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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.

A new report based on research from pharmacists across England by Sanofi, has called for the introduction of a 'national self-care strategy' to relieve the burden currently faced by health services. The new report, titled 'Driving a self-care revolution in the UK', explores the views of pharmacists, patients and doctors on self-care and the support needed to deliver it more effectively. While self-care policy measures are estimated to increase monetary savings for healthcare systems and national economies by 16%, this report highlights the right tools and resources are not yet in place to enable pharmacists to play a greater role in delivering self-care advice and medicines to patients. "As many as 77% of pharmacists said they would support the creation of a National Self-Care Strategy to provide national leadership on improving understanding of self-care and encourage its use among both patients and clinicians," the report said. According to the report, currently, 33% of pharmacists working for independent or small pharmacy chains do not have the resources to support patients with self-care, alongside their other roles. "To tackle this, close to half (45%) of pharmacists believe greater emphasis by primary care practitioners on the benefits of self-care would leave pharmacists in a better place to support patients. Similarly, 42% believe that training and recruiting more pharmacists would improve their capacity to deliver self-care advice."

Health Education England (HEE) has developed funded training offers for community pharmacists, including locums aiming to become independent prescribers. Almost 3000 independent prescribing training places will be available to pharmacists from March 2023. This training enables pharmacists to support patients from diagnosis to prescribing, and to provide advice and follow-up - while also helping them to feel confident and prepared for the new challenges of their role. Courses will be available between April 2023 and March 2024, with several universities offering multiple dates for cohort intakes. Start dates will depend on the university provider. Training will enable the provision of new models of care: supporting patients from diagnosis to prescribing, providing advice and follow-up, and preparing pharmacists to provide clinical care, as pharmacy services become more widespread within emerging clinical pathways.

With the Labour Party now in power, there is keen interest in the healthcare initiatives they pledged during their election campaign and how these proposals will shape the future of NHS. One of the key pledges in their healthcare reform is the introduction of the Community Pharmacist Prescribing Service, which aims to empower pharmacists with independent prescribing rights where clinically suitable. While pharmacists appreciated Labour's acknowledgment of their role in patient care through expanded prescribing rights, they foresee some challenges in implementing the service. "Budgets will be a key issue," said Pharmacist Thorrun Govind, also a Healthcare Lawyer (Brabners LLP). However, she noted that, given the success of pharmacist prescribing services in the devolved nations, there is "a road map in place."

The fusion of the unique in-depth understanding of medicines by pharmacists together with the competence to prescribe offers will improve access to care and increase capacity in the health system, said the Royal Pharmaceutical Society (RPS) Director for England Ravi Sharma to Parliament at the Health and Social Care Select Committee's inquiry on workforce on Monday (May 23). However, he also stated that a new workforce strategy must support and harness the skills of pharmacist independent prescribers in clinical care with investment in training, both for new and existing workforce; access to supervisors; protected learning and development time; and commissioning of services to make best use of independent prescribers across care settings, supported by appropriate prescribing budgets in community pharmacy. "We're about to see new generation of pharmacists independent prescribers that will make a huge difference to the clinical role of pharmacists to support patient care, but this must be underpinned by protected learning time and a more ambitious approach to commissioning new services to use their skills," Ravi said. He spoke to MPs in Parliament at the Health and Social Care Select Committee's inquiry on workforce, highlighting the vital contribution of pharmacy teams during the pandemic and called for action to support the current and future workforce. Some of the key issues highlighted in the parliament included, the risk of burnout and the need to help boost staff retention; staff wellbeing, including a zero tolerance of abuse from the public; the importance of professional development and protected learning time to enhance patient care and support rewarding careers; the potential of new pharmacist independent prescribers and the need for investment in the current workforce and the need for better workforce data and a pharmacy workforce strategy.

Healthcare reform emerged as a cornerstone of the Labour Party's manifesto leading up to the recent general election. A standout pledge was the establishment of a Community Pharmacist Prescribing Service, aimed at granting pharmacists independent prescribing rights where clinically suitable. This initiative is seen as a positive step in addressing critical challenges within the National Health Service (NHS). Numark Chairman Harry McQuillan praised Labour's recognition of pharmacists' role in patient care through expanded prescribing rights. "Let's be honest, pharmacists are an underutilised resource within the healthcare system. We possess extensive training and expertise, yet our full potential hasn't always been acknowledged. "By harnessing pharmacists expanded prescribing rights, Labour is acknowledging our significant role in patient care. This initiative aims to recognise our skills and enhance patient care, ensuring quicker access to necessary treatments," he said. However, he pointed out that the concept requires further exploration, as the rights to prescribe are already granted through the recent change to undergraduate training that incorporates prescribing.

Two more independent community pharmacists have been appointed to the UK Commission on Pharmacy Professional Leadership. NPA board member Reena Barai and Sheelin McKeagney from Lurgan in Northern Ireland will join 25 other commission members, including Ash Soni who was the only practising community pharmacist on the initial list published in June. Welcoming the announcement, the National Pharmacy Association chief executive, Mark Lyonette, said: "To their great credit, the co-chairs of the commission and the UK's chief pharmaceutical officers have listened to our request for more community pharmacy presence on the commission. They have acted swiftly to achieve a better balance in its membership and we thank them for responding to our representations. "Around 70 per cent of pharmacists practice in the community. With more voices from community pharmacy within the leadership commission, there is a greater sense that the profession as a whole will be able to own the final recommendations when they are ultimately made."

HubRx has appointed Dr Sarah Passmore as superintendent pharmacist ahead of launching what the company called "the UK's first state-of-the-art automated pharmacy hub". Dr Passmore brings more than 20 years of pharmacy experience - having held key regulatory roles with Rowlands Pharmacy over a 11-year tenure, which also saw her involved in a number of pharmacy automation projects. Commenting on her appointment, Dr Passmore said: "As a pharmacist, who has spent more than 10 years working within community pharmacy, I'm excited by what a hub and spoke model for prescription dispensing can bring. "Pharmacists are highly trained in delivering clinical services to patients - and like me - it's often a part of their job that they thoroughly enjoy. The option of using hub and spoke to support dispensing prescriptions will give community pharmacists the gift of more time that can be spent helping patients. "I'm excited to join HubRx and for it to become the first state-of-the-art automated pharmacy hub designed for independent community pharmacists to launch in the UK."

A new NHS-funded training course on clinical examination skills has been announced by Health Education England (HEE) for 10,000 community pharmacists. The training will be provided by CliniSkills and be coordinated by HEE with the Pharmacy Integration Programme at NHS England. With pre-registration now open to all community pharmacists, the programme will be available from 17th April 2023 and will until March 2024. It will be delivered online, with optional face-to-face attendance for pharmacists who would find this beneficial. Pharmacists will be required to complete a module on history taking and identification of serious conditions and can then choose from four optional modules, which cover the following themes: dermatology; cardiology; paediatrics; and ear, nose and throat. The training is designed to be complementary to the independent prescribing training and can be completed prior to or after an independent prescribing training course. It is open to all community pharmacists including those that work part time and locums.

Tesco, one of the leading pharmacy chains in the UK, has been allegedly accused of forcing some locum pharmacists to accept lower rates or it will cancel their booking. The issue has been brought to the notice of the Pharmacists' Defence Association (PDA) by some of its locum pharmacists members. "Some locum pharmacists who had existing confirmed bookings at Tesco stores have reported to the PDA that the company has contacted them to say that if they do not agree to accept lower rates than have already agreed, the company will cancel their booking," said PDA. "The reported messages follow a communication from Tesco setting self-imposed so-called "wage rates" for locums. This is confusing as locums are self-employed and therefore should be able to negotiate rates with their clients just as any other independent supplier can do. Using terminology such as "wage rates" is more indicative of an employer-employee relationship and could undermine the status of the locum market in community pharmacy. Employees are also entitled to various extra benefits and have greater employment rights."

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 Royal Pharmaceutical Society (RPS) has introduced a new comprehensive learning programme to support pharmacists in Wales to deliver the Pharmacy Independent Prescribing Service (PIPS). Developed in collaboration with Health Education and Improvement Wales (HEIW), the programme is designed to "equip pharmacists with the essential knowledge, skills, and confidence needed to provide excellent patient care." While the primary emphasis is on pharmacists operating within primary care settings, those from various practice settings are also encouraged to register and participate in the programme. Commenting on the collaboration with HEIW, Elen Jones, director for Wales at the Royal Pharmaceutical Society, said that it will empower pharmacists across the country to deliver high-quality prescribing services to local communities.

The GP Community Pharmacist Consultation Service (GP CPCS) is also delivering 'unexpected' insights to help transform patient care and facilitate integrated working between pharmacists and GPs across Greater Manchester. Since April 2021, almost 14,000 appointments have been referred using the GP CPCS across the Greater Manchester Health and Social Care Partnership - a figure that is growing as its success gathers pace and they continue to support practices to increase referral activity. Joshua Nolan, a pharmacist at Internet Pharmacy in Heywood, one of the first in the area to join the referral service, said: "The number of patients we're seeing from GP CPCS has been building consistently month-on-month. On average we see around 50 patients, but recently we recorded 53 in just one week." The pharmacist, who has been practising for six years and is also an independent prescriber, believes the GP CPCS has helped bring about more awareness to the clinical services community pharmacy can offer.

Community pharmacy bodies have said that the current crippling financial pressures and severe staff shortages will limit the sector from fully supporting the new health secretary's ambition to improve patient care in England. Thérèse Coffey announced her plans on Thursday (September 22) which would be looking to reduce the country's reliance on general practice by expanding the range of services available from community pharmacies and allowing pharmacists more "prescribing powers". "Pharmacists will be able to manage and supply more medicines, without a prescription from a GP. We will look to go further on enabling pharmacists with more prescribing powers and making more simple diagnostic tests available in community pharmacy," she said in her foreword to Our Plan for Patients. However, the National Pharmacy Association has lamented that the plan stops short of promising any fresh funding for community pharmacies to deliver patient care and develop clinical services. NPA vice-chair, Nick Kaye, said: "The life is being choked out of independent pharmacy businesses by the continuation of a fundamentally under-resourced contract in England.

Centre for Pharmacy PostGraduate Education (CPPE) has announced the launch of a new learning programme, Preparing to train as an independent prescriber. The programme aims to build the confidence and competence of pharmacists who are planning to apply and train as independent prescribers and is open to pharmacists from all sectors of practice, including community pharmacists who are planning to commence their independent prescriber training with a Higher Education Institute (HEI). The course is made up of four main components, including a self-directed e-course and self-assessment framework, a mandatory online workshop to support you to review your self-assessment of competencies, an optional online workshop to support your readiness for academic writing and reflective practice, and optional peer support sessions, providing the opportunity for you to develop your professional network and establish communities of practice.

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."

In a bid to bolster professional leadership within the pharmacy sector, the four government Chief Pharmaceutical Officers (CPhOs) have embarked on a significant initiative, forming the UK Pharmacy Professional Leadership Advisory Board (UKPPLAB). In a recent communication, all pharmacists and pharmacy technicians received confirmation of the board members selected by the CPhOs, alongside a note from the board's appointed chair, who was chosen collectively by the four CPhOs and reports directly to the CPhO for England. Over three years, the 21-member Board will implement recommendations from the UK Commission on Pharmacy Professional Leadership's report aimed to enhance professional fulfillment among pharmacists while simultaneously augmenting patient safety standards. This announcement also follows with the appointment of Sir Hugh Taylor as its Independent Chair and the appointment of Independent Expert Members who expressed his delight over the role's "potential to lead and support collaboration across the professions in the UK". However, the move has been met with cautious optimism from the Pharmacists' Defence Association (PDA), urging the new board to uphold transparency and openness to garner trust among pharmacists.

Sixty-seven per cent of UK independent pharmacists say the pandemic has positively changed how patients view the clinical services offered by community pharmacy. The research - carried out with an independent panel of more than 100 community pharmacists - revealed that 35 per cent of them had increased their clinical services to fulfil patient demand during the pandemic. Seventeen per cent said they had expanded their private clinical services such as vaccinations and dermatology, with a further 17 per cent adding sexual health services such as emergency contraception and chlamydia screening in their services offer. Thirty per cent introduced NHS health checks and emergency supply NHS services during the pandemic.

Health Education England (HEE) has invited community pharmacy contractors to a meeting to discuss training of pharmacists to become Independent Prescribers (IP). Earlier, HEE together with NHS England and NHS Improvement has supported a first phase of IP training for community pharmacists from January to March 2022, and is now working to secure a further rounded of funded training from Autumn 2022. The upcoming virtual meeting is aimed to help inform future independent prescribertraining offers by ensuring it is aligned with the needs of the pharmacy workforce.

A leading pharmacist and member of the Royal Pharmaceutical Society (RPS) Scottish Pharmacy Board has been chosen to share her experiences of working in a community pharmacy in Scotland. Catriona Sinclair FRPharmS will speak at a roundtable entitled 'International Experiences in Professional Pharmaceutical Health Services' in Madrid on Thursday (May 5). Catriona, who owns and runs a pharmacy in the Highlands, is expected to give her take on community pharmacies' significant contribution towards achieving improved health outcomes and reducing health inequalities for local populations in Scotland. As an active independent prescriber, she is at the cutting edge of the profession in Scotland. Speaking ahead of her visit to Madrid, Catriona said: "I'm honoured to have the opportunity to collaborate with pharmacists from across Europe, and to share my experiences of working as a community pharmacist in Scotland.