Action should be taken to 'investigate' placing Additional Roles Reimbursement Scheme (ARRS) staff  'in community pharmacy instead of GP practices’, a policy report has suggested.

And to overcome the ‘outsized voice’ of general practice within primary care, decision making around ARRS deployment could be moved up to integrated care board (ICB) level, The Public Policy Projects (PPP) report said.

Going further, the report also called for the implementation of an 'ARRS-equivalent scheme for community pharmacy’.

The Public Policy Projects (PPP) report, published last week, draws upon a roundtable conducted in February, with attendees including ICB chief pharmacists, primary care representatives including national primary care medical director at NHS England, Claire Fuller, and community pharmacy representatives from the National Pharmacy Association (NPA).

According to the report, roundtable attendees had ‘expressed concern’ that community pharmacy was ‘not receiving sufficient allocations’ of funding.

And it suggested that ICBs, rather than Primary Care Networks (PCNs), be responsible for deciding how ARRS funding - which helps PCNs cover the salaries of some staff, including pharmacists and pharmacy technicians - should be deployed.

This could help ‘promote system level thinking and the greater inclusion of pharmacy’, the report added.

It also claimed that by utilising existing funding, ‘there is opportunity for ARRS roles to be placed in community pharmacies rather than in general practice’.

'Decision making around the current ARRS deployment should include community pharmacy and investigate placing roles in community pharmacy instead of GP practices,' the report added.

One roundtable attendee suggested that ‘a social prescriber could work out of a community pharmacy one day per week, helping to drive demand away from general practices and value into community pharmacy’.

But for ARRS roles in community pharmacy to be successful, ‘the sector will need similar levels of support offered to implement ARRS roles in general practice, including educational and training support,’ the report said.

Increased opportunities for 'cross-sector working’ at all levels was cited by the report as a way of reducing competition for workforce.

This would also ‘help to support an understanding of joint priorities across the system, promoting collaboration within the pharmacy profession itself as well as with industry partners’, the report suggested.

In addition, the report recommended that ‘to ensure workforce retention, pharmacy must break out of historically flat career progression structures’.

While ‘advanced roles such as consultant pharmacists have gone some way to address this’, ‘clear career pathways which encompass both clinical, managerial and leadership roles must be well mapped out and advertised to ensure pharmacy takes a competitive position as a profession’, the PPP report said.

And it added that ‘supporting contractual arrangements that support workforce sharing across different pathways’ would be required to support portfolio careers.

More widely, integrating pharmacy services within integrated care systems (ICSs) would enable pharmacists to ‘play a pivotal role in delivering high-quality and cost-effective care’, the report concluded.

And it highlighted that medicines are ‘the second biggest cost to the NHS after staffing’, with optimisation an undeniable opportunity to deliver better value for money.

In particular, supporting effective collaboration between community pharmacy and hospital teams could help reduce patient harm and produce cost savings through more effective implementation of the Discharge Medicines Service (DMS), the PPP suggested.

And NHS England medicines policies and contractual frameworks should ‘prioritise patient outcomes over cost savings’, the report recommended.

Commenting on the report, NPA local integration lead Michael Lennox, suggested that expanding the role of community pharmacy could ‘deliver a marked uplift in medicines optimisation’.

‘This will deliver benefits to cost-effective patient care, provided a re-imagination of our national contract paves the way, and local systems embrace and enable these opportunities,’ he added.