More than half of primary care networks (PCNs) have reported paying above the Additional Roles Reimbursement Scheme (ARRS) allowance to their pharmacists, a survey has suggested.

Carried out by our sister title Pulse PCN, of 147 PCN respondents, some 55% said they had paid over 5% more than the ARRS allowances for their pharmacist, with 8% of those paying more than 20% above this.

This was a greater proportion than for other ARRS professions, including for advanced nurse practitioners – 40% of whom were suggested to be paid above the ARRS reimbursement rate.

Since October, PCNs in England have been able to claim £65,838 (annual equivalent) towards the salary of each clinical pharmacist employed under ARRS, following updates to the PCN DES that did not see overall ARRS funding uplifted to match the increased allowance per employee.

Graham Stretch, president of the Primary Care Pharmacy Association (PCPA), told The Pharmacist that pharmacists had always been seen as 'good value' and were employed in general practice even before the ARRS funding was introduced.

And he suggested that the set amount that PCNs could claim back against their ARRS staff salaries had created an expectation that that was what the pharmacist should be paid, 'when of course somebody's worth what they're worth to a business'.

Instead, he said that many PCNs topped up their ARRS staff's salary from the PCN budget.

And he noted that the pharmacist workforce was maturing, with many who had entered general practice under the ARRS scheme having now trained as independent prescribers.

Dr Stretch, who is a pharmacist partner in a GP surgery, suggested that if pharmacists were using their prescribing qualification by 'practicing autonomously and managing patient workloads', then they would likely want and deserve a pay rise.

Meanwhile, PCN pharmacist and RPS vice chair of the English Pharmacy Board, Brendon Jiang, said it was 'encouraging' to see PCNs 'rewarding the expertise of advanced practice' with salaries above the ARRS maximum reimbursable amount.

'For too long it was considered a salary cap restricting career progression,' he said.

Mr Jiang also said that 'without alignment of ARRS and AfC [Agenda for Change] banding, there will continue to be divergence between sectors'.

'We need a strategic approach to workforce planning across the system, and for all professions,' he urged.

Do you pay above the reimbursable allowances for any PCN staff member recruited through the ARRS? Pharmacist Paramedic ANP Physio MHP
No (or by less than 5% above the allowances) 45% 72% 60% 73% 76%
Yes, by between 5%-20% above the allowances 47% 24% 28% 22% 19%
Yes, by more than 20% above the allowances 8% 5% 12% 4% 5%
Total 147 85 60 98 88

 

The survey was conducted in collaboration with The Pharmacist's sister titles Pulse and Pulse PCN between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool.

After removing duplicate entries from the same PCN, a total of 228 PCN representatives from England responded to these questions, although respondents varied by question.

The survey also asked about recruitment and retention of ARRS roles.

One respondent said all of the ARRS positions have a ‘very high turnover’, with most staying in the role for only one year.

One PCN respondent who had recruited a pharmacist said while they found pharmacists ‘easy to recruit’, they had found them ‘very difficult to retain’.

Overall, 49% of the 228 PCN representatives who responded to this question said they were able to recruit pharmacists 'with little or no difficulty'.

And 42% said they had recruited a pharmacist, but they had found this difficult.

An additional 4% said they were unable to recruit a pharmacist.

Mr Jiang told The Pharmacist that difficulties with recruitment and retention were 'unsurprising'.

'The transition to general practice has its challenges and rewards. While it may not suit everyone, retention difficulties could reflect on NHS workload pressures and the culture of belonging,' he said.

Have you recruited any of the following staff for your PCN? Pharmacist Paramedic Enhanced nurse ANP Physio MHP
Yes, with little or no difficulty 49% 32% 5% 15% 49% 31%
Yes, but recruitment was difficult 42% 23% 9% 18% 26% 42%
No, because we were unable to recruit 4% 10% 15% 19% 4% 11%
No, we haven’t tried to recruit 3% 33% 60% 43% 18% 11%
Don’t know 2% 2% 11% 5% 3% 4%
Grand Total 228 225 222 227 227 227

The survey also found that less than half of PCNs have given their ARRS staff a pay rise of at least 5.5% since April this year.

This survey was run in collaboration with our sister title Pulse and Pulse PCN and open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same primary care network, a total of 228 PCN representatives from England responded to these questions. For the question on paying above allowances, we removed don’t knows. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 John Lewis voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the PCN population.

A version of this article first appeared in Pulse PCN.