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Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the NHS ad campaign highlighting how community pharmacies can support patients with non-health advice amidst the growing pressure on pharmacies. It believes the campaign will only 'worsen' the pressure on pharmacies. "It is always deeply concerning to see campaigns directing people to pharmacies without any regard for the pressures they are under: it is irresponsible and extremely unhelpful," said PSNC Chief Executive Janet Morrison. She called the campaign 'particularly irritating' just weeks after the committee rejected a series of proposals from NHS England and DHSC on relief measures to ease pressure on pharmacies as being totally inadequate. "NHS England Board Members have noted the pressure on pharmacies - so why are their teams so often acting to make these pressures worse? We need to see a radical change in how NHS England treats pharmacies and we're continuing to press for that via our influencing and campaigning work," she added. The NHS launched the new campaign on Monday (27 February) to highlight how high-street pharmacies can support patients with non-urgent health advice for minor conditions including coughs, aches and colds.

The leading pharmacy bodies have come together to launch the 'Save Our Pharmacies' campaign which highlights the pressure and untapped potential of the sector. Pharmacy bodies- Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC) have agreed to work together on a programme of activities to lobby for fair NHS funding for pharmacies in England, including co-ordinating efforts to mobilise public support. The campaign will focus on highlighting both the pressures that pharmacies are under and the huge untapped potential of the sector - including to offer a Pharmacy First service - if appropriate resourcing is made available. Mark Lyonette, NPA Chief executive, said: "Together we will be cranking up the noise to persuade Government and NHS to make the right choices and back the community pharmacy sector with decent funding. Maintaining patient and public support is critical to our campaigning success, so this will be a key focus in the months ahead. Our joint message is very clear: pharmacies can help get the NHS back on its feet, but not while the sector itself is on its knees." The pharmacy bodies will develop shared resources for effective parliamentary lobbying and mobilising public opinion, in the face of chronic underfunding that threatens further pharmacy closures. They will also work hard to show off the value of pharmacy and to continue pushing for a fully funded Pharmacy First service.

In celebration of World Pharmacy Technician Day today, we have gathered some significant achievements from this year that highlight the growing recognition of pharmacy technicians as integral members of the pharmacy team. During the Association of Pharmacy Technicians UK (APTUK) Conference in September, NHS England's Chief Pharmaceutical Officer, David Webb, announced 530 apprenticeships for community pharmacy pre-registration pharmacy technicians (PTPs) for the 2024/25 period. "This announcement shows a real investment in pharmacy technicians. It will impact all areas of practice, not just within community pharmacies," said Nicola Stockmann, APTUK President, in an exclusive interview with Pharmacy Business. In August, the Centre for Pharmacy Postgraduate Education (CPPE) was allocated funding to offer 80 NHS England-funded places in its Accuracy Checking Pharmacy Technician (ACPT) programme. This 3-12 month course is designed to help pharmacy technicians develop a range of competencies, ensuring they can deliver safe and effective patient care. Up to 10 NHSE-funded spots will be available each month on a first-come, first-served basis for pharmacy technicians working in community pharmacies, NHS hospitals, and health and justice settings. The funding will remain available until all 80 places are filled or until March 2025.

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.

The Local Pharmaceutical Committees (LPCs) has rebranded to be known as Community Pharmacy to present a strengthened and unified identity to the local NHS, local government and other stakeholders, as the local voice of community pharmacy. "There are now 58 LPCs in England. The number of LPCs has reduced from 69, with further consolidation expected by April 2024 to a network of 48 local organisations," said Community Pharmacy England. "The changes mean there will be better alignment between LPCs and the 42 NHS Integrated Care Systems in England, who have taken on the responsibility for commissioning pharmaceutical services delegated by NHS England." "This marks a significant milestone, as similar to Community Pharmacy England, LPCs have been undergoing changes to respond to the Review Steering Group (RSG) recommendations on pharmacy representation. The sector voted in favour of the RSG proposals in the summer of 2022, and since then progress has been made on many of the changes at both local and national level as part of the Transforming Pharmacy Representation (TAPR) Programme."

NHS England has commissioned the Royal Pharmaceutical Society (RPS) to develop guidance that helps community and hospital pharmacy teams across Britain to reduce the impact of pharmacy services, pharmaceutical care and medicines on the environment. The RPS said the Greener Pharmacy Guidance will enable pharmacies to self-assess their impact against the standards, benchmark and improve through evidence-based activities and actions. "I'm delighted our strong commitment to helping pharmacy reduce its environmental impact can now be taken to the next level through developing guidance and accreditation for pharmacy teams," RPS president Professor Claire Anderson said. "Medicines account for 25 per cent of carbon emissions within the NHS and this initiative underscores our commitment to promoting sustainable healthcare and supporting the NHS's goal of achieving 'net zero' emissions by 2040." Peter Morgan, medicines assistant director at NHS England, commented: "Pharmacy staff are involved in the purchasing and dispensing of almost every medicine used in the NHS and the new Greener Pharmacy Guidance and Self-accreditation scheme will provide support for pharmacy professionals by outlining clear actions to deliver more environmentally sustainable pharmacy practices." The RPS said the guidance and digital self-assessment toolkit will integrate with carbon calculator tools to help pharmacy teams to measure their carbon footprint, action plan to reduce use of carbon and improve sustainability.

A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

Wes Streeting's speech at the Labour Party Conference 2024 outlines several key health and social care reforms, which hold significant implications for community pharmacy in England. His focus on reforming and rebuilding the NHS to ensure fair, universal access to care, with prevention and early intervention at its core, presents both opportunities and challenges for community pharmacy. Here are the potential implications: 1. Prevention Focus Streeting's vision of a shift from a reactive, hospital-based model to a preventive healthcare system presents a promising future for community pharmacies. These changes could significantly reduce pressures on GPs and hospitals, integrating pharmacies more closely into primary care networks and enhancing their role in preventive care. 2. Digital Transformation The move from an "analogue to digital" NHS could see community pharmacies adopting more digital tools and systems for service delivery. This would likely involve greater use of digital prescribing, telehealth consultations, and AI-driven services. Pharmacies will need to invest in digital infrastructure and ensure that pharmacy professionals are trained to operate within a more tech-centric environment. 3. Reform and Redistribution of Services Streeting's plans to extend choice and equitable access to services mean that community pharmacies could become integral to providing care in underserved or disadvantaged areas. With a focus on decentralising healthcare and bringing it closer to local communities, community pharmacies could play a more significant role in supporting healthcare delivery in areas where GP services are stretched. This may include expanding access to pharmacy services in the most deprived areas, aligning with Labour's emphasis on addressing health inequalities.

NHS England announced at the Pharmacy Show this morning that Ministers have decided to amend the Pharmacy First thresholds for the remainder of the year. This decision follows concerns raised by Community Pharmacy England (CPE) regarding difficulties faced by pharmacy owners in meeting the required number of clinical pathway consultations for monthly Pharmacy First payments In response to CPE's representations to the Department of Health and Social Care (DHSC) and NHS England, the threshold was earlier reduced from 20 to 15 in August, and from 30 to 20 in October. At the Pharmacy Show on Monday, Ali Sparke from NHS England announced the revised thresholds, setting them at 20 for November and December 2024. Starting in January and February 2025, the number of clinical pathway consultations needed for the monthly Pharmacy First payment will rise to 25, with a further increase to 30 in March.

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information. Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of Services (DoS) profile information is kept up-to-date. The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been introduced to make the process as quick as possible and it can be done on either a smartphone or computer. PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."

NHS England has urged the pharmacy owners to continue to voluntarily submit New Medicine Service (NMS) quarterly summary data to the NHS Business Services Authority (NHSBSA) for Quarter 4 (Q4) 2022/23 (January to March 2023). Community Pharmacy England have agreed with NHS England that the quarterly returns will continue to be on a voluntary basis, with Q4 (January to March 2023) as the second quarter to be reported. It has thanked all the members that submitted NMS quarterly summary data for Quarter 3. The mandatory requirement to submit this data has been suspended since 2020, due to the COVID-19 pandemic. "NHS England wants to continue collection of the quarterly returns to provide baseline data to support a long-term evaluation that will be conducted as part of ongoing work to expand the scope of NMS," said Community Pharmacy England. Voluntary submissions can be made via the NHSBSA website, where an updated reporting spreadsheet is also available for head offices to use who are able to submit data on behalf of multiple pharmacies.

The new data from NHS England has revealed that more than 100,000 patients were treated for minor illness by their high street pharmacist in just one month. According to new NHS figures, in June, 118,123 people with minor illnesses such as a sore throat or constipation, or those in need of medicine urgently, received a same-day consultation with their local pharmacist after calling NHS 111 or their GP practice - an increase of more than four-fifths (83%) on the number in the same month last year (64,512). The data comes alongside expanded roles for community pharmacies ahead of winter, announced at the NHS England board meeting today. "From this week, NHS 111 online can directly refer people to their high street pharmacist for a same-day consultation, rather than patients needing to call the phone line," said NHS England. Amanda Pritchard, NHS chief executive, said: "Our local pharmacies ensure hundreds of thousands of people every week get the support and medication they need and today's figures show that in just one month, over 100,000 patients have also had consultations with their local pharmacist for minor illnesses - this means patients are getting the care they need quickly but also in a convenient way that can fit in with their busy lives.

The Pharmaceutical Services Negotiating Committee on Tuesday (June 30) renamed itself as Community Pharmacy England, promising a "strengthened commitment" to champion and engage with the sector. "The name Community Pharmacy England better reflects the breadth of work that we do to both represent and support community pharmacies in England. We are their champion," the pharmacy negotiator said. Explaining that the rebranding exercise was in line with proposals put forward by the Review Steering Group (RSG), it said the rebrand was part of its Transforming Pharmacy Representation (TAPR) work and that it would signal the beginning of a "new engagement strategy" to build stronger relationships with pharmacy owners. "Becoming Community Pharmacy England is much more than a name change or a new logo, it is a driver for cultural change across our organisation. "Our members want us to be more authoritative, representative, and influential, and rebranding gives us a clearer and stronger voice, helping us to better speak out for community pharmacy."

In response to concerns raised by Community Pharmacy England (CPE), ministers have decided to lower the October threshold for the Pharmacy First service to 20. This decision addresses a major worry for pharmacy owners who have struggled to meet the required number of clinical pathways for monthly Pharmacy First payments, especially as the October increase to 30 pathways approached. CPE has been actively engaged in discussions with the Department of Health and Social Care and NHS England over the past few weeks to address this issue. Commenting on the decision, Janet Morrison, CEO of Community Pharmacy England, said: "It is great that ministers have responded to our concerns about another increase to the Pharmacy First payment threshold: this decision will save many community pharmacies from missing out on a vital payment this month." Morrison added that CPE will continue to monitor service data and, if needed, make further representations to ministers about future months. She also emphasised the need to find a long-term solution, which involves "NHS England marketing Pharmacy First effectively and ensuring that GPs are actively referring people to the service."

Eighty-five per cent of adults responding to a survey commissioned by the National Pharmacy Association (NPA) have agreed that community pharmacies are underfunded and that the sector needs more investment to be able to do the work it does. The survey of 1,000+ adults in England was carried out online between August 26 and 30 by an agency called Research Without Barriers (RWB) on behalf of the NPA. Pharmacies in England are now paid less for providing NHS services than they were before the Covid-19 pandemic, after years of real terms cuts. Seventy-four per cent respondents think it's unfair that community pharmacies in England have had no increase in funding for eight years, despite rising business costs. When asked whether it's fair or unfair that pharmacies in England are now paid less for providing NHS services than they were before the pandemic, 81 per cent of people replied that it's unfair.

"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."

Tase Oputu, Chair of the RPS England Pharmacy Board, has been appointed to the NHS Assembly, to represent the pharmacy profession. The NHS Assembly is a national forum that brings together stakeholders from across the health and care sectors to advise the NHS England board on implementing the NHS Long Term Plan (LTP). Members include national and frontline clinical leaders, patient leaders, staff representatives, health and care system leaders and voluntary, community and social enterprise sector leaders. The NHS Assembly meets four to five times a year. Tase will officially join the Assembly during its meeting on 11 September. Tase highlighted the crucial role of pharmacists and pharmacy teams in the healthcare system while expressing her anticipation of representing the pharmacy profession at the NHS Assembly.

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 Welsh government has reached an agreement with the NHS and Community Pharmacy Wales (CPW)-the statutory representative body for all community pharmacies-on a six per cent funding increase as part of the 2024/25 Community Pharmacy Contractual Framework (CPCF). The £9.9 million increase will bring the total CPCF funding to £175 million per year, representing a 24 per cent rise in funding since 2017. In a statement published on 20 December 2024, Jeremy Miles, cabinet secretary for health and social care, said that the additional investment will be used to address "both immediate pressures facing community pharmacies and to maintain momentum on our longer-term ambitions for reform." Miles also said that the government would continue to invest in integrating pharmacies in primary care clusters, developing the skills and scope of practice of the wider community pharmacy workforce including pharmacy technicians, and the Choose Pharmacy IT system. In contrast, community pharmacies in England are still awaiting progress on CPCF negotiations for 2024/25. Last month, Community Pharmacy England (CPE) warned of the sector's worsening financial situation, urging ministers to provide immediate funding relief.