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The Association of Independent Multiple Pharmacies (AIMp) celebrated achievements of its members during the pandemic at its first annual 'ball and award' ceremony held last week in London. To highlight the important role played by pharmacy teams, the association representing community pharmacy businesses with multiple branches, introduced two award categories - for patient safety and social care. Stephen Walls from H I Weldricks won the Patient Safety Awards and Sandeep Dhami, Nadia Hussain and Sachin Basandrai from MW Phillips won the Social Care Award. Congratulating the winners, Leyla Hannbeck, CEO of AIMp, said that community pharmacy teams "have worked tirelessly to deliver patient care throughout the pandemic." David McNicol, head of sales at AAH Pharmaceuticals, noted that the country and community pharmacy witnessed the toughest 18 months, and the gathering provided an opportunity to discuss ongoing challenges.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."

Pharmacy bodies have welcomed the new minister in charge of the profession amid warnings that he will find the sector in a state that is "more fragile that ever" due to "untenable funding and workforce pressures". Neil O'Brien was re-appointed as parliamentary under secretary of state in the Department of Health and Social Care (DHSC) on October 25 and was later assigned the pharmacy brief. The Conservative MP for Harborough - who will have a wide-ranging portfolio of responsibilities, including primary care and pharmacy - has taken over the position from Will Quince MP, who had a brief stint as pharmacy minister but remains at the department on a different role. O'Brien was was handed a junior minister's job at DHSC on 7 September 2022 in the government led by Liz Truss but fellow Conservative Quince was assigned primary care duties including pharmacy. Welcoming him to his new role, The Company Chemists' Association said that the minister would find that the community pharmacy sector was "more fragile than ever" with untenable pressures over funding and workforce.

Lack of appropriate funding is making survival a massive challenge for community pharmacy, a sector relied upon as a vital support system by both primary and secondary care in England. The Telegraph newspaper ran a story on Monday (August 22) which highlighted the dire straits community pharmacy finds itself in. Seasoned pharmacist Ian Strachan told the paper: "Our four pharmacies were the only point of call that was open (during Covid). We were there every single day, even when the virus was prevalent and people were dying." Describing the current situation, he said: "What is happening is we're facing a system that's just not working at all in our favour." Strachan says the issue is that pharmacists are "just not getting the help we need to be able to do this job properly". The sector is hugely dependent on funding from the NHS. The government had agreed in 2019 to set £2.6bn as annual funding for the sector. However, according to a report from EY that amount was already down £200m on the 2016 levels of government funding. "We've been starved of appropriate funding since 2016," Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies told The Telegraph. "It looks grim for businesses. The fees pharmacists get are going nowhere, but now, there's higher utility bills, higher staff fees and higher drug costs."

The Health and Social Care Select Committee (HSCC) on Tuesday held the first session in their pharmacy inquiry, with a panel of experts discussing the key issues facing community pharmacies in the country. Representatives from community pharmacy associations highlighted some of their biggest challenges and their vision for the future, as well as actions that government and NHS England can take to address those challenges for a better future for the sector. Opening the session, the Committee's vice-chair, Rachel Maskell MP, asked the representatives if they felt the government was ambitious enough in what it believes community pharmacy can do to address NHS pressures, or are pharmacists being held back by issues around workforce funding, contracting, and technological changes. Malcolm Harrison, Chief Executive, Company Chemists' Association (CCA), expressed that the government is not ambitious enough, saying "there's always opportunity to be more ambitious".

Patients are highly satisfied with the new Pharmacy First service, which enables pharmacists to assess and treat patients for seven common conditions, according to a survey by the National Pharmacy Association (NPA). Nearly 100 NPA members participated in the snapshot poll conducted at the end of the first full week of the service. Nine in ten respondents (87 per cent) said that "most or all patients expressed satisfaction" with the service they received. However, many independent community pharmacy owners are facing challenges in implementing the service. While 56 per cent of pharmacy owners surveyed expressed feeling "motivated" by the new service, a larger proportion (70 per cent) indicated being "under additional pressure." More than 30 per cent of the respondents found implementation of the service "harder" than they had expected.

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare. Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists. Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence. In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.

Laura Wilson, Director of the Royal Pharmaceutical Society (RPS) in Scotland discussed the future of the pharmacy workforce with Michael Matheson, Cabinet Secretary for Health and Social Care at the SNP conference. The event, which took place on 17 October in Aberdeen, Scotland featured other health officials including Colin Poolman, Director of the Royal College of Nursing; Kenryck Lloyd-Jones, Public Affairs and Policy Manager for Scotland, Chartered Society of Physiotherapy; and Chris Marshall, Deputy Editor at Holyrood Communications. The Scottish government has recently unveiled its national workforce strategy for health and social care, laying out its plans for achieving recovery, growth, and transformation. Wilson highlighted the challenges and opportunities for the pharmacy workforce in Scotland to attract potential pharmacists into the profession and encourage them to stay within the profession. "This was a great opportunity to discuss with the Cabinet Secretary the challenges which exist for the pharmacy workforce in Scotland and to highlight some of the solutions which need to be implemented to ensure a pharmacy workforce in Scotland which is fit for the future," she said.

What skills does a pharmacist need these days? You'd think it would be sufficient to have a good understanding of pharmacy and the ability to offer a great patient service. Whilst this is true of course, the reality of the day to day role demands skills which most pharmacists have not been trained for as part of their formal qualification. At the very least, pharmacists find themselves responsible for running the pharmacy, managing people, managing processes and dealing with issues relating to customers, suppliers, surgeries, regulators and stakeholders. Even the most junior pharmacists quickly find themselves being accountable for the financial performance of their department and having to work within budgets or deliver on targets. Remarkably, despite the apparent lack of any formal training in these areas, pharmacists have been able to adapt and meet the challenges of whatever their job has thrown at them. Many pharmacists go even further, bringing out their inner entrepreneurial spirit to set up their own business. There are now over 6,000 pharmacy businesses owned by independent pharmacists, with this segment growing. Whilst pharmacists have historically adapted to their environments and picked up the necessary business skills, the rapidly changing landscape of pharmacy will require pharmacists to establish new skills to help ensure their businesses survive and thrive.

Pharmacists, councillors and NHS leaders came together at Portsmouth's first Community Pharmacy Summit to address some of the challenges facing community pharmacy locally. They explored ways to reduce the huge pressures on pharmacy, tackle abuse towards staff, enable pharmacists to undertake training to treat more illnesses, and to protect the current and future workforce. Portsmouth City Council, which hosted the Summit on Wednesday 15 November, also invited representatives from Hampshire and Isle of Wight Constabulary, University of Portsmouth, Hampshire and Isle of Wight Integrated Care Board and businesses to discuss new opportunities to work together. Held at Portsmouth Guildhall, the event was chaired by Cllr Matthew Winnington, Cabinet Member for Community Wellbeing, Health and Care, and Cllr Gerald Vernon-Jackson, Cabinet Member for Transport.

Pharmacy owners discussed the key concerns and priorities for the future at the Community Pharmacy England's (CPE) digital briefing event held last week (on 7 May 2024). More than 500 pharmacy owners and their representatives registered for the event, which provided them an opportunity to learn more about the committee's work in key areas and share their views on important issues. Major concerns raised by them included underfunding, dispensing at a loss, and challenges in implementing Pharmacy First. Attendees described the new service as "slow", "challenging" and "underfunded", while also highlighting the importance of improving GPs' understanding of the service.

NHS England and NHS Improvement published on May 26 the findings of the Fuller 'stocktake' - setting out how primary care can work with partners across health and care to best meet the needs of their local communities. Dr Claire Fuller's report lays emphasis on the essential role of primary care and the potential of integrated neighbourhood teams in reducing the burden of ill health and tackling health inequities. It commends community pharmacy for keeping "its doors open to the public throughout" the pandemic whilst being "among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country". The report highlights "recruitment and retention challenges across the wider primary care workforce" including in community pharmacy. Stressing the importance of community pharmacy teams in urgent care and prevention, including early diagnosis of cancers, the report points out that pharmacists could play "a more active role in signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme".

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

Now is the best time for community pharmacy to integrate its model of NHS representation and support to ensure better outcomes for contractors, said James Wood, director of Contractor & LPC Support, Pharmaceutical Services Negotiating Committee (PSNC). It is important for the sector to adapt to the new landscape and address challenges such as workforce, digital data, integration of pharmacy services, and medicines optimisation, he said during the first session of the sixth annual Pharmacy Business Conference held online on Tuesday, September 21. Under the new system, every part of England will be covered by integrated care systems (ICSs) from April 2022. ICSs have been created to bring about big changes in how health and care services in England are planned, paid for and delivered. They are a key part of the direction of travel for the NHS as outlined in the NHS Long Term Plan.

Working conditions in pharmacies have worsened in 2021, the annual Safer Pharmacies Survey conducted by the Pharmacists' Defence Association (PDA) revealed, highlighting the challenging and unsafe environments that some pharmacists are working in. The survey asks pharmacists across all areas of practice about their experiences of key safety measures in the workplace. Since the launch of the Safer Pharmacies Charter in 2017, PDA's annual surveys have monitored their feedback against the Charter's commitments, which covers seven basic areas as standard practice for pharmacy work. The commitments are No Self-Checking, Safe Staffing, Access to a Pharmacist, Adequate Rest, Respect for Professional Judgment, Raising Concerns and Physical Safety. The survey revealed that eight out of 10 feel unsafe at work as violence and abuse still remain areas of concerns in pharmacy.

The National Pharmacy Association has published a medium-term prospectus for the development of pharmacy services, calling it a challenge to old ways of thinking and an opportunity to redefine the sector's role in the NHS. It follows months of dialogue with NPA members about what a clinical future could look like for the sector. The document - Making Changes Meeting Needs - will be shared with the King's Fund and Nuffield Trust who are currently working on a new vision for the future on behalf of Community Pharmacy England. NPA chair, Nick Kaye, said: "Building out from the existing portfolio of services, there are some major opportunities within this decade, encompassing prevention, medicines optimisation, long term medical conditions and urgent care.

The Pharmaceutical Services Negotiating Committee (PSNC) has published an update on the work it is doing as part of the Transforming Pharmacy Representation (TAPR) Programme to take forward the mandate from contractors to deliver the Review Steering Group (RSG) recommendations. The update is primarily aimed at LPCs - with whom PSNC has been working closely on some of the TAPR work over the summer. The TAPR Programme is being undertaken in support of PSNC's work to address the severe challenges facing the community pharmacy sector at present. Alongside ongoing negotiations with Government and the NHS, two of the TAPR workstreams - focusing on Vision and Strategy, and on Influencing and Negotiation - are essential to supporting CPCF negotiations. "The workstreams are looking at the future of community pharmacy and how best to persuade policymakers to implement a shared vision, with their objective being to put the sector in a stronger position going into future CPCF negotiations," said PSNC.

The Pharmaceutical Services Negotiating Committee (PSNC) has rejected Department of Health and Social Care (DHSC) and NHS England's proposal on price concessions reform and relief measures to ease pressure on pharmacies. The Committee called the proposal 'insufficient' to meet the sector's needs considering the impact of the current crisis, reflecting on the economic pressures that accelerated through the autumn and winter. The Ministers and other decision-makers have shown their interest in the potential role of community pharmacy, particularly in using a Pharmacy First approach and making use of PGDs and the skills of independent prescribers. But the Committee had made clear to them that without new money this is all a pipedream. "We need an urgent injection of funds into the sector, otherwise we will continue to see a degradation of services and eventual collapse of the network. The Committee is clear that there is no further place for warm words while pharmacy collapses," said PSNC. The Committee reflected that the 5-year CPCF agreement had been based on working together to create the capacity and context necessary to deliver the shift towards greater service delivery. Not only has that capacity-release not happened due to slow progress by Government, but pharmacies have also been burdened with these additional, and insurmountable, challenges.

The Department of Health and Social Care (DHSC) in recent response to the questions asked by members of the House of Lords addressed the concerning trend of pharmacy closures in rural areas across the UK. Led by The Bishop of St Albans, inquiries focused on the number of community pharmacies that had ceased operations over the past five years and the ongoing financial challenges faced by those remaining in rural regions. Lord Markham, the Parliamentary Under-Secretary for Health and Social Care, provided insights into the stark reality confronting rural communities. Highlighting data as per Guide to applying the Rural Urban Classification to data (2019-2023) Markham illustrated the significant closure rates of rural pharmacies compared to the limited number of new openings between 2019 and 2023. The figures revealed a fluctuating trend over the past five years, indicating a dynamic landscape within rural pharmacy provision.