An increasing number of pharmacists undertaking ‘portfolio’ careers could spell the end to workforce ‘stealing’ between settings, a panellist at the recent King’s Fund conference suggested.
Patricia Wright, a pharmacist and chief executive of the Hillingdon Hospitals NHS Trust, suggested that pharmacists spending time working within different settings including community, general practice and hospital, could help them ‘learn different ways of working’ rather than ‘stealing [workforce] from each other’.
But Alastair Buxton, director of NHS services at Community Pharmacy England (CPE), warned that multi-sector placements, which he said could enable portfolio careers, were still facing logistical difficulties.
‘In terms of portfolio careers, I think we're going to start to see more of that,’ he told delegates at The King’s Fund conference earlier this month.
Though he noted that funding would be fundamental to making that happen.
And he said that multi-sector placements – in which newly qualified pharmacists from 2026 will need to have undertaken training experiences in hospital, primary care and in community pharmacy – ‘could be the start’ of ‘moving to more of a portfolio-based career’.
But he added: ‘The logistics of how on earth that's going to actually be organised is far from being sorted by NHS England.’
[Since this article was published, NHSE announced an increase in the training grant for foundation year pharmacists, which will allow some funding to be used to support prescribing training in multiple settings.]
In a report released earlier this year, the Company Chemists’ Association (CCA) suggested that the recruitment of pharmacists into Additional Roles Reimbursement Scheme (ARRS) positions was ‘stealing’ the workforce from community pharmacy.
And it called for better workforce planning across systems.
But Dr Graham Stretch, president of the Primary Care Pharmacy Association (PCPA), has suggested that factors other than ARRS could be responsible for workforce issues in community pharmacy.
And last year, the then deputy chief pharmaceutical officer Dr Bruce Warner stressed the need to make community pharmacy ‘a much more exciting place where people want to be’, suggesting that with the introduction of independent prescribing on a widespread scale, pharmacists will be more likely to have ‘portfolio careers’.
The King’s Fund Conference panel also discussed other practical ways that patient access, workforce and funding issues could be addressed.
Supervision changes
Ms Wright said that changes to pharmacy supervision would be a key enabling factor for community pharmacy teams to do more.
Mr Buxton responded that ‘the supervision point is hopefully going to be addressed by the Department of Health and Social Care fairly soon’.
He highlighted that ministers had until March 2024 to deliver on their commitment to ‘sort out the supervision issue’ by the end of the five-year community pharmacy contractual framework – although he said that the change was coming ‘far too late’ as it was really needed five or 10 years ago.
Commissioning changes
Ms Wright also suggested that community pharmacy income relies too much on dispensing.
She said there needed to be ‘a very serious discussion at a national and local level about what is the baseline that gets commissioned’.
And she suggested that primary care networks (PCNs) could commission services ‘across the multidisciplinary team’, including baseline services in community pharmacy.
At the same event, Mr Buxton suggested that there needed to be a ‘stronger baseline’ of services provided by every single community pharmacy, as well as diverse commissioning to meet local needs.
Patient access
Also speaking on the panel was East London GP Dr Farzana Hussain, who suggested there could be a ‘common front door’ to the NHS, that would signpost patients to the most appropriate provider to meet their needs.
While she acknowledged this might be ‘hard to do contractually’, she highlighted the value of ‘collaboration not competition’ between different primary care providers.
She gave the example of flu vaccinations, noting ‘there’s enough work for all of us out there’.
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