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The proposed increase in the national living wage (NLW) is expected to impose an implementation cost of £150 million to £195 million on the community pharmacy sector, Community Pharmacy England (CPE) has warned. Chancellor Jeremy Hunt recently announced a 9.8 per cent increase in the national living wage, raising it from £10.42 to £11.44. "The Autumn Statement overlooks the knock-on effects these measures will have on small businesses like community pharmacies," CPE Chief Executive Janet Morrison said in a statement. "The majority of pharmacies employ staff on or around the NLW, which has increased nearly 40 per cent since the start of the current contractual framework." "This is at a time when pharmacies have faced a 30 per cent real terms reduction in funding since 2015," Morrison added. "No viable business can absorb these cost increases without significant support. This is just another cost pressure that pharmacies cannot control and must be addressed through a sustainable, long-term funding arrangement."

Shortage of pharmacists remains a big challenge for community pharmacies as the chief executives of the national community pharmacy bodies met with senior NHS England and NHS Improvement officials to discuss the precarious situation in October-end. In the last few months, several pharmacy contractors have reported increased staff shortages that caused difficulties in maintaining services, leading to temporary closures in some instances. The sector is also facing chronic shortage of other staff including van drivers and pharmacy technicians. During the meeting, NHS England's director for primary care, Ed Waller, and chief pharmaceutical officer Keith Ridge held talks with leaders from across the pharmacy sector on a variety of topics.

The recruitment of pharmacists in Primary Care Networks (PCNs) has exacerbated a general shortage of pharmacists, revealed an independent review of Integrated Care Systems (ICSs) published on Tuesday (4 April). The review, Rt Hon Patricia Hewitt, highlighted the impact that the Additional Roles Reimbursement Scheme (ARRS) roles for pharmacists are having on the community pharmacy sector. "Contracts with national requirements can have unintended consequences when applied to particular circumstances. For instance, the national requirements and funding of Additional Roles Reimbursement Scheme (ARRS) roles for community pharmacists within PCNs, has on occasion exacerbated the problem of a general shortage of pharmacists, with some now preferring to work within primary care rather than remain in community pharmacies or acute hospitals, compounding the problem of community pharmacy closures and delayed discharges." It set out to consider the oversight and governance of ICS in England and the NHS targets and priorities for which Integrated Care Boards (ICBs) are accountable, including those set out in the Government's mandate to NHS England. As part of this work, Hewitt and her team engaged with a wide range of stakeholders representing various local health and social care settings, including LPCs.

The NHS England and Improvement has announced the emergency provisions introduced during pandemic to provide flexible opening hours for pharmacy contractors end today. The flexibilities were enacted in March 2020 when changes to the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 were made following a declaration of emergency at the height of the Covid-19 pandemic. Since March 2020, the flexibilities have permitted temporary opening hours and closures during a specified period due to a genuine Covid-19 related emergency. NHS England and Improvement has advised pharmacy contractors that the emergency declaration will not be extended further and will expire on 31 March 2022. Pharmacy contractors will therefore no longer have the option to close pharmacies within their agreed contracted hours with the NHS.

Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling it "the biggest dis-service ever done" to community pharmacy. The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years. This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector. The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework. The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she assured everyone that the committee was well aware of the pressures the sector was facing. "I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce crisis is critical, leading to temporary closures.

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."

Community Pharmacy England (CPE) Chief Executive, Janet Morrison met with the new Pharmacy Minister, Dame Andrea Leadsom MP this week and discussed a range of critical topics, including funding and pressures. Janet informed the minister that community pharmacies continue to face immense financial pressures, and highlighted the need for an improved core contract. She told the minister that 35-50 per cent real term cuts and rising costs have led to closures, consolidations and cashflow. This has weakened the capacity for the network to respond to displaced patients, increased risk in terms of the safety of medicine supply, and led to loss of service for communities in the most deprived areas, she said.

In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising issue of medicines supply. "Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary. In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area." The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why will they not do so?

The Pharmacists' Defence Association (PDA) has created a form to help locum and other pharmacists to report about breach of NHS contract by community pharmacy. According to the association, they have been told by increasing number of pharmacists about contractors closing pharmacies, despite a locum readily available to cover the shift. The PDA said this is an issue of NHS contractual breach and creates difficulties for patients, and so they have created the form to assist members to report unnecessary closures to the relevant NHS England & Improvement pharmacy contract team. A locum pharmacist, who does not wish to be named, has alleged that a community pharmacy declined their offer to cover an extra shift for £5 more per hour, and decided to close the store, denying the public access to services. The pharmacist recalled the occasion while writing in the PDA's latest member voice article.

London's Great Ormond Street Hospital and Alder Hey Children's Hospital in Liverpool are poised to introduce groundbreaking gender-related services in England, following the closure of the Gender Identity Development Service (Gids) operated by the Tavistock and Portman NHS Foundation Trust. Amid concerns expressed by hospital executives regarding the closure of Gids, with leaked emails revealing apprehensions about appointment cancellations and inadequate communication with the new services, the National Health Services England (NHSE) has confirmed "its commitment to ensuring continuity of care for patients already accessing endocrine care in GIDS." NHSE's decision to transition to regional services stems from a 2022 interim review, led by Dr. Hilary Cass, which highlighted the need for improved support structures for gender-distressed youth. It emphasized a significant increase in referrals to Gids, surpassing 5,000 in 2021/22, compared to less than 250 a decade ago.