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As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

Nestled in the heart of a bustling high street and a housing estate, at Lincoln Pharmacy, part of Mildcare Ltd Group, in Tower Hamlets in London, the scene is a testament to resilience and innovation, where queues of people seek aid from a pharmacy technician stationed behind a glass window-a symbol of the enduring impact of the pandemic. Amidst the array of modern amenities at the pharmacy stands Atulkumar Patel, the proprietor and Independent Prescriber (IP) at Lincoln Pharmacy, whose vision has propelled the establishment into a beacon of progressive healthcare. Owner of two Pharmacies, Patel's team of 20 dispenses an average of 20,000 prescriptions monthly, maintaining an NHS/OTC split of 80/20. Recipient of the prestigious Independent Prescriber of the Year award at the Pharmacy Business Awards 2023, Patel reflects on the pivotal moment when his pharmacy pioneered the rollout of COVID-19 vaccine jabs within the community. "When doctors' doors closed, pharmacy was the only place where people could get help and care," Patel recounts, emphasising the pivotal role pharmacies played during the crisis. Patel's dedication during the pandemic extended beyond mere service provision; it was about showcasing the untapped potential of pharmacies.

"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of their business." Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and the larger role pharmacies play in complementing traditional NHS facilities. Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain information from NHS England regarding protocols and procedures. She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were desperate to take part in the vaccination scheme" in her constituency. Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy closures "should be a real wake up call for the government."

The National Pharmacy Association (NPA) highlighted the role played by community pharmacies during pandemic to provide urgent care and vital support to people with long-term medical conditions at its opening remark in the Covid-19 public inquiry held on Tuesday (28 February). NPA is the core participant in the Covid-19 public inquiry. lawyer Brian Stanton made an opening statement on the NPA's behalf which focused on three areas- health inequalities and the needs of vulnerable patients; the impact of medicine shortages and medicine price increases and the challenge that community pharmacy faced in responding to the pandemic and maintaining patient services following long-term under investment. Stanton said: "The UK's community pharmacies were on the frontline of efforts to limit the impact of coronavirus and to keep people well, and as well as handling a massive increase in demand for healthcare advice and medicines, they also continued to provide urgent care and vital support to people with long-term medical conditions. "However, there are now very many at risk of closure during to underfunding and when the Inquiry comes to consider its recommendations the NPA would encourage you [the presiding judge] to think about how resilience can be built into future plans." The statement included a compelling account of the commitment typical of so many pharmacies during the pandemic - from husband and wife Pete and Sukhi Johal, both NPA members and pharmacists, who co-own Calow Pharmacy in Chesterfield.

The 'SaveOurPharmacies' roundtable held on Tuesday (21 March) to discuss severe challenges faced by the community pharmacies in England witnessed the support of 15 MPs. Janet Morrison, Chief Executive, Pharmaceutical Services Negotiating Committee (PSNC); Andrew Lane, independent pharmacy owner and Chairman, National Pharmacy Association (NPA) and Ian Strachan, independent pharmacy owner and Board Member, Association of Independent Multiple Pharmacies (AIM) attended the summit, which was chaired by Stephen Hammond MP, to brief MPs on the severe challenges facing the sector. MPs in attendance were Stephen Hammond, Sally-Ann Hart, Peter Aldous, Anna Firth, Taiwo Owatemi, Bob Seely, Derek Thomas, David Rutley, Lilian Greenwood, Tulip Siddiq, Hillary Benn, Sarah Olney, Christian Wakeford, Daisy Cooper (researcher) and Victoria Atkins (researcher) The title of the event 'Community pharmacy's role in the Primary Care Recovery Plan' which is expected imminently, is set to include a variety of measures aimed at helping primary care to recover from the impact of the pandemic. PSNC has been pressing for the plan to include a fully-funded national Pharmacy First service as this is the best chance for getting significant additional funds into community pharmacies.

Community pharmacies played a central role in the government's response to the Covid-19 pandemic, delivering more than 22 million jabs in the past 12 months. Besides delivering millions of jabs, latest figures from NHS England and NHS Improvement (NHSE&I) revealed a 50 per cent increase in the number of pharmacies delivering Covid boosters compared from October 2021 to January 2022. NHSE&I released the data on Friday (January 14) to thank community pharmacy teams for their work during the crisis time. Lauding the efforts made by community pharmacy teams during the pandemic, Pharmaceutical Services Negotiating Committee (PSNC) director of NHS Services Alastair Buxton said: "Just over a year ago we were fighting for Government recognition of the part community pharmacy could play in administering Covid vaccines, so a year later it is great to see the efforts of the pharmacy vaccination sites being praised by NHSE&I, with recognition of the significant role they have played in the overall programme.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

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.

In his maiden speech delivered to community pharmacy since becoming new minister with responsibility for the sector, Will Quince MP said he's determined to be "your champion" and "voice in government". Addressing delegates on Wednesday (Oct 12) as chief guest at the 22nd Pharmacy Business Awards in central London, he praised community pharmacy for delivering 25 million Covid-19 vaccines, five million flu jabs, 200 million lateral flow testing kits and millions of medicines throughout the pandemic. "These local efforts became the national success story," he told over 600 attendees at a gala dinner held at the iconic Park Plaza Westminster Bridge hotel overlooking the Houses of Parliament. 'We need you now' Quince, who was appointed minister of state at the Department of Health and Social Care on 7 September 2022, added: "Just as we needed you in the pandemic, we need you now," highlighting the vital role of community pharmacy in realising the secretary of state (Thérèse Coffey)'s vision, particularly in regard to her much talked about 'Plan for Patients'.

Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015. It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders. The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector. The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a result, maintaining prescription and medication adherence services is challenging to say the least. Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services since the start of COVID. This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported clinically by pharmacists. This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations a year - a staggering rise of 44 per cent in the last 24 months alone.

I have always been passionate about Community Pharmacy and am proud of the way that the sector navigated itself through Covid-19 and is currently navigating itself through all the changes in the NHS landscape. When I started my role in Sep 2019 as the CEO of Kent LPC, I used to say that community pharmacy has changed more in the last five years than the 15 before that, however, I now believe community pharmacy has changed more in the last two years than the 20 before. The year 2019 saw the start of the five-year Community Pharmacy Contractual Framework which set out how community pharmacy would support delivery of the NHS long term plan. What PSNC (or any of us) when negotiating this deal had not envisaged was the Covid-19 pandemic. Whilst the world turned upside down, we saw high street shops close their doors and immense pressure flood the NHS. Community pharmacy did what they always do, they adapted, teams came together, worked through, and showed resilience in the face of adversity. In Kent, I saw us integrate into primary are and into the NHS structure very quickly, in the first few weeks after Covid-19. All the usual red tape was removed, we all worked together to implement services to help patients in a matter of weeks when they would have normally taken months.

The Royal Pharmaceutical Society (RPS) has been on the lookout for innovative ideas and suggestions that could transform the future of pharmacy practice in England over the next decade. The society's new project with the King's Fund to transform the future of pharmacy practice in England is at a consultation phase, seeking views and opinions of pharmacy teams from all areas of practice including primary, secondary, social and community care to ensure that the system gets the best out of pharmacy and the public receives seamless, joined-up care. "We want to build a vision that sets out the role of and value of pharmacists and pharmacy teams working across systems, providing patient care and NHS services," said RPS in a statement. "Transforming the future of pharmacy practice recognises the urgent need to build on new ways of working established across health and care systems during the pandemic to meet the increasingly complex health needs of people and improve patient outcomes."

On World Pharmacists' Day, the Council of the Pharmaceutical Society NI (PSNI) thanked pharmacists working in every sector of pharmacy in Northern Ireland (NI) for their continued service to the public. The theme of this year's International Pharmaceutical Federation's World Pharmacists' Day, (25 September 2022) was 'Pharmacy united in action for a healthier world'. In acknowledgement of the day, Dr. Jim Livingstone, president of the Council of the Pharmaceutical Society NI said: "The theme of this year's World Pharmacists' Day, 'Pharmacy united in action for a healthier world' highlights pharmacy's positive impact on health around the world and seeks to further strengthen solidarity amongst the profession. "In Northern Ireland, pharmacy played a prominent role in primary health care throughout the pandemic and remains the public's most trusted and accessible frontline health care profession. "As pharmacy continues to develop additional services for the public and encompasses broader roles for pharmacists than ever before, it is essential, no matter what pharmacy sector pharmacists practise in, that the Pharmaceutical Society NI's Code (Professional standards of conduct, ethics and performance for pharmacists in Northern Ireland) remains at the core of pharmacists' practice. It is through this adherence to the Code, that pharmacy remains a united profession, providing positive health outcomes for patients and maintaining public trust.

The National Pharmacy Association (NPA) has emphasised that the community pharmacy sector must be involved right from the start in all local planning meetings pertaining to the roll-out of vaccine services in potential future pandemics. This includes crucial discussions regarding supply logistics and resource allocation, lawyers representing the NPA told COVID-19 public inquiry hearing. Chaired by Baroness Heather Hallett, the independent public inquiry is examining the UK's response to the Covid-19 pandemic and lessons for the future. The NPA has been designated as a 'core participant' in Module 4 (vaccines) of the inquiry, which considers various issues related to vaccine development and rollout, as well as Module 3 (healthcare). During the hearing on September 13, NPA lawyers outlined three key areas the association says must be improved in future pandemic vaccination programs, including properly utilising existing primary care expertise, better planning and engagement, and improved access to information for community pharmacists.

Has the government in England learned nothing from the Covid-19 pandemic? Nigel Swift, Managing Director of Rowlands Pharmacy, part of Numark, the UK's largest pharmacy membership association, asks reflecting on the disorderly launch of this year's flu and Covid booster vaccination program as evidence to the contrary. "Community pharmacies play a crucial role in ensuring eligible individuals can easily access their free NHS flu and Covid vaccinations," Swift said, adding that delivering this essential service necessitates pharmacy staff allocating time for preparation and appointment scheduling. "Just a few weeks ago, NHSE informed us that the vaccination program would be postponed until October, prompting pharmacies to plan accordingly and notify patients," he said. "However, NHSE has now reversed its decision and set the program to commence on Sept. 11. Pharmacy recommended an earlier start, but NHSE opted for a delay instead, resulting in avoidable problems." On Aug. 30, NHSE announced plans to move up the start of the autumn vaccination drive in England to September 11, deviating from the initial October schedule, citing concerns about a new Covid-19 variant.

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".

A community pharmacist, Viral Doshi was honoured with the British Citizen Award (BCA) on Thursday (26 January) at the Palace of Westminster for transforming his community centre into vaccination hub during Covid-19 pandemic. Viral was presented with his Medal of Honour by Liam Sargeant, Senior Company Communications Manager, from supporters P&G and TV presenter and Patron of the BCA, Nick Knowles, who hosted the event. At the height of the pandemic, Viral obtained approval to transform his community centre into a vaccination hub. Located in the heart of a multi-ethnic population, with social deprivation, surrounded by wards experiencing high rates of Covid-19. His determination to increase uptake and reduce vaccination hesitancy, led to 80,000 vaccinations being administered, the overall highest vaccination uptake in North West London. Viral is a passionate advocate for the role that GP practices and community pharmacies can play in supporting the health agenda. His objective, to provide better choice and access for the community have been fully met and appreciated by patients. His initiatives led to a dramatic increase in the clinical skills, knowledge and services offered by local community pharmacies around a variety of health topics. This enabled pharmacies to adopt a holistic health approach to working with their communities.

Community pharmacies are well placed to play a role in preventing deaths from cardiovascular disease (CVD) said Director of NHS Services. The recent analysis by the British Heart Foundation (BHF) revealed that nearly 100,000 more people with cardiovascular disease than expected have died since the start of the pandemic in England. Latest figures show that the number of people waiting for time-sensitive cardiac care was at a record high of nearly 390,000 at the end of April in England. Average ambulance response times for heart attacks and strokes have consistently been above 30 minutes since the beginning of 2022, and in December 2022 they even breached 90 minutes. The target is 18 minutes, though the Government has set a new average target of 30 minutes over 2023/24. Director of NHS Services, Alastair Buxton, said: "It is concerning to hear that there have been tens of thousands of preventable deaths from cardiovascular disease (CVD) since the start of the COVID-19 pandemic. We share BHF's desire to see more action on preventing the causes of CVD and, subject to appropriate funding being in place, community pharmacy teams are well placed to play a role in this.

It's no secret that as pharmacists we are navigating a new and more demanding healthcare landscape. Our role has changed significantly since the start of the 21st century due to increased expectations from the public, advances in science and technology and changing workforce pressures. The Community Pharmacy Contractual Framework for England has placed a higher focus on clinical service. In addition, the Covid-19 pandemic resulted in significant acceleration in changing how we work day-to-day and the public perception of our role. Community pharmacy owners and staff have been under relentless pressure for the last two years. Dispensing volumes are continually increasing but dispensing revenues are being replaced by launching new services. We must find solutions to reduce the time it takes to dispense medication so we can focus on these new revenue generating services. To not just succeed, but to thrive, it is becoming increasingly important to understand and embrace the technology available.

Anyone who has studied the finances of an independent pharmacy business knows that money is tight. In many cases, they are perilously close to failure. It's easy to assume they are retail businesses, cashing in on the higher public profile the sector has enjoyed during the pandemic years. But those have been mere words. Certainly, the pandemic represented a halcyon period for the profession. We engendered a feeling of normality, dependable and accessible to society. We played a substantive role in keeping people out of hospitals and giving the vulnerable the ability to live independently from their own homes for longer. We mobilised to smash flu vaccination records and deliver covid jabs. But despite the warm words of a new service based future and the incessant expressions of gratitude contractors desperately need the headroom to prepare, plan and invest. Platitudes, press releases and assurances of a bright clinical future are small comfort to what is needed and that's cash on the table. As the adage goes: "Talk is cheap, money buys houses." Cashflow crisis Since 2016, we have witnessed almost 650 pharmacies fall by the wayside. Some may have merged; the majority, however, have perished due to the relentless need for an increasing cashflow. It is cash, or rather the lack of it, which is killing independent pharmacies.