribe', unless they set up their own private practice.

'Community pharmacy has always been told to increase its clinical skills and its clinical offerings. But until there's a model that enables you to be able to do that, you haven't got a choice other than to do it outside of the NHS,' Ms George told The Pharmacist.

'So you can see the attraction to want to go and work in a PCN or a GP practice, because you will get that opportunity.'

And she said prescribers working in general practice settings where they could use the skill were 'more fulfilled'.

'I've coached pharmacists who did that prescribing qualification several years ago, but never wrote a prescription afterwards. And I think you'll be surprised at how often that still happens in community pharmacy.

'On the one hand, everyone's becoming prescribers, and they're getting through the qualification, but to not be able to prescribe means that you're losing that skill pretty much straight away because you're not using it.

'There's definitely a skills and confidence gap now, because people are not able to use that skill and they have to look elsewhere to see where they can use that skill.'

Pressures in community pharmacy could drive portfolio working

In addition to a lack of prescribing opportunities, Ms George suggested that other issues, like medicine shortages and lack of funding were causing pharmacists to look outside the community pharmacy sector.

'Burnout, as we know, is a big issue within the profession,' she said.

'As a pharmacist, you've got to ask yourself, "what's going to be the best solution for me, for my own well being?" Because, as a health professional, you can't serve people if you're not looking after yourself.'

And she suggested that there would be 'much, much more' portfolio working as pharmacists look to build opportunities with the right work-life balance.

'I don't think it's going to be necessarily as clear cut as people moving from one sector to another in droves,' Ms George said.

More than 5,500 pharmacists have been recruited to work in PCNs since the Additional Roles Reimbursement Scheme (ARRS) began funding the role in 2019.

But recruitment of pharmacists, as well as other roles, is slowing, and Ms George suggested that the recent addition of GPs to the scheme could change the recruitment landscape even further.

Multi-disciplinary and learning opportunities in practice pharmacy

Mina Hunjan, a clinical pharmacist at the South Warwickshire GP Federation, said she moved into general practice pharmacy to continue her independent prescribing (IP) training after the pandemic.

While she acknowledged that experiences of general practice employment varied, Ms Hunjan told The Pharmacist that she found the role offered 'so many opportunities', including being able design clinical work around her interests in diabetes and frailty.

'[The surgery] listen to me quite a lot... I said to them, when I've done my IP, I want to do home visits for the frail and elderly, so I can optimise their meds.'

Now, she spends Monday afternoons visiting frail and elderly patients and speaking to them about their medications, often accompanied by another member of the surgery's multi-disciplinary team such as health and wellbeing coaches and social link workers.

'We get to work in this multi-disciplinary way. We get to really make an impact... and you can follow it up. In a big multiple you just wouldn't never be able to follow up people like that,' Ms Hunjan said.

'And these are things that we want to do, because we're health professionals and we care,' she added.

She also said the role offered 'incredible' opportunities for learning, with five study days each year, the opportunity to share her expertise with the wider team, and a scheduled catch-ups with her GP lead each week.

'If we have more complex cases, we can discuss them [with the GPs or other clinicians]... that's an opportunity which you won't get in a community setting, it's so isolated, quite often,'  Ms Hunjan told The Pharmacist.

While general practice roles generally pay less than community pharmacy, Ms Hunjan said she felt it was worth it for the better work-life balance in general practice.

'The potential for burnout is a lot less... in the community [burnout is] a big thing at the moment. They don't even have a contract – it's not nice. It's living under stresses which you just don't need.'

And she suggested that many practice pharmacists chose to 'top-up' their earnings by taking on out-of-hours access work or community pharmacy shifts at the weekend.

Our survey also suggested that expanding clinical opportunities in community pharmacy, such as Pharmacy First, are not enough to make pharmacists working in GP surgeries want to reconsider a career in the sector.

A previous snapshot survey by The Pharmacist found concerns about salary and career progression among ARRS pharmacists.

Of the 44 respondents to the previous survey in early 2024, 56% said they did not feel they had good career progression in their role, while 60% said pay was not adequate for the role.

One North East London Integrated Care Board (ICB) has piloted a retention scheme for clinical pharmacists to tackle issues caused by the difference in outer and inner London salary weightings.

The scheme offers pharmacists portfolio roles across general practice and specialist or academic work.