Medicines-led PCN efficiency

18th December 2025

Medicines-led PCN efficiency is often discussed in the context of digital tools, hub models and workforce expansion. These all matter. But in practice, many PCNs find that workload pressure remains stubbornly high, even after new systems and pharmacy roles are introduced.

The reason is simple.

Efficiency in primary care is usually decided by how medicines workflows are designed.

Medicines touch almost every patient, every week. When prescribing, monitoring and review processes are fragmented or poorly owned, inefficiency becomes embedded across the system. When medicines workflows are deliberately designed, capacity is released across the entire network.

This article explains what Medicines-led PCN efficiency really means, why it matters, and how PCNs can approach it as a system rather than a series of disconnected tasks.

Key takeaways

• PCN efficiency is driven more by Medicines workflow design than tools or staffing alone
• Fragmented prescribing processes increase workload, variation and clinical risk
• Medicines-led workflow design releases capacity across practices, not just pharmacy teams
• Structured Medication Reviews deliver value only when embedded into end-to-end workflows
• Governance is what turns short-term efficiency gains into long-term value

What PCN efficiency Really Means in Practice

PCN efficiency is often discussed in terms of access, appointments and demand management. For PCN leaders, efficiency is usually felt in three practical ways.

Operational efficiency means fewer hand-offs, fewer interruptions and fewer avoidable queries. Clinical efficiency shows up as safer prescribing, better monitoring and fewer escalations. Workforce efficiency means the right work is being done by the right role, first time.

When any one of these breaks down, pressure appears elsewhere, usually as GP interruption, admin overload or increased clinical risk.

Medicines workflows sit across all three.

When Medicines workflows in primary care are poorly designed, inefficiency shows up simultaneously as operational drag, clinical risk and misaligned workforce effort.

Why Medicines Sit at the Centre of PCN Workload

Unlike appointments, medicines create continuous demand.

Every PCN and Practice manages repeat prescriptions, acute prescribing, monitoring and recalls, medication queries, hospital discharge changes, Structured Medication Reviews (SMRs) and safety alerts. This work arrives constantly, across multiple practices and multiple roles. This is because medicines workflows in primary care are continuous by nature, creating demand that cuts across clinical, administrative and pharmacy teams every day.

In many PCNs, Medicines workflows in primary care account for a significant proportion of daily GP and managerial interruptions. Repeat prescribing at PCN level and medicines-related queries generate thousands of contacts each month, often cutting across clinical, administrative and pharmacy teams.

That is why medicines are one of the most underestimated drivers of workload, variation and risk.

Medicines related work-streams never switch off in primary care. Until PCNs design medicines workflows properly, efficiency initiatives will always feel temporary.

Adeem Azhar, Co-Founder and Chief Executive Officer – Core Prescribing Solutions

If medicines workflows are fragmented, inefficiency multiplies. When they are designed properly, pressure reduces everywhere else.

FAQs

Where PCN efficiency Commonly Breaks Down

Many PCNs invest in efficiency initiatives but continue to experience the same pressures. The causes are usually consistent.

Medicines tasks are split between practices, roles and systems, with no clear end-to-end ownership. Variation between practices creates duplication and confusion at PCN level. Repeat prescribing is treated as admin rather than a safety-critical workflow requiring structure and governance. At scale, repeat prescribing at PCN level becomes one of the most significant sources of avoidable interruption when processes are inconsistent or poorly owned.

Structured Medication Reviews are often bolted on rather than embedded, delivered as isolated activity without redesigning what happens before and after the review. Clinical Pharmacy teams absorb work without the authority or escalation routes needed to resolve issues fully.

In these situations, the workload is simply moved, not removed.

What Medicines workflow design Actually Means

Medicines-led PCN efficiency starts with workflow design, not activity volume.

In practice, this is where medicines optimisation in PCNs shifts from a clinical concept into an operational discipline.

Medicines workflow design means deliberately defining how prescribing, monitoring and review work flows across the network from start to finish. This includes clear end-to-end ownership, standardised protocols across practices, defined escalation thresholds and decision-making authority.

It also means embedding SMRs into routine prescribing processes, using electronic Repeat Dispensing (eRD) as the default where clinically appropriate, and putting governance, reporting and review mechanisms around the entire workflow.

This shifts medicines from a background burden into managed infrastructure.

The Building Blocks of Medicines-led PCN efficiency

Medicines-led efficiency is not one initiative. It is an integrated system made up of several components.

Medicines optimisation in PCNs provides the clinical framework for safer, more effective prescribing when delivered consistently across practices. When delivered consistently across practices, it reduces variation, improves monitoring and supports better decision-making. This is why many PCNs invest in structured approaches to medicines optimisation and medication safety rather than isolated interventions.

Repeat prescribing at PCN level is one of the highest-volume workflows in primary care. Treating it as infrastructure rather than admin reduces interruption, improves safety and releases capacity across practices.

Prescribing hubs allow PCNs to standardise medicines workflows, improve oversight and reduce duplication. When clinically governed, Prescribing hubs that standardise medicines workflows can significantly reduce medicines-related GP workload and variation.

Clinical Pharmacists and Pharmacy Technicians play a critical role when they are embedded into workflows with clear scope, authority and escalation routes. When Clinical pharmacists in PCNs are given defined ownership of medicines workflows, supported by clear protocols and escalation routes, efficiency gains are sustained rather than short-lived. Clinical pharmacist support within PCNs is most effective when aligned to operating models rather than used to plug gaps.

Structured Medication Reviews deliver the most value when they are targeted and integrated into wider prescribing processes. This approach aligns with NHS guidance on Structured Medication Reviews, which prioritises outcomes and clinical impact over activity volume.

Governance Is the Difference Between Efficiency and Risk

Efficiency without governance is short-lived.

Sustainable medicines optimisation in PCNs depends on clear governance, shared protocols and routine review of prescribing data.

High-performing PCNs have clear Prescribing governance in primary care, agreed PCN-wide protocols, defined clinical oversight and regular review of prescribing data and exceptions. This reflects NICE guidance on medicines optimisation, which emphasises safety, consistency and value alongside efficiency.

Without governance, efficiency gains often reverse as risk and rework increase.

What High-Performing PCNs Do Differently

PCNs that consistently reduce workload and variation treat medicines as core operational infrastructure. They design workflows once and deliver them at scale, reduce interruption upstream rather than downstream, measure avoided work rather than completed tasks, align pharmacy roles to workflows and review medicines processes as part of routine governance.

Efficiency becomes a system property rather than a series of fixes.

Summary and next steps

PCN efficiency is not just about access models, digital tools or workforce numbers. It is shaped every day by how medicines work is designed and delivered.

When medicines workflows are fragmented, inefficiency spreads across the system. When they are designed deliberately, PCNs unlock capacity, reduce risk and create more resilient primary care.

Is your PCN’s medicines workflow acting as a drain or a driver of workload? A medicines workflow diagnostic can quickly identify where interruption, variation and risk are being created across your network.

This is the foundation of Medicines-led PCN efficiency.

Use Workforce Data to Improve ARRS Workforce Planning

12th December 2025

Using workforce data for ARRS workforce planning means analysing delivered full-time equivalent (FTE), activity, utilisation and demand trends to decide which ARRS roles are needed, where they should be deployed, and why. For Primary Care Networks (PCNs), this data-led approach replaces reactive recruitment with purposeful planning based on real workload, population need and system pressure. By understanding how roles are actually used – rather than how they are funded or intended – PCNs can design an ARRS workforce that reduces GP workload, improves consistency across practices and delivers long-term value rather than short-term relief.

• Why Workforce Planning Matters in Primary Care
• What commonly goes wrong without workforce data
• What Workforce Analytics Reveals for ARRS Teams
• Workforce Planning Tools That Make Decisions Easier
• Workforce Forecasting: Planning Next Year’s Workforce Now
• Capacity and Demand Modelling: Matching Workload to Workforce
• How Predictive Analytics Strengthens Workforce Decisions
• Turning Data into ARRS Workforce Optimisation

Key Takeaways

• Workforce data shows how ARRS roles are actually being used, including FTE delivered, utilisation and demand, not just how they are funded.
• Data-led workforce planning improves decisions about which ARRS roles to recruit, where to deploy them and how to balance skill mix across a PCN.
• Using workforce analytics and forecasting prevents common problems such as underutilised roles, rising GP workload and reactive recruitment cycles.

Why Workforce Planning Matters in Primary Care

Most PCNs manage increasing demand, complex patients and variation across practices. Without accurate information about capacity, ARRS roles can feel disconnected from day-to-day pressures. Effective workforce planning provides structure, reduces uncertainty and replaces annual cycles of reactive decision making. Workforce planning is also shaped by national priorities, with the NHS Long Term Workforce Plan setting out how the system must build a workforce that can meet rising demand while improving long-term capacity.

Good planning helps PCNs:

• Match roles to population health need
• Quantify available clinical workforce capacity
• Redistribute tasks to reduce GP workload
• Demonstrate the impact of workforce changes
• Prepare for future service requirements and DES priorities

This clarity strengthens NHS workforce planning and ensures decisions are defensible, fair and aligned with current and future demand.

What commonly goes wrong without workforce data

When workforce planning is not guided by clear data, ARRS investment often fails to translate into reduced workload or improved service delivery. PCNs frequently experience the same patterns, regardless of size or population.

Common issues include:

• Over-recruiting the wrong ARRS roles
  Roles are added based on funding availability or short-term pressure rather than actual demand, leading to gaps remaining elsewhere in the system.
• Underutilised pharmacists and pharmacy technicians
  ARRS staff may be technically in post but spend large proportions of time on low-impact or poorly defined activity, limiting their contribution to workload reduction.
• GP workload not reducing despite ARRS growth
  Without visibility of activity and outcomes, additional roles do not reliably displace GP work, meaning pressure remains unchanged.
• Informal gap-filling without governance
  ARRS roles often drift into covering immediate needs without clear scope, job planning or performance measures, creating inconsistency and risk.
• Reactive recruitment cycles
  Decisions are driven by crises rather than planning, resulting in repeated hiring, role redesign and frustration across practices.

This is why workforce analytics, forecasting and capacity modelling are not optional extras. They provide the structure needed to turn ARRS funding into measurable workforce impact.

What Workforce Analytics Reveals for ARRS Teams

Many PCNs hold large amounts of data but lack the insight needed to interpret it. Workforce analytics transforms numbers into actionable intelligence, enabling leaders to understand workforce behaviour and make informed decisions.

Workforce analytics provides visibility of:

• Actual full time equivalent (FTE) delivered across ARRS roles
• Where workload is rising before it becomes a risk
• Time spent on clinical and non clinical tasks
• The effect of roles on GP appointment volume
• Variation in demand across sites or days
• Recruitment and retention rates

This level of insight supports more accurate PCN capacity planning and allows leaders to identify priority areas. It also forms the foundation for more advanced planning approaches, including workforce forecasting and capacity and demand modelling.

Workforce Planning Tools That Make Decisions Easier

Workforce planning tools help consolidate information into a single, accessible view. PCN managers and PCN Clinical Directors often spend significant time gathering data from disparate systems. Simple, practical tools reduce this administrative burden and support clearer decision making.

Useful features include:

• Dashboards showing FTE, vacancies and utilisation
• Demand and capacity reports based on appointment data
• Heat maps to highlight high-pressure areas
• Automated alerts for emerging gaps
• Comparisons across practices or demographic groups

These tools enhance the quality of workforce planning by making information easier to interpret. They also support more consistent decision making across the network.

Workforce Forecasting: Planning Next Year’s Workforce Now

Workforce forecasting brings together FTE, appointment activity, population health trends, patient and practice needs along with demand patterns to project what the workforce will need in the future. This gives PCNs greater control over planning cycles and reduces reliance on short-term fixes. Resources from Health Education England highlight how workforce analytics and structured planning approaches support better decisions, enabling PCNs to anticipate future pressures and design a workforce that is responsive to population need.

Effective forecasting helps PCNs:

• Identify which additional ARRS roles are required
• Anticipate seasonal variation or long-term increases in demand
• Plan for GP retirements or changes in capacity and turnover in clinical staff
• Adjust the skill mix to meet future needs
• Justify requests for support to the ICB

Primary care workforce forecasting provides structure and predictability. It allows PCNs to act early and avoid last-minute recruitment decisions.

Capacity and Demand Modelling: Matching Workload to Workforce

Capacity and demand modelling helps PCNs understand where pressure is building and how workload compares to the workforce available. This aligns with NHS England’s wider demand and capacity principles, which emphasise the importance of matching system demand with sustainable workforce capacity.

 Most PCNs encounter bottlenecks caused by rising demand across same-day access, long-term condition management and home visiting.

Modelling helps identify:

• Same-day access pressure points
• Increasing demand in long-term condition pathways
• Growth in home visiting requirements
• Population groups that require additional support
• Future service delivery needs

This supports realistic workforce planning and prevents overreliance on existing staff. It also strengthens evidence for recruitment decisions and ensures ARRS roles are positioned where they deliver the greatest impact.

How Predictive Analytics Strengthens Workforce Decisions

Advanced predictive analytics healthcare tools take planning a step further by identifying future challenges based on historic trends. While standard reporting tells you what happened yesterday, predictive models allow PCNs to prepare for emerging pressures before they materialise.

Predictive analytics can reveal:

• Clinics likely to experience pressure months ahead
• Emerging mental health or frailty needs based on population data
• The potential effect of rising long-term conditions on workforce load
• Which ARRS roles offer the strongest long-term value

By integrating these insights, PCNs can enhance both planning and operational delivery, building a workforce strategy that is prepared for tomorrow as well as today.

Turning Data into ARRS Workforce Optimisation

The value of data lies in how it informs day-to-day decisions. ARRS workforce optimisation focuses on structuring roles effectively, reducing duplication and improving the balance between clinical and non clinical activity.

Optimisation helps PCNs:

• Refine skill mix and reduce variation across sites
• Shift tasks to the right professional at the right time
• Improve retention through clearer expectations
• Achieve more consistent service delivery
• Build a workforce aligned to population need

Networks that adopt data-led optimisation typically see better workload distribution, clearer job planning and improved use of ARRS roles.

Expert Insight

When PCNs, GP Practices and GP Federations understand their real workforce capacity and demand patterns based on practice and patient needs, decision making becomes clearer. Data gives leaders the confidence to design a workforce that fits their population. ARRS clinical  roles deliver far more value when they are planned, monitored and adjusted through insight rather than pressure.

Adeem Azhar, Co-Founder and Chief Executive Officer – Core Prescribing Solutions

FAQs

Ready to move from reactive recruitment to data-led strategy?

Stop guessing with your ARRS funding. Book a consultation with our team today to see how our workforce planning tools can give you full visibility over your PCN’s capacity and demand.

The Hidden Cost of GP Workload: Why Clinical Pharmacists and Pharmacy Technicians Are Your Untapped Resource

11th November 2025

Every month, GP practices across England deliver record numbers of appointments, yet the pressure inside those surgeries keeps rising. The headlines talk about productivity, but they miss something important. A large part of GP workload isn’t in consultations at all. It sits in prescription checks, test results, medication reviews, inbox management and supervision time.

For most practices, this invisible layer is what drains capacity and adds risk. It is also where practice workload management can make the biggest difference. When managed properly, clinical pharmacists and pharmacy technicians can safely take on much of this work, freeing up GP time, improving safety and allowing practices to focus on what matters most: patient care.

Key Takeaways

1. GP workload keeps rising even though appointment data suggests capacity gains.
2. Around 40% of GP time is medicines-related and can be managed by pharmacists.
3. The solution is not more roles, but better management and governance.
4. Well-integrated pharmacists improve QOF, IIF and safety metrics.
5. ARRS funding, used strategically, turns workforce pressure into lasting capacity.

Key Stats

• 32.5 million GP appointments were delivered in January 2024, up more than 5 million since 2019.
• 75% of GP trainees cite admin workload as a top concern.
• 15% increase in Structured Medication Reviews (SMRs) in 2023/24.

(Sources: NHS Digital, NIHR, NHS England SMR guidance)

What’s driving GP workload pressure?

General practice is busier than ever. NHS Digital shows appointment numbers continuing to rise while GP headcount falls. But those figures only tell part of the story.

Behind every appointment are hours of unseen work: reviewing results, signing prescriptions, managing medication queries and supervising new roles. The NIHR refers to this as the delegation tax, the extra coordination time that builds up when tasks aren’t clearly delegated.

This challenge sits at the heart of workload in the nhs, where rising expectations and workforce shortages collide.

Appointment data is a poor reflection of true GP workload and workload in the NHS. When you count the time spent on medication queries, supervision and follow-ups, you see why practices feel permanently behind and why there should be an increased focus on better practice workload management .

says Adeem Azhar, Co-Founder and CEO of Core Prescribing Solutions.

How clinical pharmacists and pharmacy technicians reduce the admin burden

Clinical Pharmacists and Pharmacy Technicians can safely manage about two-fifth of a GP’s workload, particularly in medicines-related areas such as:

• Repeat prescribing and medication reviews
• Medicines reconciliation after discharge
• Structured Medication Reviews (SMRs)
• Deprescribing and safety monitoring
• Responding to patient medication queries

As outlined in NHS England’s SMR guidance, pharmacist-led reviews improve patient outcomes and safety, particularly for those on multiple medicines.

This approach is one of the most effective ways of reducing GP admin burden while maintaining continuity and safe prescribing.

When clinical pharmacists are integrated properly, with defined protocols and governance, the impact is immediate. Practices that use a managed model, such as our Clinical Pharmacist Provision service, report measurable time savings and improved patient outcomes. The benefits grow even further when pharmacy technicians are part of that structure. They handle repeat prescription requests, support medication audits, and maintain accurate records, allowing pharmacists to focus on higher-level clinical work. Together, they form a streamlined medicines team that reduces admin pressure and keeps patients safer.

Our Medicines Optimisation framework also helps practices track these benefits as part of wider practice workload management, linking activity to QOF, IIF and audit performance.

Why adding more roles hasn’t solved the problem

Since the launch of the Additional Roles Reimbursement Scheme (ARRS), PCNs have expanded quickly. Yet workload often feels the same. Without structure and supervision protocols, new roles can add clinical workforce pressure instead of easing it.

The solution is structure, not headcount. A managed clinical pharmacy model ensures that ARRS-funded roles deliver measurable results by focusing on:

• Clear workflows for repeat prescribing and results management
• Case-finding rules for SMRs
• Shared inbox systems and escalation routes
• Continuous audit and transparent reporting

When these processes are in place, practices turn funding into genuine time savings. Our insights on using ARRS funding effectively show how this can be achieved even in practices that feel “fully staffed” but still under pressure from workload in the nhs.

Real-world example: cutting 18 hours of admin each week

One Northern PCN used a managed pharmacist service to take over medicines reconciliation, prescription authorisation and patient queries. Within six weeks, the practice cut 18 hours of GP administrative time per week, equivalent to around 40 extra appointments.

The freed-up capacity went straight into continuity and proactive patient care. At the same time, safety indicators improved and prescribing errors dropped.

What good integration looks like

To make clinical pharmacist and pharmacy technician integration work, practices need structure, not just funding. The most successful models follow four key steps:

1. Protocol-first planning – map repeat prescribing, SMR and reconciliation processes from start to finish.
2. Clear governance – define scope, escalation and accountability for clinical decisions.
3. Data and reporting – measure released GP time, interventions and safety improvements.
4. ICB visibility – share outcomes that support ongoing funding and workforce planning.

Workforce planning helps practices and PCNs build this structure so each role contributes to overall efficiency and reduces clinical workforce pressure across the system.

Questions to ask before expanding your team

Before adding new clinical pharmacy or pharmacy technician staff or expanding ARRS roles, practices should ask:

• Do we have clear prescribing and review protocols in place?
• How will we measure time released and outcomes achieved?
• Is our pharmacist working at the top of their licence?
• Can our ICB see measurable results from these roles?

These questions make expansion sustainable and focused on long-term improvement rather than short-term relief.

FAQs

In summary

GP workload isn’t just about appointment numbers. The hidden administrative and medicines-related work consumes most of the time and energy within practices. Managed clinical pharmacy teams can safely take on that work, improve safety and reduce pressure across the system.

This is one of the most practical routes to reducing GP admin burden and strengthening long-term practice workload management.

Learn how our Clinical Pharmacist Provision service helps practices release time, improve patient outcomes and make better use of ARRS funding.