NHS Restructure
Pharmacists in the 42 Integrated Care Boards (ICBs), England’s equivalent of Health Boards since 2022, continue to learn more about the potential future of their roles. A model ICB blueprint promised by NHS England for the end of April, was finally published in early May.
Each ICB must now develop proposals for how they will match their future structures to that model in an environment of approximately 50% cuts to budgets and the harmonisation of funding per capita of population, meaning some Boards may need to cut more. The restructure proposals are expected to be finalised by end of May to be implemented between October and December of 2025. Major changes that may include potential redundancies or TUPE transfers, must be subject to necessary consultation with trade unions during that time.
The new model ICB blueprint identifies which responsibilities may be transferred to Regional or National bodies, which may be transferred to NHS providers, which to neighbourhood providers and which may be retained. For example, for pharmacists working in medicines optimisation and medicine management teams, the model indicates that this function would be moved to ‘neighbourhood health providers’ over time. It is widely expected that to meet the financial challenge, some ICBs may agree to merge.
Pharmacists employed at Regional and National parts of NHS England are simultaneously impacted by the announcement to abolish NHS England as an arm’s length entity and transfer its responsibilities back into the Department of Health and Social Care (DHSC). NHS Providers have also been tasked with reducing spending, with a focus on cutting corporate services budgets, such as Human Resources.
However, the potential impact of the restructure does not simply cease at the limits of those directly employed by NHS employers. The PDA has already received queries from some members employed at Commissioning Support Units (CSU) who are concerned that the changes at ICB level may have significant knock-on effect on their workload and job security too.
Impact on pharmacists
Pharmacists employed in these organisations are understandably concerned that their jobs may change significantly or be made redundant. There is a lack of clarity as to who ‘neighbourhood health providers’ might include and there are concerns that this could mean being transferred from Agenda for Change contracts and into the employment of non-NHS employers.
Where jobs are ending, there needs to be a fair selection process and appropriate compensation for redundancy, with individuals given options on their future where possible. Where transfers of employment occur, the rationale for the transfer needs to be justifiable and the transfer process undertaken properly. Finally, those who remain need to be in roles that suit them and for which they can be fully trained with a manageable workload.
However, while this is coming, proposals for specific roles are still unclear.
PDA action
The PDA is already working hard to represent pharmacists and their views both at national and local level regarding the restructure.
The PDA is now part of the NHS Staff Side council structure and is therefore working alongside other trade unions representing NHS employees on Agenda for Change contracts to proactively influence the government’s thinking. Those NHS staff unions will collectively champion fair processes and policies relating to the restructure.
Once specific proposals are made, local consultations should take place, and the PDA wants to represent pharmacists collectively at every employer. There are already PDA Workplace Representatives in some ICBs, representing members at local Staff Partnership Forums.
Through the consultation stage and once clear decisions are made about how this will impact individuals, PDA members may also want to contact the PDA Member Service Centre to lodge their concerns and get advice and support on their specific circumstances.
Impact on pharmacy
As an organisation representing the pharmacist workforce, the PDA is also closely following developments and decisions which impact the wider healthcare system.
Recently, Chief Pharmacists from across ICBs highlighted in a letter to NHS England leaders the important role of medicines in patient care and the expertise that ICB medicines teams have demonstrated in optimising value and delivering efficiency.
More detail is needed around these future arrangements and what is meant by neighbourhood health providers, as the blueprint document outlines that as medicines management and medicines optimisation responsibilities transfer to neighbourhood health providers over time, the ICB will retain some strategic commissioning oversight. There needs to be clarity to those currently working in this area, and reassurance that the significant investment that is made in medicines is operated at a strategic level utilising pharmacist expertise and not purely as a cost containment function.
As the voice of the profession, alongside supporting pharmacists to understand and exercise their employment rights, the PDA will continue to speak up in the professional interest of pharmacists and their patients regarding how NHS structures impact care, careers and system effectiveness.
What next?
PDA members in a workplace should talk to their local representative or agree amongst themselves who can become the local rep if there is currently a vacancy at their employer. Those wishing to find out the name of their local rep or those interested in becoming a rep to fill a vacancy, can email [email protected].
Meanwhile, all Individuals should ensure they have copies of their up-to-date job descriptions and their employment contract, collating notes of any subsequent changes to their role or terms of employment they have agreed in case these are needed during any process that seeks to change or end their current job.
Individuals should also take the time to read management messages and further communications from the PDA, to keep updated on developments.
The PDA will continue to provide support and advice to members and recognise that changes of this nature can also impact on wellbeing. There is a reminder that the PDA’s charity partner, Pharmacist Support, is available with various support services.
Learn more
- Model Integrated Care Board – Blueprint
- PDA Member Support Centre
- The role of medicines leadership in the future NHS
- Pharmacist Support
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