How Do You Support Your PCN Pharmacist’s Progression When You Have Devolved That Role Down to Practice?
- 5 days ago
- 4 min read
Updated: 2 days ago
The devolution tension
PCNs receive funding through the Additional Roles Reimbursement Scheme (ARRS) to employ a range of clinical staff, including pharmacists. Some PCNs manage that funding centrally; others pass it down to their member practices. This blog is about what happens in the second scenario.
Back in 2023, I wrote about the unintended consequences of devolving your ARRS budgets. I know this is common practice and there are advantages, but I thought it would be helpful to look at the implications again, and more specifically at the role of the pharmacist. You can read the original piece here: The Unintended Consequence of Devolving Your Primary Care Network Budget. Keep reading if this is your PCN arrangement.
Once an ARRS role is devolved to a practice, the practice owns the relationship, and they are protective of that person. If a PCN Manager or Clinical Director starts asking questions about what the pharmacist is doing, it can read as criticism of the practice, even when that is not the intent at all.
So PCN leaders say nothing. And nobody knows whether the pharmacist is progressing because there is no forum where anyone can find out, and there are limited opportunities to share best practices, connect with other pharmacists, and learn from each other.
The absorption problem
Many pharmacists, particularly those devolved to individual practices, have become deeply embedded in the day-to-day. Repeat prescriptions. Medicines queries. Structured medication reviews. They are valued, trusted, and largely getting on with it.
That embeddedness is an asset. A pharmacist who has been with a practice for two or three years knows the prescribing patterns, the clinical team, and the patients. That relationship takes time to build and is easy to underestimate.
But embeddedness can quietly become a ceiling.
A survey of practice pharmacists cited in the same Healthcare Leader report found that 58% of those who had moved from community pharmacy into general practice did so because they preferred the work, while 42% wanted to develop their prescribing skills.
However, if nobody is actively enabling this, the very thing that attracted them to the role goes unmet. And you may not notice, because the structured medication reviews are still going out, and nobody is raising a concern.
The missed opportunities: Shaun Hockey, MD at Medacy
I asked Shaun Hockey, MD at Medacy and our resident pharmacy expert, what are the most common missed opportunities you see when visiting PCNs and practices?
“When I visit PCNs and practices, I'm rarely surprised by what's going wrong. I'm more often struck by what's going unasked.
The temptation may be to start setting up reports and processes to try to get on top of the issue. But there is a much simpler (and effective) first step to take.
Pharmacists coming into primary care through ARRS bring something that is easy to overlook, years of experience in other settings. Community pharmacy. Secondary care. Industry. Each of those environments shaped how they think about risk patients and systems. And, in most cases, nobody has ever thought to ask them what they learned there.
So here is one thing you could do this week, without restructuring anything or inserting yourself into a practice relationship: sit down with your pharmacist and ask them a single question.
‘You have experience outside of primary care. What one learning from that experience could we apply here to make outcomes better for patients?’
In our experience at Medacy, that conversation unlocks something. It signals to the pharmacist that their whole career matters, not just the part that fits neatly into a repeat prescription workflow. And it often surfaces practical ideas around medicine safety, patient communication, or clinical process, that the practice would never have thought to look for. The pharmacist already has the answer. You just haven't asked the question yet.”
Final Thoughts
The PCN does not need to manage the pharmacist to either listen to or support them. There is a meaningful difference between the two.
Once you've spoken with your pharmacist, your next steps should be clearer.
Enabling these priorities could involve: sharing information about independent prescribing qualification routes. Facilitating a peer group, even an informal one, across practices. Including the pharmacist workforce in PCN-level clinical conversations. Asking the question at a PCN board or clinical meeting: Are we making the most of this role across our network?
None of that requires the PCN to insert itself into a practice relationship. It requires the PCN to remember that the role exists, that it was created at PCN level, and that the responsibility for enabling it did not disappear when the budget moved.
What good looks like in practice
For a detailed look at what the role can and should include - and how it can develop - read: The Role of the PCN Pharmacist and Pharmacy Technician.
If you are looking to improve how your pharmacy team is structured or struggling to recruit, Shaun Hockey at Medacy is worth a conversation.
You can reach him at shaun@medacy.co.uk or find out more at www.medacy.co.uk.
The question to sit with
Do you know what your PCN pharmacist is doing? And do you know whether anyone is supporting them to do more?
If the honest answer is no, that is not a failure. It is a starting point. The role has been here since 2019. There is still time to make the most of it.
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