General Practice Forward View Update : Clinical Pharmacists in GP Practices. 2/08/2017

What has been achieved? Programme update 2016 Pilot update March 2017 Application Update – Wave 1 May Application Update 2017 –Wave 2

Programme Update – Overview The General Practice Forward View (GPFV) includes a commitment to deliver an additional 5,000 clinical and non-clinical staff in general practice. Out of these 5,000 additional staff members there is a commitment to have ‘’a pharmacist per 30,000 of the population… leading to a further 1,500 pharmacists in general practice by 2020’’. The Clinical Pharmacists in General Practice programme launched in 2015 Phase 1 Pilot July 2015- 2016 In October 2016: 491 pharmacists in 658 practices across 89 pilot sites Phase 2 2017 – 4 application waves 112m has been made available to NHS England for the roll-out of Wave 2. Investment of £36 million over three years The funding will cover recruitment, employment, training and development of clinical pharmacists and the development of employing/participating practices. For London this equates to 252 WTE Clinical Pharmacists Or 84/ year for the next 3 years.

Programme update -2016 pilot sites, 2017 wave 1 & 2 Phase 1 - 2016 Pilot sites 49 WTE Clinical Pharmacists across 11 applications. Phase 2 2017 London has been set a national allocation of 84 WTE clinical pharmacists per annum for 3 years, which is a cumulative total of 252 WTE clinical pharmacists. In terms of progress of clinical pharmacist applications for wave 1 and wave 2:- In wave 1 a total of 43.1 WTE approvals were achieved covering 177 GP practices, serving a total practice population of 1,452,781. In wave 2 equates to 81.1 WTE clinical pharmacists covering 342 GP practice, serving a total practice population of 2,464,554. To date London region has achieved 49% of its cumulative 3 year total allocation in the 2 waves in 2017.

Programme Mapping 2016 Pilot , Wave 1 & Wave 2 NCL 2016 Pilot Haringey 2 WTE pharmacists Islington 2 WTE pharmacists Wave 1 Feb 2017 Islington 7 WTE Camden 1.5 WTE, Camden 2.4 WTE Wave 2 Barnet 5.5 WTE, Enfield 2.8 WTE Camden 1.4 WTE NEL 2016 Pilot Barking & Dagenham 10 WTE pharmacists City & Hackney 5 WTE Newham 12 WTE Pharmacists Wave 1 Feb 2017 none Wave 2 City & Hackney 1.7 WTE Waltham Forest 10 WTE Tower Hamlets 10 WTE NWL 2016 Pilot Ealing 1 WTE clinical Pharmacist Hammersmith 2 Clinical Pharmacist Harrow 0.9 WTE Clinical Pharmacist Wave 1 Feb 2017 Ealing 3 WTE pharmacists Hammersmith 2.8 WTE Wave 2 Hounslow 4WTE Central London 3WTE Brent 10 WTW Westminster 3WTE SWL 2016 Pilot Kingston 2 practices 2 WTE Pharmacist Wave 1 Feb 2017 Wandsworth 2 WTE Pharmacist Wandsworth 1.4 WTE Pharmacist Wave 2 Croydon 13.5 WTE Sutton 6.4 WTW SEL 2016 Pilot Bexley 6 WTE pharmacists Wave 1 Feb 2017 Southwark 6 WTE Pharmacists Lambeth 12.4 WTE pharmacists Lewisham 5 WTE pharmacists Wave 2 Greenwich 6WTE Southwark 2.5 WTE Grafton Practice Wave 1 Wave 2 Feb 2017 2 WTE pharmacists Wandsworth/Merton/Lambeth Hurley /Kings Wave 2 Lambeth/Southwark/Lewisham /Tower Hamlets/Havering/ Camden  /Hackney/Merton 2.5 WTE

Next steps Wave 1 & 2 Implementation Wave 3 September 2017 Support for this programme Strategic Direction

Next Steps Contractual implementation wave 1 and 2 Service model - Contracting model will be via a GP enhanced service. Service payments National allocation to regional teams Payments vis CQRS method of payment one month in arears. (process being updated and not deployed yet) Interim – allocation from National team to the regional team to allocate to applicants Recruitment - Successful applicant can start recruiting. Regional teams have been asked to monitor and agree recruitment plans Training & education Health Education England has recently completed a procurement exercise for a training and development pathway for clinical pharmacists. The Independent Prescribing training procurement and practice development procurement is being finalised.

Wave 3 September 2017 A third application wave has been announced and the deadline is September 2017. NHS England is inviting GP practices and other providers of general practice medical services to apply for funding to help recruit, train and develop more clinical pharmacists. https://www.england.nhs.uk/gp/gpfv/workforce/building-the-general-practice- workforce/cp-gp/ London Region and the National Team are in the process of agreeing the application cap.

Strategic direction GP 5 year forward view The Clinical Pharmacy Programme is part of the workforce initiative of the GP 5 Year forward view. This is one of many initiatives to support General Practice. Pharmacy in Primary care The programme should not be run in isolation from other primary care pharmacy workstreams I.e. NHS Community Pharmacy reforms. NHS Integration fund which has two Initiatives The deployment of pharmacy professionals in care homes and funding workforce development for these pharmacists to include a prescribing qualification. Funding for pharmacists working in urgent care clinical hubs, e.g. NHS 111 or GP out of hour’s services, and again this will include a prescribing qualification. Community pharmacy - Pharmacy 5 Point Forward Plan 

Links , References PCC update July 2017 https://www.pcc-cic.org.uk/article/clinical-pharmacists-programme-provides-model-wider-workforce-change NHS England https://www.england.nhs.uk/gp/gpfv/workforce/building-the-general-practice-workforce/cp-gp/ Guidance Sample application form CPPE Clinical Pharmacist training pathway. https://www.cppe.ac.uk/career/gp-pharmacist-training-pathway London & SE Deanery https://www.lasepharmacy.hee.nhs.uk/primary-care/pharmacists-in-general-practice/ Primary Care Pharmacist association https://www.pcpa.org.uk/assets/documents/PDF-guide-for-GPs-considering-employing-pharmacist.pdf. Employment Guidance JD’s