EXCLUSIVE Pharmacists working in Additional Roles Reimbursement Scheme (ARRS) jobs have raised concerns about salary and career progression in our recent snapshot survey.

However, respondents reported positive experiences of inductions, training and support.

The survey, run in conjunction with our sister titles Healthcare Leader and Pulse PCN, had 44 ARRS pharmacist respondents.

Of those, 56% said they did not feel they had good career progression in their role, while 60% said pay was not adequate for the role.

Laura Buckley, primary care lead for the Guild of Healthcare Pharmacists (GHP), said that the GHP's own survey earlier this year had revealed 'a number of comments around pay and progression for primary care network (PCN) pharmacists in ARRS roles'.

'The limitations of funding for pharmacists undoubtedly affects progression and retention,' she told The Pharmacist.

'Any salary above ARRS reimbursable amount is at the discretion of the employing PCN. The funding deficit in general practice now impacts on all roles, and with a recent change in government, we await to see what effect this will have on ARRS funding.'

While she said ARRS pharmacist roles had 'demonstrable benefit in general practice', as evidenced by recent growth in the number of pharmacists employed within GP practices, she noted that funding for the role does not allow for terms and conditions or salary progression to mirror the NHS Agenda for Change pay scale.

'While funding for general practice remains limited, this in turn limits the ability of general practice to remunerate its teams in line with developing job roles,' added Ms Buckley.

How much do ARRS pharmacists get paid?

The ARRS scheme was introduced in 2019 and enables primary care networks (PCNs) to claim funding for additional roles within general practice, including pharmacists and pharmacy technicians.

Pharmacists are still the most popular ARRS role hired by PCNs. In April 2024, there were 5,308 full time equivalent (FTE) ARRS pharmacists working in PCNs.

Last summer, PCNs were given permission to uplift the salaries of ARRS pharmacists in line with the government’s latest NHS pay deal, but were not given a funding increase to do so.

PCNs are able to claim £62,340 (not including the inner or outer-High Cost Area Supplement) for the salary of each clinical pharmacist.

But individual salaries are at the discretion of each employer, and could in theory be higher or lower than this.

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.

Ongoing concerns over career progression and job security

Brendon Jiang, PCN senior pharmacist and vice chair of the Royal Pharmaceutical Society's England Pharmacy Board, told The Pharmacist that he was 'not surprised' by the results around career progression for ARRS roles.

He noted that PCNs 'vary very much in their maturity and how they're structured'.

'This has been identified as an issue before and I think will continue to be. As PCNs mature, and as the team become more embedded, I would hope that this this would improve,' he said.

Mr Jiang highlighted the RPS's advanced and specialist pharmacist credentialling programmes, aiming to enable access to consultant level roles across all sectors.

'We're seeing that, but I think there's still a lot of work to do as evidenced by this survey,' he said.

A recent study found recurring concerns over career progression in interviews with 91 general practice staff.

Some participants even told the study authors that ARRS pharmacists had left roles over the issue.

One pharmacy technician said: ‘You don’t keep pharmacists for two minutes. As soon as they finish the [independent prescribing] pathway they’re gone.’

A workforce lead observed: ‘One of the other challenges is that there is no kind of entry level pharmacist role in general practice.’

The study was authored by Bethan Jones, Zoe Anchors, Sarah Voss and Nicola Walsh and published by The British Journal of General Practice.

And a recent agenda item at the RPS's England board meeting suggested that pharmacy workforce in general practice was 'being directed away from structured medication reviews, and instead being tasked with other activities.’

Our survey also suggested that less than half (43%) of ARRS pharmacists were confident in their job security, and 36% said they did not have job security.

The British Journal of General Practice study also found issues with job security.

Mr Jiang told The Pharmacist that he did not think ARRS pharmacists needed to be 'too worried' about the scheme reaching the end of its funding envelope.

‘I think pharmacists have really demonstrated how valuable we are within general practice. Regardless of how you wrap it up, and name it, the value of multidisciplinary teams working at a neighbourhood level, it's still spelled out in the NHS Long Term Plan, which has another five years to run. So it's all it's all part of the strategic direction,' he said.

Mixed feedback around workspaces

Our survey did find that 68% of ARRS pharmacist respondents said they had a dedicated workspace for their PCN work, compared to 29% who said they did not.

This was an improvement on the result of a similar survey conducted last year, where 72.8% practice staff respondents said they did not have the space to house their ARRS staff.

Positive responses on inductions, training and support

Our survey also found that 74% of ARRS pharmacist respondents had a formal induction into their role, compared to 26% who said they did not.

And 76% said they had time for protected learning and/or ongoing training, compared to 21% who did not.

The majority (88%) said they were supported in their role, compared to 12% who said they were not.

A larger-scale survey conducted by the Pharmacists' Defence Association (PDA) last year reported concerns about inadequate inductions and a lack of ongoing training and support for pharmacists working in general practice. 

Mr Jiang suggested to The Pharmacist that the independent prescribing (IP) pathway for PCN pharmacists was 'almost a double-edged sword'.

While he noted the 'significant investment' in training for the qualification, he had heard anecdotally that 'sometimes pharmacists can come out of that feeling a bit aimless'.

'They get all this initial training and investment for protected learning time, 28 days over the 18 months. And then at the end of that you've done your IP. And it's a big sort of what next?' he said.

He suggested that both pharmacists and PCN leaders should work out the needs of the PCN and put specialist roles in place, like the heart failure pharmacist roles he said were seeming to work well for retention in his North Oxfordshire PCN. 

'Culturally there's a lot of protected learning time given within the general practice environment, which is really helpful and probably why you're seeing a lot of those results,' said Mr Jiang.

'But I think what's probably missing is the direction on where to expand on an individual level.

'PCNs need more maturity, need a bit more love and care and support and direction to really realise the health benefits that they were created for.'

Read the full State of Primary Care report on our sister title Pulse PCN.