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Acknowledging the ongoing challenges in delivering the required IT systems for the scheduled launch of the Pharmacy First service on January 31, NHS England reported progress in fulfilling 'many' commitments outlined in its plan to enhance primary care access during a board meeting on Thursday. However, it noted that the digital infrastructure supporting Pharmacy First, included in the £645 million fresh funding for community pharmacy, will require additional time for implementation. "Delivery remains challenging due to changes needed in digital infrastructure, and we are working with suppliers to support January implementation," NHSE said. "A public campaign is planned for 2024." The Pharmacy First service allows pharmacists to supply prescription-only medicines for seven common health conditions (sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women), eliminating the need for a GP visit. Meanwhile, NHSE is leveraging the widespread accessibility of pharmacies by expanding blood pressure monitoring and introducing direct prescribing of clinically safe oral contraceptives-an initiative that has been well-received.

The Association of Independent Multiple Pharmacies (AIMp) has called upon all pharmacy organisations to unite and collectively represent the sector. While underlining the need for the sector to adopt a straightforward manifesto that can be presented to the public, politicians, and decision-makers, the association also advocated for a revitalisation of the 'Save Our Pharmacies' campaign, injecting it with renewed energy and a stronger sense of purpose. AIMp pointed out that a lack of cohesion is one of the factors contributing to the sector's struggle in gaining attention. "The current trajectory of community pharmacy is unsustainable," said Dr. Leyla Hannbeck, Chief Executive of AIMp. "To tackle the significant challenges ahead, we must work together cohesively. The most effective approach is to actively engage with Parliament, leveraging politicians from across the political spectrum to advocate for our cause." Meanwhile, the association urged various pharmacy bodies to unite in support of the Pharmacy All Party Parliamentary Group (APPG) to enhance its effectiveness and broaden its influence, rather than working independently.

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".

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.

The Company Chemists' Association (CCA) has highlighted a worrying trend of increasing numbers of pharmacy closures in England, which is disproportionately affecting the most deprived communities in the country. With 338 more pharmacies closed this year, an average of eight pharmacies closed per week, there has been a net loss of 1,008 pharmacies in England since 2015, the CCA said. Between 2015 and June 2023, maximum number of pharmacies were closed in the 20 per cent most deprived neighbourhoods of the country, with 37.5 per cent of the total closures occurring in Indices of Multiple Deprivation deciles 1 and 2. The association has raised concern that "permanent closures will undermine healthcare accessibility in deprived areas, where access tends to be more limited despite greater need."

With the government gearing up and pushing community pharmacies in England to adopt the hub and spoke dispensing model, stakeholders of the sector and industry leaders analyse the pros and cons related to the new concept. The model rose to prominence in 2015 in community pharmacy and the medicine supply chain in the UK, and has undergone a few consultations and reviews at the professional and governmental level since then. From a broader perspective, the industry agrees that the model will bring in efficiency to the system, much needed amid community pharmacy's flat funding settlement in England, at the same time highlighting some real challenges. The National Pharmacy Association (NPA) has so far released three reports on this matter and a review of the challenges and enablers of the hub and spoke in the UK in 2016. Besides, a review of international evidence and the report of a roundtable meeting was brought together in the supply chain with government and regulators in early 2020.

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

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".

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.

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.

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 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 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.

MP Steve Brine, the chair of the health and care committee, said that the healthcare in the UK "doesn't work without pharmacy". The inquiry focuses on addressing current issues, particularly around the "funding model, digital infrastructure and workforce recruitment, training and retention." Brine said at the Sigma annual conference on Sunday, that he wants to "focus on the sector", and "drill down into some of the challenges and potential" that lies ahead. "The Health and Social Care Committee, we think about much of our work through the lens of pharmacy, what role it plays, the quality of care that it delivers, and the potential for it to do more," said Brine. He further said that he wants to "build on the groundwork" and to "cover as many of the different pharmacy services within the pharmacy sector as we can, so pharmacy in our communities, in hospitals and general practice".

The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

The National Pharmacy Association (NPA) has welcomed the Chancellor's commitment to increase the NHS budget, hoping that 'community pharmacies benefit from this investment'. The association is urging the government to address years of underfunding so that community pharmacies can avoid staff lay-offs to cover the increasing costs of the national living wage. The government's uplift of the National Living Wage was confirmed in its latest budget announcement to tackle the cost of living crisis. The NHS budget will also be increased in each of the next two years by £3.3bn. A recent NPA commissioned report by Professor David Taylor from University College London predicted that wage inflation and other cost pressures could combine with funding cuts to lead to cut-backs and pharmacy closures.

Leading pharmacy bodies and associations are looking forward to working with 'reappointed' Secretary of State for Health and Social Care, Steve Barclay, on 'future roles' and 'funding' for the community pharmacy. The Royal Pharmaceutical Society (RPS) England Country Board Chair, Thorrun Govind, hopes that the ministers will now be able to focus on addressing the key challenges facing the health service and the country. "This means not just getting through the winter, but planning for and investing in the future." She added: "It will be crucial to use the skills of all our health professions to support the NHS recovery, reduce health inequalities, manage the growing cost of long-term conditions, and deliver best value from medicines.

Pharmaceutical Services Negotiating Committee expects the next round of negotiations to set the arrangements for the Community Pharmacy Contractual Framework (CPCF) in 2022/23 - Year 4 of the five-year CPCF deal, to begin soon. The negotiator held a meeting on November 24 and 25 to discuss the burning issues affecting the sector and to plan for upcoming negotiations with the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I). It aims to complete these negotiations by April, allowing ample time for contractors to make arrangement prior to the beginning of the financial year. PSNC vice-chair, and independent contractor, Bharat Patel said the entire sector is worried about the "outlook for pharmacies as we head into a difficult winter," and is working to find solutions. He noted that PSNC "will be bringing proposals for additional funding and support, particularly around the treatment of 'walk-in' patients, to the table, along with a heavy dose of realism for government and the NHS about the current challenges in the sector." While expecting a difficult round of discussion with the government, Patel remained optimistic about a favourable outcome for pharmacies.

Jhoots Group, a West Midlands based independent community pharmacy chain, has unveiled plans to expand its digital services after securing a funding worth £8.23m from HSBC bank. The new money will allow the groups branches to offer a digital platform for customers to request prescriptions online, enabling the implementation of a hub and spoke dispensing system to automate prescription deliveries. The innovation aims to reduce the burden of manual processes on pharmacists, allowing staff to use their time efficiently and support the NHS by offering vaccines and minor ailment medicine services. San Jhooty, chief operating officer at Jhoots Group, said: "When faced with the unprecedented challenges of the pandemic, primary and community services came together to support the community and each other.

The Royal Pharmaceutical Society (RPS) has published its general election manifesto highlighting some of the key challenges the next Government will face to support patients and the NHS. The manifesto calls on general election candidates to show their support to securing patient access to medicines, a better-connected NHS, enhancing accessible prescribing in local communities, and maximising health improvement through locally accessible pharmacy teams. Candidates are urged to called on the next Government, if elected, to support the pharmacy workforce to deliver patient care, unlock the potential of new advances in medicines, and continue to support funding for the UK science and research community. The manifesto highlights the need for investment in IT infrastructure to support a better-connected NHS to enable all health professionals to access and update a patient's record.