The Additional Roles Reimbursement Scheme (ARRS) put clinical pharmacists at the centre of primary care. For many Primary Care Networks the funding looks generous on paper, but the practical question is harder. How do you turn that budget into reliable clinical work, week after week, without creating a recruitment and management headache for already stretched practices? Good ARRS pharmacist support for PCNs is about exactly that. This guide looks at how networks get genuine clinical value from the funding, how to keep governance and accountability tight, and how to avoid the underspend that quietly erodes the scheme’s benefit.
What ARRS pharmacist funding is meant to deliver
ARRS reimburses PCNs for a defined set of additional roles, with clinical pharmacists among the most widely used. The intent is straightforward. Bring pharmacy expertise close to the patient so that medicines are reviewed properly, high-risk drugs are monitored and prescribing is safer, while GPs can concentrate on the work that needs a GP.
ARRS reimbursement depends on role eligibility, actual eligible salary and employer National Insurance and pension costs, the applicable role cap and the PCN’s available allocation. A managed-service fee may include costs that ARRS does not reimburse. Check the current DES and your commissioner before committing funding. A well-defined clinical scope, supervision and clear reporting help a network turn eligible funding into useful medicines work.
If you want a refresher on how the wider scheme fits together, our overview of ARRS support sets out the eligible roles and how PCNs typically use them.
The gap between funding and clinical value
Plenty of PCNs have drawn down ARRS funding and still feel they are not getting the clinical return they expected. The reasons tend to repeat:
- Recruitment is slow and competitive. Experienced primary care pharmacists are in short supply, and a vacancy left open for months is funding that delivers nothing.
- The role lands on the practice to manage. Induction, rotas, appraisal, indemnity, IT access and day-to-day supervision all fall on a practice manager or GP who already has a full plate.
- Clinical scope drifts. Without a clear remit, a pharmacist can end up absorbed into reception-adjacent admin or query handling rather than the medication reviews and monitoring that genuinely improve safety and QOF.
- Turnover resets everything. When a directly employed pharmacist leaves, the PCN loses continuity and momentum, and starts the recruitment cycle again.
Each of these turns a funded role into a partial one. The budget is committed, but the clinical work is thinner than it should be.
Managed service versus a staffing model
This is where the delivery model matters more than most PCNs expect. There are broadly two ways to use ARRS pharmacist funding. You can run a staffing model, where the PCN or practice recruits, employs and manages the pharmacist directly and carries the whole burden of that arrangement. Or you can commission a managed clinical pharmacy service, where the work is delivered, governed and made accountable by a provider.
For subcontracted remote clinical pharmacy, the DES requires continuity with the PCN multidisciplinary team: rotating a different pharmacist into every session would not meet that expectation. Agree consistent clinicians, induction, supervision and cover as part of the service arrangement, and check the current Part B requirements before commissioning.
Virtual Pharmacist operates the second model. We deliver a managed, remote clinical pharmacy service inside your own clinical systems, working directly in EMIS, SystmOne, Vision or Medicus. We hold the clinical governance, quality assurance and accountability for the work itself, so the PCN is commissioning outcomes rather than taking on another person to line manage. The practice is not left to run an induction, chase indemnity or cover absence.
The distinction is practical, not cosmetic. A managed service means the clinical workload is owned end to end by people who do this every day, with consistent standards across a national network of GPhC-registered pharmacists and pharmacy technicians. You can read more about how that works on our clinical pharmacist support page.
Getting real clinical work done
The point of ARRS pharmacist funding is the clinical activity it pays for. A well-run service should be producing tangible work that practices can see and measure:
- Structured medication reviews and clinical medication reviews for patients on multiple medicines, with documented outcomes. See our approach to clinical medication reviews.
- High-risk drug monitoring to identify required checks for patients on medicines such as DMARDs, lithium and amiodarone, review results and escalate overdue monitoring. This is detailed work that benefits from a dedicated, governed process rather than ad hoc attention. Our high-risk drug monitoring service is built around exactly this.
- Prescribing support and medicines optimisation, including switches, deprescribing where appropriate, and aligning to formulary and cost-effective choices.
- Prescription signing by our independent prescribers.
- Audits and QOF support that support the clinical activity, coding and follow-up required by the relevant indicators.
When this work is delivered consistently, the funding stops being an abstract budget line. It becomes safer prescribing, fewer monitoring gaps and demonstrable QOF progress.
Governance and accountability done properly
Clinical pharmacy in primary care carries real risk if governance is loose. Who is accountable when a monitoring blood is missed? Who assures the quality of a medication review? Who holds the indemnity and the information governance? With a directly employed model, those answers sit with the PCN and the supervising GP. With a managed service, they sit with the provider.
Virtual Pharmacist works within a full information governance stack, including NHS Data Security and Protection Toolkit compliance, Cyber Essentials, HSCN connectivity, ICO registration and data sharing agreements. We hold the clinical governance and quality assurance for the work we deliver. You can see how we approach this on our clinical governance and data security page. For a PCN clinical director or ICB medicines lead, that means the audit trail, supervision and assurance are built in rather than improvised.
Avoiding ARRS underspend
Underspend is one of the most common and avoidable problems in the scheme. Funding is allocated, but recruitment stalls, a post sits vacant, or a role turns over and the clock keeps running.
A managed service can help a PCN plan delivery and cover against an agreed workstream. Mobilisation depends on the service scope, capacity, clinical-system access and governance arrangements. Claims must relate to eligible costs and activity; commissioning a service does not guarantee full use or reimbursement of the allocation.
If your PCN has a vacant pharmacist post or a forecast underspend, review the delivery plan, eligible costs and remaining allocation with your commissioner before agreeing additional work.
What this looks like across a PCN
For PCN clinical directors, the attraction is consistency across member practices without each one having to manage its own arrangement. A single managed service can cover medication reviews, monitoring and optimisation across the network, with reporting that rolls up to PCN level. That also supports broader PCN management support and frees clinical directors from chasing the operational detail of individual roles.
For ICB medicines leads, a governed, remote service offers a route to consistent medicines optimisation at scale, with the assurance that the work is delivered to a known standard. Our wider NHS support covers how we work with practices, PCNs and ICBs alongside the clinical team.
Frequently asked questions
Can ARRS funding be used for a managed clinical pharmacy service?
Yes, eligible roles can be delivered through a commissioned service subject to the DES requirements. ARRS reimbursement depends on role eligibility, actual eligible salary and employer National Insurance and pension costs, the applicable role cap and the PCN’s available allocation. A managed-service fee may include costs that ARRS does not reimburse. Check the current DES and your commissioner before committing funding.
How is a managed service different from employing a pharmacist?
With direct employment, the PCN or practice recruits, manages, supervises and covers absence for the pharmacist, and holds accountability for the clinical work. A managed clinical pharmacy service delivers the work, the governance and the quality assurance as a package. Virtual Pharmacist is accountable for the service it provides, so the practice is not left to manage another person.
How does remote delivery work in practice?
Virtual Pharmacist works remotely inside your own clinical system, EMIS, SystmOne, Vision or Medicus, over secure HSCN connectivity. Pharmacists and pharmacy technicians carry out medication reviews, monitoring and prescribing support in the same records your team uses, with the activity documented in the patient record as it would be for any other clinician.
Will it help us avoid ARRS underspend?
A managed service can help plan capacity and cover against defined workstreams. It does not guarantee full use of the allocation: start dates, eligible costs, delivered activity and commissioner requirements still need to be checked.
Who holds clinical governance and indemnity?
Virtual Pharmacist holds the clinical governance, quality assurance and accountability for the work it delivers, and operates within a full information governance stack including NHS DSPT, Cyber Essentials, HSCN, ICO registration and data sharing agreements. This is set out on our clinical governance and data security page.
If your PCN wants to turn ARRS pharmacist funding into consistent, governed clinical work without taking on another person to manage, we would be glad to talk it through. Contact Virtual Pharmacist to discuss what your network needs and how a managed, remote clinical pharmacy service could fit.
