Primary Care Networks (PCNs) in England will be able to claim £65,838 (annual equivalent) per clinical pharmacist from October, following updates to the PCN DES issued yesterday.

Under the new framework, the government will reimburse PCNs 5.6% more per clinical pharmacist Additional Roles Reimbursement (ARRS) role from 1 October 2024 than they have done since March 2023.

But the total amount of ARRS funding allocated to each PCN will remain at January 2024 levels, which was in itself an uplift of just 22p per weighted patient from the 2023/24 DES.

As in previous years, this could mean that if PCNs uplift ARRS salaries, they risk having less money to hire further roles, or may even need to reduce their workforce.

From 1 October 2024, PCNs will be able to claim up to £65,838 (annual equivalent) per ARRS clinical pharmacist working at band 7-8a.

In outer London, this rises to £73,189, and £76,313 in inner London.

And the reimbursable amount for advanced practitioners working at band 8a will rise by 5.6% to £72,141, or £79,492 in outer London and £82,616 in inner London.

For pharmacy technicians working at band 5, PCNs can claim up to £42,437 (annual equivalent), or £48,991 in outer London and £51,176 in inner London - a 5.7% increase compared to last year.

For the first year, GPs have been added to the ARRS scheme, with funding for these roles coming from a ringfenced budget that is separate from other ARRS funding.

President of the Primary Care Pharmacy Association (PCPA) and pharmacist partner in a general practice, Graham Stretch, told The Pharmacist that he welcomed the uplift to the maximum reimbursable amounts per role.

But he said that without an uplift to the overall funding sum, 'you're just putting pressure on budgets elsewhere, in a place where we're already in dispute about those very budgets'.

He said that staff would 'naturally' and 'not unreasonably' want a pay rise in line with the uplift to reimbursable amounts and roles in other sectors.

He suggested that wages in the sector were 'stagnating' and noted that the ARRS workforce, which may have been in place since the scheme was introduced in 2019, were now 'maturing' and 'quite reasonably, not only want an inflationary rise, they also want recognition for attaining qualification and experience.'

He suggested that pharmacists employed by PCNs might, by 2024, have 'done their prescribing pathway, they might be well into their advanced practitioner [roles], they might be taking on more responsibilities, might be taking on trainees, might be becoming DPPs [Designated Prescribing Practitioners], and all the things we want them to do for the benefit of patients.'

But if a PCN had 'maxed out' its total budget, even though in theory it would be allowed to claim more for each ARRS role, it would not be able to as it would be 'up to the buffer'.

'Which then puts more pressure on practice budgets, because if you want to retain your staff, you're going to have to find the money, or they're just going to go back to the managed care sector potentially,' Dr Stretch said.

And he warned that many PCNs would have spent up to their maximum budget for ARRS roles, given that uncertainty about whether the scheme would continue beyond its original end date of March 2024.

'We weren't sure what was going to happen with the budget post last year, everybody did exactly that [maxed out their budget]. Quite a few PCNs overshot, actually,' Dr Stretch said.

He told The Pharmacist that the only way to 'stay within the [funding] envelope' and give pay rises to staff would be to reduce the size of the workforce.

And he suggested that some redundancies were already happening among ARRS roles, while other clinical directors might be welcoming flexible working or reduced hours requests from staff.

'But we shouldn't have to rely on that. Given that we're trying to provide more capacity as part of the whole point of [ARRS], reducing your headcount is not going to help us with more capacity.'

And he suggested that less capacity among clinical staff could have an impact on patients.

'Whilst [the government and NHS] recognise the value of the skills of all the ARRS professions, they're not giving PCNs the budget in order to be able to pass that on,' he told The Pharmacist.

'They need to invest appropriately,' Dr Stretch added.

NHS England and the Department of Health and Social Care have been approached for comment.