Recent reports from ICBs across the UK (most notably the April 2026 risk assessments and reporting pathways in North Central London) have highlighted a critical threat to patient safety, the unsustainable transfer of workload from Secondary Care to Primary Care.
With the 2026/27 GP Contract now mandating same-day responses for urgent clinical needs, the primary care inbox has become a frontline for safety. When hospitals fail to issue adequate discharge medication or push routine monitoring back to the community without funding, it isn’t just a nuisance; it is a direct drain on the capacity required to meet these new mandatory access targets.
Where the pressure is building
While the transfer of work from secondary care is often discussed in general terms, the reality for PCNs in 2026 is a specific set of clinical and administrative bottlenecks that drain capacity:
Hospital discharge errors: When discharge letters lack clear medication instructions or hospitals fail to provide the required initial supply, the burden of correction falls entirely on the practice team.
Requests for diagnostics: Secondary care clinicians frequently request that routine blood tests or investigations be carried out in primary care “on their behalf,” often without the necessary resource or clinical context.
Redirected prescribing: Patients are increasingly directed back to their GP for medications that should, under the NHS Standard Contract, be initiated and stabilised within the Trust.
Without a robust clinical governance layer, these tasks don’t just add to the workload, they create clinical risk. Every minute a GP spends reconciling a poorly documented hospital letter is a minute lost to complex patient care.
Why Standard Recruitment Often Fails to Solve the Problem
Many PCNs have attempted to solve this by using the Additional Roles Reimbursement Scheme (ARRS) to hire pharmacists directly. However, for many PCN Clinical Directors, this has inadvertently created a new type of workload: management overhead.
Directly employing clinicians means the PCN must take on the burden of:
- Clinical supervision and training.
- Staff turnover and recruitment cycles
- Quality assurance and performance monitoring.
- Navigating the complex interface between the practice and the local Trust.
In a climate where GP leaders are already stretched to their limit, shifting the workload from “doing the tasks” to “managing the person doing the tasks” is not a net gain.
A Managed Infrastructure Solution
Medacy’s model was built to solve this structural flaw, while still remaining fundable through ARRS. We do not simply provide “additional roles”, we provide a fully managed clinical infrastructure that removes the management and training burden from PCN and ICB leadership.
Our Virtual Practice approach is underpinned by a centralised management team that takes 100% responsibility for clinical oversight and governance. This ensures that GP partners are not expected to provide clinical supervision beyond responding to normal clinical queries as they would for any member of the practice team.
Our service delivery is built on a stable, employed workforce model (not a locum-based approach) allowing us to scale support across three key levels:
- Practice Level: A dedicated pharmacist integrated into your team, but managed and supervised by Medacy’s senior clinical leads. Every pharmacist we deploy is a qualified and experienced Independent Prescriber, meaning they can work autonomously from day one without requiring a GP to countersign prescriptions.
- PCN Level: A team of floating pharmacists and technicians who can move across a network to address QOF gaps or pharmacy-led clinics. Our pharmacists are familiar with local workflows and communicate through whatever channels the practice prefers, such as EMIS, SystmOne, or AccuRx.
- ICB Level: A rapid response team designed to stabilise failing practices or manage large-scale transitions, such as mass medicines reconciliation projects.
Reducing Workload Through Clinical Governance
The core of our philosophy is that for a service to be effective, it must be self-sustaining and transparent. Our centralised management team takes full responsibility for the quality of work through regular clinical audits and a robust Quality Management System (RADAR) to manage any incidents.
We don’t just “do the work”—we provide monthly performance reports tailored to your priorities, covering activity volumes, cost savings identified through medication optimisation, and direct contributions to QOF and IIF indicators.
From Passive Recipient to Active Manager
By taking total ownership of medication-related tasks (from complex discharge summaries to the latest 2026 clinical indicators), we provide PCN leaders with more than just a body in a chair. We provide the clinical capacity GPs need to focus on complex patient care and meeting the new urgent access requirements.
As ICBs look for ways to mitigate the risks of workload transfer this year, look beyond normal recruitment cycles and toward managed clinical services. Medacy provides that stability, ensuring that when the hospital pushes work back, you have a professional, managed system ready to catch it.
Ready to protect your practice capacity?
Contact Medacy today to discuss how our managed clinical pharmacy service can stabilise your PCN’s workload for the 2026/27 contract year.
