Briefing on Clinical Pharmacists and the Network Contract DES

In January 2019, NHS England and the British Medical Association’s General Practitioners Committee agreed a five-year GP (General Medical Services) contract framework from 2019/20.  The new contract framework marks some of the biggest general practice contract changes in over a decade and will be essential to deliver the ambitions set out in the NHS Long Term Plan through strong general practice services. We have now published more detailed supporting guidance.

This includes the criteria and eligibility for GP practices to sign up to the new Network Contract Directed Enhanced Service (DES) for 2019/20.

Following sign-up to the Network Contract DES, the requirements on GP practices will apply from 1 July 2019. It will ensure general practice plays a leading role in every Primary Care Network (PCN) and mean much closer working between networks and their Integrated Care System.

A specification sets out how GP practices signing up to the Network Contract will receive funding for additional clinical pharmacists and social prescribing link workers during 2019/20 and additional physician associates, first contact physiotherapists, community paramedics in future years.

It outlines transition arrangements for pharmacists employed under/funded by the existing Clinical Pharmacist in General Practice and Medicines Optimisation in Care Homes programmes. Bigger teams of health professionals will work across PCNs, as part of community teams, providing tailored care for patients and will allow GPs to focus more on patients with complex needs.

A set of questions about the Network Contract DES are below, but if you have any further questions please contact:

From July 2019, funding will be available within the Network Contract Directed Enhanced Service (DES) to support the recruitment of clinical pharmacists under a new Additional Roles Reimbursement Scheme. Primary care networks (PCNs) will be able to claim reimbursement of 70% of the actual ongoing salary costs of additional clinical pharmacists up to a maximum amount.

In 2019/20, all PCNs will be able to claim reimbursement for one whole-time-equivalent (WTE) clinical pharmacist (2 WTE if the PCN covers a population of 100,000 or more). Networks transferring staff from the existing national Clinical Pharmacists in General Practice and Medicines Optimisation in Care Homes schemes will also be able to claim reimbursement for those staff, subject to specific rules.

Clinical pharmacists being employed through the Network Contract DES funding will either be enrolled in or have qualified from an accredited training pathway that equips the pharmacist to be able to practice and prescribe safely and effectively in a primary care setting (currently, the Clinical Pharmacist training pathway: CPPE Clinical Pharmacists in General Practice Training PathwayCPPE Medicines Optimisation in Care Homes Training Pathway) and in order to deliver the key responsibilities of the role. NHS England will be arranging a funding mechanism to allow all clinical pharmacists to access and complete an accredited training pathway that equips the pharmacist to achieve this.

The following key principles form the original schemes will be rolled over into the Network Contract DES:

  • The posts are clinical and patient facing in nature.
  • All pharmacists will receive support and supervision to allow them to do the job safely and confidently.

NHS England is committed to supporting the transfer of all clinical pharmacists employed under the current national schemes to the new Network Contract DES.

The Clinical Pharmacists in General Practice Scheme will close to new approvals effective from 31 March 2019 and will close for any appointments to approved posts made after 30 April 2019 (appointments would be considered a signed contract of employment even if the clinical pharmacist is due to start in post thereafter).

The Enhanced Service (ES) for the current scheme will continue for those practices claiming reimbursement for an employed clinical pharmacist, or which have received approval and appointed a clinical pharmacist prior to the 30 April 2019, until either:

  • The clinical pharmacist is transferred to become part of a PCN’s workforce team from 1 July 2019 onwards (and in accordance with the rules set out in Table 1 of the Network Contract DES guidance); or
  • The reimbursement for the clinical pharmacist under the terms of the current ES comes to an end, e.g. at the end of the three-year tapered funding period.

The Medicines Optimisation in Care Homes Scheme will come to end on 31 March 2020.

PCNs may claim reimbursement under the Additional Roles Reimbursement Scheme rules for any care homes clinical pharmacist who transfers to work across the PCN during 2019/20.  The expectation is that upon the end of the current national scheme, these clinical pharmacists will be employed under the terms of the Network Contract DES to support delivery of the network national service specifications.

In relation to pharmacy technicians employed via the Medicines Optimisation in Care Homes Scheme, NHS England will work with Health Education England during 2019 to explore the opportunities for them for working across PCNs. Further information will be provided in due course.

The full details and impact of this change are set out in the published guidance.

This is a decision for the employer and employee. The national schemes will continue for practices currently claiming reimbursement as set out above.

Practices considering transferring staff are advised to read the Network Contract DES guidance at the earliest opportunity as strict workforce additionality rules will apply to the Network Contract DES which may affect the number of clinical pharmacists that can be transferred to the new network scheme.

The Network Contract DES begins on 1 July 2019 and PCNs will be able to claim reimbursement for clinical pharmacists from this date, subject to specific rules.

Employing practices will be responsible for supporting their staff through these transitional arrangements.