The government has issued a joint response to the Health and Social Care Committee (HSCC)’s report into integrated care systems (ICSs) and the Hewitt Review today.

But Janet Morrison, chief executive of Community Pharmacy England (formerly known as PSNC) criticised the government’s response for being ‘lacklustre’ on addressing the pharmacist workforce issues across primary care.

Paul Day, director of the Pharmacists' Defence Association (PDA) said that 'all parts of the health system need to make best use of pharmacists'.

And James Davies, Director of the Royal Pharmaceutical Society (RPS) for England said that the government must urgently publish the NHS workforce plan, as well as support the data sharing and interoperability of patient records across care settings that was recommended by the Hewitt review.

And Steve Brine, chair of the HSCC, expressed his disappointment that his committee’s recommendation of mandatory public health representation on ICB boards had not been taken forwards, and said that there was still a lack of clarity around what ICSs should be delivering.

The HSCC report and the Hewitt Review both focus on the newly formed ICSs and make recommendations for the future of local health and social care.

In particular, the Hewitt Review highlighted the impact of pharmacists moving to work in general practice and PCNs on a workforce shortage in community pharmacy.

In her report published in April, Patricia Hewitt, former health secretary and chair of Norfolk and Waveney Integrated Care Board said that the national requirements and funding of Additional Roles Reimbursement Scheme (ARRS) roles for community pharmacists within PCNs, ‘has on occasion exacerbated the problem of a general shortage of pharmacists’.

Ms Hewitt added that some pharmacists were ‘now preferring to work within primary care rather than remain in community pharmacies or acute hospitals’ and that this was ‘compounding the problem of community pharmacy closures and delayed discharges’.

But she said that integrated care boards (ICBs) taking on responsibility for commissioning pharmaceutical services provided an opportunity to ‘integrate the whole primary care offer for communities, making the best use of both the staffing resource available and the premises’.

She added: ‘Instead of each element of primary care being treated as a separate silo, ICBs now have the opportunity – and the responsibility – to work with all elements of primary care to achieve the accessible, high-quality and integrated services that residents and local communities need.’

But the government’s response, published today, does not set out any specific strategy for addressing the pharmacist workforce shortage, but instead highlighted the upcoming NHS England long-term workforce plan, which it said would be published ‘shortly’.

The government said that this highly anticipated workforce plan would ‘help ensure that we have the right numbers of staff, with the right skill sets to transform and deliver high quality services fit for the future’.

Janet Morrison, Chief Executive of Community Pharmacy England, said that the government’s response ‘understandably focusses on the ICS infrastructure’, but was ‘rather lacklustre on addressing the primary care workforce issues which are more urgent if we are to avoid catastrophe’.

‘Whilst the Hewitt Review is clear that action should be taken to carefully consider the best use of the limited pharmacist workforce going forwards, the government continues to point to the long-awaited NHS workforce plan as the bringer of solutions,’ she said.

‘Their long-term plan must cover the entirety of the pharmacy workforce across the NHS, including community pharmacy.’

And James Davies, RPS Director for England also called for the government to 'urgently publish the long-awaited NHS workforce plan'.

Paul Day, director of the PDA said that 'all parts of the health system need to make best use of pharmacists'.

'Government need to resource all parts of the NHS, to publish and deliver a workforce plan and ensure health professionals can meet their potential. Each ICS must then play its part in the overall system', he added.

Community pharmacists have long asked for confirmation that the workforce plan will include the community pharmacy workforce, with Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA) saying that it ‘must think about how to best use and coordinate the existing pharmacist workforce across different systems’, including community pharmacy and general practice and primary care networks.

What else is in the government’s response?

The Hewitt Review highlighted the importance of data sharing and interoperability of patient records across care settings to support patient care, which the RPS said 'must be backed by Government and the NHS'.

And Mr Davies added that with ICSs taking over commissioning of local pharmacy services, he shared Hewitt’s concerns that 'the scale and timing of cuts to ICB funding risk diverting time and energy from staff who want to focus on improving patient care'.

The HSCC recommended that every ICB should include a public health representative, such as a public health director or public health lead. But the government’s response said that it would not mandate who should be on ICB boards beyond what was already set out in the Health and Care Act 2022.

Committee chair Mr Brine said that it was ‘disappointing’ that some of the HSCC recommendations had not been taken forward. ‘We had called for ICBs to guarantee a seat for a public health representative, but the government has not changed its position to enforce this where it is not happening,’ he added.

The HSCC also called for the government to simplify targets and make them outcome-based, and said that any update to NHS England's Long-Term Plan must put prevention and long-term transformation at its heart.

Mr Brine said that the HSCC welcomed ‘the government’s acceptance of the importance of outcomes as a basis for setting targets for ICSs’.

It was ‘also good to see that preventing ill-health, an ongoing focus of our work, will be at the heart’ of the government’s upcoming Major Conditions Strategy, added Mr Brine.

However, following today’s response, Mr Brine said that the HSCC remained ‘concerned about the government’s lack of clarity about what the new joined-up systems should be delivering’.

‘Without this, it will be difficult to measure their success and ensure accountability in future,’ he added.