NHS Pay Review Body (PRB) asks Government to reconsider rejection of national recruitment and retention premium (RRP) for pharmacists

In a letter to the Department of Health (DH), dated 10^th December 2009, the NHSPRB has suggested the Government, and other parties, reconsider the decision to reject the recommendation made in its 24^th report for a national RRP to be paid to band 6 and band 7 pharmacists employed in the NHS. The recommendation was for a short term national RRP ranging from £500 to £5000 per annum depending on agenda for change (AfC) pay point.

This suggestion is based on an assessment of the latest evidence put before the PRB in November by the DH, NHS Employers and Unite the Union (GHP put forward evidence as part of the Unite delegation). In its consideration of the evidence, the PRB made a number of comments:

• They did not agree with the view of the Health Departments that there must be clear and robust evidence of a recruitment and retention difficulty across all four countries of the UK. The AfC handbook refers to national recruitment and retention pressures, which, interpreting national to mean UK, means recruitment and retention pressures in the UK. The requirement that these pressures should exist in all four countries is nowhere mentioned in the AfC agreement or handbook.
• The Migration Advisory Committee (MAC), in its October 2009 report, stated that the large pay difference between NHS and community pharmacy made it more difficult to attract and retain pharmacists within the NHS. It agreed with the Review Body that this was an issue that needed to be examined, and, if possible, resolved. They recommended that pharmacists working in the NHS or hospitals- and pre-registration pharmacists training in these posts- should remain on the shortage occupation list because the clearest evidence of shortage in relation to pharmacists related to NHS pharmacists.
• The Government accepted the Committee’s recommendations for a revised shortage occupation list.
• They were concerned that the recommendation made in their 24^th report, which was based on robust evidence, was rejected.
• Problems with recruitment and retention of junior pharmacists are pressing and give rise to significant risks for morale, motivation, workloads and service delivery.
• They were not persuaded that actions being taken by the Health Departments and local employers will be sufficient to prevent further deterioration and address the problems, especially in the short term.
• The latest survey data on vacancies reinforced their view that the problems are UK-wide.
• The potential benefits resulting from increasing the supply of pharmacists will not be realised until 2011 at the earliest and it cannot be assumed that trainee pharmacists will stay in the NHS once they complete their training. If pharmacists are to be encouraged to remain in the NHS on completion of their training, then pay must be sufficiently attractive in comparison with that on offer in the wider labour market.
• They were concerned that some parties do not acknowledge that the level of pay for junior pharmacists is an important factor in the current shortage.
• The use of local RRPs on an unco-ordinated basis to address the problems of recruitment and retention is inefficient.
• They were concerned that there is anecdotal evidence that employers may be implementing grade drift to overcome local problems. This undermines the job evaluation process and could harm services and morale.
• The cost of the RRP could be partially offset by savings made from the reduction in the need for locum and agency pharmacists working in the NHS.

Overall, the PRB felt that the new evidence reinforced and strengthened their view that a short term, targeted national RRP was the appropriate means to deal with the current recruitment and retention problem with pharmacists in bands 6 and 7, as part of a balanced package of measures.

Although the letter is not a formal recommendation, they suggested that the Government and other parties may wish to reconsider the matter. The PRB expect to return to this issue in 2010.

Dave Thornton, Chair of the Terms and Conditions Committee of the Guild, welcomed the letter from the PRB and fully agreed with their analysis of the situation. “I would like to thank the PRB for recognising the urgency of the situation. I too am concerned with the effects the current vacancy situation is having on staff morale and service delivery and support the view that the Government should reconsider its rejection of the recommendations made in the PRB’s 24^th report” he said. “The letter outlines why, in their independent view, a short term, national RRP is still required to help resolve the current serious difficulties that exist with recruiting and retaining junior pharmacists in the NHS. It also challenges the rationale for rejecting the proposal made in the 24^th report by the Secretary of State for Health in England and the responsible ministers in the devolved administrations. The suggestion that the Government reconsider this decision is well timed since large numbers of pharmacy departments will be looking to appoint current pre-registration pharmacists to band 6 posts over the coming months. A decision to implement the evidence based findings of the PRB will, in my opinion, have a large impact on the numbers of pre-registration pharmacists deciding to stay in the NHS” he added. “I only hope that a swift reconsideration is made otherwise we will miss the opportunity to recruit a significant number of pharmacists at a time when our valuable contribution to patient care has recently been highlighted in the EQUIP study.”

The contents of the PRB letter and further evidence can be found at:
http://www.ome.uk.com/Article/Detail.aspx?ArticleUid=c239a903-6aca-4580-be6c-eab09692ca15