Hot on the heels of the newly published GP Contract for the coming year, NHS England have published guidance on the new PCN Network DES for 2025/26.
The landscape of primary care is constantly evolving, and the latest Network Contract Directed Enhanced Service (DES) for 2025/26 brings significant changes, particularly concerning the Additional Roles Reimbursement Scheme (ARRS).
Understanding these updates is crucial for your PCN to plan your workforce and service delivery for the year ahead, so we’ll take a look at what this could particularly mean when it comes to hiring Pharmacists this year (and how Medacy could help mitigate some of the risks).
What is the PCN DES?
The Network Contract DES is a vital part of the NHS framework in England, acting as a voluntary extension to the standard GP contract.
Introduced initially in 2019, its primary goal is to support the formation and development of PCNs, typically groups of practices serving populations between 30,000 and 50,000. The DES aims to enable these networks to offer a broader range of services, fostering more integrated and accessible primary care within local communities and ultimately improving patient care and outcomes.
The 2025/26 update marks a significant point, following the end of the initial five-year GP contract framework. It represents a significant move to widening ARRS support with a nod to future Neighbourhood working. And, while it brings with it an increase in funding to PCNs, real world uplifts may be offset by hikes in National Insurance and the minimum wage (likely to be around 4% in real-terms).
Key features of the 2025/26 DES include:
- ARRS Expansion: Including GPs and practice nurses.
- ARRS Cap Removal: No more national limits on role recruitment.
- Increased GP Reimbursement: Higher rates for GPs recruited via ARRS.
- CAIP Modifications: Streamlined Capacity and Access Improvement Payment.
- QOF Streamlining: Significant reduction in Quality and Outcomes Framework indicators.
- Digital Accessibility: New requirements for online tools and record access.
- New Enhanced Service: For Advice and Guidance.
Strategically, these changes reinforce the move towards community-based healthcare delivery and preventative care measures, aligning with the NHS Long Term Plan’s objectives.
For a comprehensive breakdown off all DES changes, read these excellent guides from THC Primary Care.
ARRS: Increased Roles and Flexibility
The Additional Roles Reimbursement Scheme (ARRS) sees some of the most impactful changes in the 2025/26 Network DES. Here’s a breakdown:
- Expanded Eligible Roles: GPs and practice nurses are now included in the core ARRS framework, offering PCNs much greater flexibility in shaping their teams to meet local health needs.
- Recruitment Caps Removed: National caps on recruiting any ARRS-eligible role have been eliminated. This empowers PCNs to recruit based on patient demand, although the overall ARRS funding allocation (based on the PCN’s adjusted population) remains the ultimate financial ceiling.
- Reimbursement Rate Changes: The maximum reimbursable salary has increased across key ARRS roles, including GPs and Pharmacists.
- Merged Funding Pots: The previously separate ARRS funding streams are now combined into a single, more adaptable pot, giving PCNs greater flexibility in allocating funds across roles.
- Reinforced “Additionality”: ARRS funding remains intended for new, additional roles beyond the PCN’s baseline workforce. To protect existing staff, PCNs cannot use funding to replace existing staff or, generally, reimburse nurses who have worked in the network within the past 12 months (unless promoted). Exceptions exist for certain roles transferred from previous national schemes.
- Planned Joint Review: A joint review of the ARRS is scheduled for 2025/26. And, with all the change happening within primary care, further evolution of ARRS is highly likely.
What does the new Network DES mean for pharmacist hiring?
For PCNs looking to expand their clinical pharmacy teams, the 2025/26 Network DES brings specific opportunities and requirements:
Eligibility: Both Clinical Pharmacists and Pharmacy Technicians remain key roles eligible for ARRS reimbursement.
Reimbursement Rates: The maximum reimbursable amounts have increased:
- Clinical Pharmacist (Band 7-8a): Up to £66,972 nationally.
- Pharmacy Technician (Band 5): Up to £43,352 nationally. (London weightings apply ).
No Recruitment Caps: The removal of role-specific caps provides freedom to recruit the number of pharmacists and pharmacy technicians needed, within the PCN’s overall ARRS funding limit.
Funding Flexibility: The single funding pot allows PCNs to prioritise pharmacy roles based on local strategy and allocate funds accordingly.
Minimum Role Requirements: The DES specification details these requirements:
- Clinical Pharmacists: Must be enrolled in or have completed an approved 18-month training pathway (or equivalent). Responsibilities centre on medicines optimisation, prescribing safety, and multidisciplinary collaboration. Roles must be >= 0.5 WTE if still in training.
- Pharmacy Technicians: Must be GPhC registered, meet specific training criteria, and work under clinical supervision. Duties include medicines reconciliation, supporting reviews, public health expertise, and administrative tasks related to medicines optimisation.
Additionality: Reimbursement is contingent on roles being genuinely additional to the March 2019 baseline (with specific exemptions for those transferred from previous national schemes ).
Integration: Pharmacists funded via ARRS must be embedded within the PCN’s core practices, fully integrated into the team, have necessary record access, and receive appropriate clinical supervision. PCNs must also update their workforce plans.
What about National Insurance?
While the 2025/26 Network DES delivers a significant funding boost, concerns remain about rising operational costs. Analysis suggests that increases in employer National Insurance contributions and the minimum wage will likely erode some of the financial uplift.
Even with the increased ARRS reimbursement rates for roles like pharmacists, the rise might not fully cover increased NI costs. This could mean PCNs still need to fund salaries above the maximum reimbursable amount to attract and retain staff.
While the enhanced GP reimbursement does now factor in on-costs like NI, the overall financial pressure from rising employment costs remains a key consideration for PCNs when planning their budgets.
Medacy: Greater expertise, less risk
Navigating the complexities of ARRS funding, recruitment, and employment responsibilities adds significant pressure for PCNs.
The welcome flexibility in the 2025/26 Network DES also brings challenges, particularly managing budgets amidst rising costs like National Insurance and evolving employment legislation.
Medacy offers a solution. We provide fully managed clinical pharmacy services tailored to PCN needs. Crucially, our service uses permanent Medacy employees who are experienced Independent Prescribing (IP) Clinical Pharmacists who are integrated into your team but remain employed by us.
This model offers PCNs several advantages:
- Expertise on Tap: Access highly qualified, experienced IP pharmacists without direct recruitment hurdles.
- Reduced Financial Risk: Medacy absorbs the risks associated with employer National Insurance hikes and minimum wage increases.
- Simplified HR: We manage all employment responsibilities, mitigating risks related to changes in employment law (read more about recent changes here).
- Focus on Care: Free up PCN leadership capacity to focus on strategic goals and patient care, rather than HR and payroll complexities.
- ARRS Compliance: Our service is designed to align with ARRS requirements, ensuring you can effectively utilise your funding.
By partnering with Medacy, PCNs can leverage the benefits of the expanded ARRS scheme with greater confidence and less administrative burden, securing expert clinical pharmacy support while mitigating financial and employment risks.
For more information on how Medacy’s fully-managed clinical pharmacy services can help your PCN; contact us today.
