By Anna Kendrick
The PCN clinical pharmacist role is an established feature of NHS primary care, with NHS Digital workforce data from September 2025 recording more than 7,100 pharmacists working in primary care and general practice in England, most employed through Primary Care Networks (PCNs) under the Additional Roles Reimbursement Scheme (ARRS). How that workforce is deployed varies between networks and influences which clinical activities are prioritised and how consistently they are delivered across member practices.
Four deployment models are in common use: practice-embedded, PCN-wide, remote and hybrid. PCN clinical pharmacists contribute to medicines safety, repeat prescribing oversight, Structured Medication Reviews (SMRs) and medicines reconciliation after hospital discharge, so model selection should follow from the activities the network most needs delivered consistently rather than from where the pharmacist sits.
PCNs typically deploy clinical pharmacists under one of four models: practice-embedded, PCN-wide, remote or hybrid.
Clinical priorities, not logistics, should drive a PCN’s choice of pharmacist deployment model.
Clinical pharmacists in PCNs work to identical governance and supervision standards regardless of deployment model.
Remote and hybrid pharmacist deployment requires more deliberate oversight structure than on-site working.
A practice-embedded pharmacist is based within a single GP practice and works alongside the existing team day to day. This allows the pharmacist to become familiar with the patient list, the prescribing patterns of individual GPs and the clinical pressures the practice is managing, which makes the role more responsive and more clinically useful to the host practice.
The model suits repeat prescribing oversight, high-risk medicine monitoring (DMARDs, lithium, methotrexate, amiodarone) and face-to-face consultations with patients on complex regimens, particularly where the pharmacist holds an independent prescribing qualification and can manage ongoing medication changes directly.
Scale is the principal limitation, since a single practice may not generate enough pharmacist workload to support a full-time post. Where deployment across a PCN is fragmented, standards of documentation, clinical protocol and prescribing governance can drift between member practices over time.
A PCN-wide model deploys a clinical pharmacist or small pharmacy team across every member practice, with workload prioritised by the needs of the network’s registered population rather than practice-by-practice demand. This supports risk stratification, consistent application of SMR eligibility criteria and uniform standards of prescribing audit.
The model suits higher-volume medicines optimisation work, including polypharmacy reviews for older adults, care home medication reviews under the Enhanced Health in Care Homes framework and network-level prescribing governance such as antimicrobial stewardship or coordinating the response to MHRA drug safety alerts.
Continuity at practice level is more limited than under a practice-embedded arrangement. A pharmacist whose time is split across five or six practices has less opportunity to build close relationships within any single team, which also lengthens response times for practice-specific queries.
Remote delivery places the clinical pharmacist off-site, with secure access to clinical systems such as EMIS or SystmOne. The work is usually task-focused and well defined, covering SMRs, medication reviews, repeat prescribing authorisation and documentary activity that does not require physical presence in a practice.
The model helps where member practices lack space for additional on-site clinical staff and where PCNs need to recruit pharmacists who live beyond reasonable commuting distance. Removing geography as a constraint can make a material difference in networks that have struggled to fill posts locally.
Remote delivery requires reliable IT infrastructure, clear communication arrangements with each member practice and documented clinical supervision that works at distance. It is less well suited to care home rounds, consultations with patients who have sensory or cognitive impairment and situations where direct observation of the patient materially informs the prescribing decision.
Hybrid models combine elements of the above, with pharmacist time divided between in-practice, PCN-wide and remote working. A common configuration is two days of practice-based work, two days of remote SMR delivery and one day each week for care home medication reviews across the network.
Hybrid arrangements work when responsibilities are allocated explicitly between the different modes, so that every clinical task has a clear route of ownership. Without that clarity, duplicated work, conflicting prescribing decisions and tasks falling between the different parts of the role become real operational risks.
The clinical work the PCN needs to deliver is the primary determinant of model choice. A network with a large care home population and significant polypharmacy prevalence will have different requirements from one whose principal priorities are repeat prescribing safety and post-discharge medicines reconciliation.
The factors most likely to shape the decision include:
Balance between face-to-face clinical work and systems-based review work.
Availability of senior clinical pharmacist capacity to supervise less experienced staff.
Physical estate available in member practices and the maturity of local IT infrastructure.
Overall size of the PCN, shape of its registered list and variation in clinical need between practices.
Care home numbers, patient complexity and the network’s known prescribing risk profile.
Scope of practice applies consistently regardless of model. Pharmacists working across more than one practice need documented responsibilities in each setting, with agreed competency frameworks, signed-off clinical activities and a named supervisor, so that accountability remains clear across locations.
The choice of model does not alter governance and clinical supervision requirements. Every clinical pharmacist in a PCN works within a defined scope of practice, receives clinical supervision from a senior clinical pharmacist or GP supervisor and has access to the CPPE training pathway where applicable.
These requirements apply equally to pharmacists working remotely or under hybrid arrangements. Oversight at distance requires the same documentation, audit and professional rigour as on-site working but needs to be more deliberately structured because it is not reinforced by daily in-person contact.
Deployment models should be reviewed as workload, workforce and population need change. An annual review drawing on clinical activity data and feedback from member practices supports ongoing alignment between the deployment model and the PCN’s current clinical programme.
MBTpg