Community pharmacists concerned about ARRS, survey suggests

Pharmacists across all settings have noted positive impacts of the additional roles reimbursement scheme (ARRS), but community pharmacists said ‘too many’ pharmacists had moved into general practice – an exclusive survey has shown.

Around three-quarters of around 100 pharmacists working across community, general practice, primary care networks (PCNs) and hospitals said that the scheme has had a positive impact on patients, pharmacists and GP practices, according to a snapshot survey by Pulse PCN.

The ARRS scheme was introduced in 2019 and enables PCNs to claim funding for additional roles within general practice, including pharmacists and pharmacy technicians.

Pharmacists are still the most popular ARRS role hired by PCNs. In April 2024, there were 5,308 full time equivalent (FTE) ARRS pharmacists working in PCNs.

Eight in 10 of all pharmacists surveyed said they thought the scheme had improved patient access, while 86% said the scheme had improved patient care.

But further questions found much higher opposition to ARRS from community pharmacists. One in three (30%) said they felt either negatively or very negatively about the scheme’s impact on the pharmacist profession.

Only 33% of the 31 community pharmacists responding to the survey said that as a result of ARRS pharmacists, general practice now had a better understanding of community pharmacy challenges. Meanwhile, 42% said it did not.

However, 59% of the 25 non-ARRS general practice pharmacists that responded thought the ARRS scheme had improved general practice’s understanding of community pharmacy challenges.

Some 36% of community pharmacy respondents said that ARRS roles had resulted in pharmacy closures, while 32% said it had not.

The majority (70%) of community pharmacists said that ‘too many’ pharmacists had moved from community pharmacy into general practice resulting in workforce shortage.

This view was shared by 46% of non-ARRS general practice pharmacists.

Meanwhile, 36% of community pharmacists said the introduction of PCN ARRS pharmacy roles had had a positive impact on their work, while 36% also said it had not.

Over half (54%) of non-ARRS general practice pharmacists agreed that ARRS roles had had a positive impact on their work, while 33% neither agreed nor disagreed, and 13% disagreed.

Liam O’Sullivan, a community pharmacist in Southampton, said that he had seen many of his colleagues move into PCN roles.

The shift had meant those working in community pharmacy had less opportunity to gain prescribing qualifications, he said.

With newer pharmacists now coming out of university with independent prescribing skills, this was causing concern.

He said: ‘I am unable to get GP support for a prescribing qualification. I have other colleagues who are travelling far to get supervision requirements. The government needs to really push support for current community pharmacists who are eager to qualify before newly qualified pharmacists can “jump the queue” despite having less experience.’

But he also noted that some PCN pharmacists have had difficulty getting support for training. ‘If even employing pharmacists under ARRS is not enough incentive to invest the proper time in mentoring, I’m not sure what the answer is.’

And Tase Oputu, England board chair of the Royal Pharmaceutical Society (RPS), commented that ARRS pharmacists had ‘made a huge difference for patients’.

‘With continued pressures on the health service, we need a strategic approach to workforce planning across the system, backed by the ongoing investment needed to deliver high-quality patient care,’ she added.

To read the full report click here.

The State of Primary Care survey took place between April 29 and May 20 2024 across Pulse PCN and our sister titles, Pulse, Healthcare Leader, Nursing in Practice, The Pharmacist, Management in Practice, Hospital Healthcare Europe and Hospital Pharmacy Europe.

There were 1,795 responses from health professionals. The majority – 72% or 1,294 – of respondents work in primary care in England. There were answers from across England with all 42 ICBs represented.

A version of this story was first published on our sister title The Pharmacist.