By Sally Greensmith, CPPE Head of national pathways for primary care education.

With the advent of primary care networks and the new Network contract directed enhanced service (DES) there are more and more pharmacists being recruited to increase the patient-facing workforce in primary care and be trained to help with the delivery of the DES. Through the Additional Role Reimbursement Scheme (ARRS), NHS England is contributing a substantial amount of money to fund these training posts. To ensure that the pharmacists are competent and confident to take on the often new, patient-facing roles taking part in the training commissioned by Health Education England through the Centre for Pharmacy Postgraduate Education (CPPE) is compulsory to receive the ARRS funding. This training pathway is the Primary care pharmacy education pathway. Pharmacists who have already completed a previous CPPE pathway or have a considerable amount of prior knowledge, skill and experience that they can demonstrate may be exempt from the pathway or part of the pathway. Exemptions must be applied for through CPPE

CPPE has adapted and updated previous pathway for pharmacists in general practice to provide the new 18-month workplace-based training. There are 28 days protected time for face to face learning time with study days, residential courses and small group learning as well as the educational supervision provided by CPPE. The employers must provide this protected time (it is not pro rata) and they are also responsible for allocating a clinical supervisor to the pharmacist. There is lots of information on the CPPE website including FAQs, exemption guidance, clinical supervisor guidance, a Pathway and role progression handbook and how to enrol. Further information is also available by emailing [email protected]

Misconceptions

The roles are for experienced pharmacists – they can be but they are first and foremost training roles. This is to grow the workforce in primary care rather than moving people around the sector. 70% funding is contribution towards salary and to be able to provide clinical supervision and release pharmacist for training. The pharmacists are taking on roles that have not previously done

Training is optional – no all pharmacists employed through the additional roles reimbursement scheme must either enrol on the training or apply for exemption. They will need evidence of exemption for CCG audit and post-payment verification purposes.

We only allow staff to have five days study leave per year so we cannot agree to the 28 days over the 18-month pathway – these PCN pharmacist training posts are funded with a substantial contribution from NHS England through the additional roles reimbursement scheme. This funding is a contribution towards the salary and to be able to provide clinical supervision and release pharmacist for training. The 28-days paid study leave are compulsory.

I need the pharmacist to get their prescribing qualification as soon as possible – it is important that the pharmacists have a solid foundation of knowledge and experience before they undertake the prescribing training. There are plenty of tasks the pharmacists can undertake in a patient-facing role without being a prescriber and these are listed in the Pathway and role progression handbook on the CPPE website

We have a senior clinical pharmacist in the PCN who is going to be the clinical supervisor – no, the pharmacists need a GP clinical supervisor if they are mainly working in the GP practice. This is because they are taking on roles that have been traditionally done by GPs. There should also be senior pharmacist support. It is NHS England’s intention for PCNs to work towards one senior to five pharmacists as in the Clinical pharmacists in general practice programme. However there is a recognition that this will not necessarily be possible initially. The NHSE guidance says “As the number of clinical pharmacists working within PCNs increases, this should be on a ratio of one senior clinical pharmacist to five junior clinical pharmacists, and in all cases appropriate peer support and supervision must be in place.”  This means that if there is not a senior pharmacist in a PCN already, senior (or peer) support should be identified by the PCN. This could be someone from the CCG or the wider integrated care system (or STP).

By Sally Greensmith, CPPE Head of national pathways for primary care education.