The recruitment of pharmacists in primary care networks (PCNs) has ‘exacerbated’ workforce shortages across the profession, an independent review of integrated care systems (ICSs) has claimed.

In addition, it also recognised the new opportunities for integration born out of a recent move of pharmacy commissioning responsibilities to integrated care boards (ICBs).

Former health secretary and government advisor Patricia Hewitt has this week published the findings of her review into ICSs.

A total of 42 ICSs were established across England on a statutory basis on 1 July 2022. They work as partnerships of organisations across local government, social care, the NHS, community and voluntary services, to help plan and deliver joined up health and care services.

The 89-page report, published on 4 April, highlights the ‘difference’ these systems are making, while also setting out ‘what needs to happen next’.

As part of her findings, Ms Hewitt suggested that contracts with national requirements ‘can have unintended consequences’.

For example, she said 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 also recognised the opportunities available following the switch of delegated commissioning responsibilities for pharmaceutical, general ophthalmic and dental (POD) services to ICBs from 1 April 2023.

‘The new responsibilities for ICBs provide an important opportunity, at place or system level, to integrate the whole primary care offer for communities, making the best use of both the staffing resource available and the premises,’ said Ms Hewitt in her report.

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.’

Responding to the report, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Janet Morrison, highlighted how the review ‘recognises the damaging consequences that ARRS has had on the sector, exacerbating workforce issues, which has left many pharmacies forced to close their doors temporarily to patients’.

‘This is something that PSNC has been warning government and NHS England about for some time, including calling for a stop to recruitment of pharmacists to PCNs or allowing the money to be spent funding collaboration with community pharmacies,’ she added.

Meanwhile, director of corporate affairs at the National Pharmacy Association (NPA), Gareth Jones, said: ‘The NPA has repeatedly highlighted that it is an own goal for the NHS to subsidise the employment of pharmacists in general practice at the expense of denuding the community pharmacy workforce.

‘Hewitt has called this out as an example of silo thinking and we urge system leaders to respond accordingly by reviewing the wider workforce impact on their patch.’

James Davies, director for England at the Royal Pharmaceutical Society, commented that: ‘The report acknowledges significant pressures on the pharmacy workforce.’

Mr Davies said an incoming NHS workforce plan for England must consider ‘the whole of pharmacy’ and ‘support a future pipeline of pharmacists backed by investment in education and training’.