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The Department of Health and Social Care (DHSC) announced on Monday (November 22) that it would integrate NHS Digital, NHSX and Health Education England into NHS England and Improvement (NHSE&I) as part of major workforce planning and technology reforms. The merger is part of the government's long-term strategy for the recruitment, training and retention of healthcare staff coupled with a digital transformation of working practices. The overhaul is based on recommendations made by NHS Digital chair Laura Wade-Gery who led a government-commissioned review to improve patient care, centralise the NHS workforce and accelerate digital delivery. Commenting on her recommendations, Wade-Gery, said: "In the rest of our lives, digital has really changed how we live and we must now make this true in healthcare. The goal of my review is to equip the national centre with the right capability to support Integrated Care Systems to deliver better citizen health. We need to have the culture, operating model, skills, capabilities and processes to put data, digital and technology at the heart of how we transform health services."

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's decision to forgo commissioning puberty suppressing hormones (PSH) for children and young people, citing insufficient evidence of their safety and clinical effectiveness, follows a comprehensive review conducted by the National Institute for Health and Care Excellence (NICE) in 2020. The clinical report underscores that "PSH treatment options will not be part of routine commissioning" for people under the age of 18 in England grappling with gender incongruence or dysphoria. The NHS England review analysed nine observational studies on Gonadotrophin Releasing Hormone Analogues (GnRHa) and found no statistically significant difference in gender dysphoria, mental health, body image, and psychosocial functioning among children and adolescents treated with GnRHa. Duncan Rudkin, chief executive of the General Pharmaceutical Council (GPhC), acknowledged the challenges faced by pharmacy professionals regarding prescriptions for puberty suppressing hormones, stating:

In a significant move to enhance the working conditions of over 50,000 postgraduate doctors in the National Health Service, NHS England has unveiled a series of measures aimed at providing greater choice and opportunities to the new entrants in the medical profession. With flexible rotas, reducing payroll errors, and easing the financial burden of course fees, the NHS has taken steps to address the issues faced by junior doctors in order to support their well-being. In recent announcement, 83 per cent of senior doctors and dentists accepted the government's pay offer. Alongside the junior doctors who still fighting for fair pay and recognition, the senior medical professionals demanded that the authorities help them tackle issues pertaining underfunding and overworking in the NHS. Junior doctors in training also often face challenges with frequent moves between trusts, leading to short notice changes in work schedules and duplicated inductions when transitioning to new hospitals. As a measure taken by the health serivces, the committee aims to review the minimum legal requirements for statutory and mandatory training, potentially halving the time burden for such training and allowing doctors to spend more time caring for patients as part of the long-term workforce plan.

Community pharmacy contractors are likely to receive more referrals from NHS 111 for the Community Pharmacist Consultation Service (CPCS) following a review of the NHS Pathway algorithms, NHS England and NHS Improvement (NHSE&I) announced on Friday (January 14). The review, conducted by an expert group of Integrated Urgent Care clinicians and pharmacists, led to inclusion of more minor illness symptoms for referral to the CPCS from NHS 111. The reviews based on data from 2021, showed it could generate 275,000 additional referral opportunities annually. With the introduction of changes, three new condition types (scratches and grazes, teething, sinusitis) and general health information requests will be added.

A final review of gender services provided by the NHS has uncovered significant shortcomings, leaving thousands of vulnerable children questioning their gender identity without adequate support. The report, led by Dr. Hilary Cass, a prominent consultant paediatrician, highlights the use of unproven treatments and the detrimental impact of the polarized trans debate on gender care provision. The investigation, commissioned by NHS England in 2020, focused on the Tavistock and Portman NHS mental health trust's gender identity development services (Gids), which treated around 9,000 children and young people between 2009 and 2020. Shockingly, the review found that despite limited evidence of effectiveness and potential health risks, puberty blockers and cross-sex hormones were routinely administered. Dr. Cass emphasized that the "rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown."

NHS England has confirmed the initial sites that will test and implement Martha's Rule in the first phase of the programme. This follows the announcement in February regarding NHSE funding for the major patient safety initiative for this financial year. The scheme is named after Martha Mills, who died from sepsis at the age of 13 in 2021. She had been treated at King's College Hospital, London, where a failure to escalate her to intensive care and a lack of response to her family's concerns about her deteriorating condition contributed to her death. Martha's Rule aims to provide a consistent and understandable way for patients and families to seek an urgent review if their or their loved one's condition deteriorates and they are concerned this is not being responded to. NHS England on Monday (27 May) announced that the scheme will be implemented at 143 hospital sites across the country by March 2025.

The Department of Health and Social Care has updated the list of community pharmacies eligible for the Pharmacy Access Scheme (PhAS) and approved 43 cases out of 63 applications, bringing the the total number of eligible pharmacies in England to 1,445. Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I regional pharmacy contract team, and determined by the relevant pharmaceutical services regulations committees (PSRC). Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the scheme.

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 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."

The Community Pharmacy England (CPE) has called the recent announcement of six per cent pay rise for the public sector workforce as 'unfair' for the community pharmacy sector. On Thursday (13 June), the Department of Health and Social Care (DHSC) announced that pay scales for most doctors and dentists will increase by at least a six per cent this year after the government accepted the recommendations from the independent pay review bodies in full. Responding to the recent announcement Chief Executive Janet Morrison, said: "The public sector workforce pay rise will be welcome news for its recipients given the huge inflationary pressures and the ongoing impact of the cost-of-living crisis. But for community pharmacy owners - who have faced 30% funding cuts in recent years and who are struggling to meet their rising wage costs - this feels unfair, and very far from good news. At Community Pharmacy England we are fully focused on the current financial and operational pressures and fighting hard for a sustainable long-term funding arrangement.

The Royal Pharmaceutical Society (RPS) has backed a new framework from NHS England to reduce inappropriate prescribing of addiction-causing medicines. It believes that the new framework is a positive step towards improving patient care by supporting medicine reviews and shared decision making to help people reduce their use of medicines that are no longer providing much clinical benefit. The society has also welcomed investment in innovative approaches to supporting patients and urged all pharmacists to refer people to such schemes. Director for England at RPS, James Davies said: "Pharmacists are well-placed to help reduce inappropriate prescribing of high strength painkillers such as opioids and other addictive medicines. "Pharmacy teams can also often spot repeat purchases of over the counter medicines by patients so are well placed to intervene and give advice on the management of chronic pain. Whilst opioids can play an important part in helping people with chronic pain there has long been a need for alternative approaches that are safer and more effective for patients.

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.

Community pharmacy contractors eligible under the revised Pharmacy Access Scheme (PhAS) will receive their first of the new monthly payments with the January reconciliation payment due on April 1, 2022. Details of the revised version of the PhAS that commenced from January 1, was published in August 2021, with contractors receiving letters from the NHS Business Services Authority (NHSBSA) indicating their eligibility in the Autumn, PSNC said in an update. Payments under the scheme are dependent on registration on NHSBSA's Manage Your Service (MYS) portal to provide the Community Pharmacist Consultation Service(CPCS). Meanwhile, the review application window is now open for contractors, which would enable the NHS England and NHS Improvement (NHSE&I) to correct inaccuracies related to a pharmacy's distance criteria/calculation.

'Tepotinib' has been recommended by the National Institute for Health and Care Excellence (NICE) to patients with a specific gene mutation of advanced non-small-cell lung cancer (NSCLC). The new potentially life-extending drug is available from Thursday (14 April). It has been recommended for routine use across the NHS in England through Project Orbis, a programme to review and approve promising cancer drugs helping patients access treatments faster. NICE has published its final appraisal document recommending tepotinib (also known as Tepmetko and produced by company Merck Serono Ltd) as an option for treating advanced NSCLC with METex14 skipping gene alterations in adults. People with METex14 skipping alterations of NSCLC make up between 1-2% of all adults with lung cancer in England. Tepotinib, which requires people to take two tablets once daily, provides a new targeted treatment for adults with METex14 skipping gene alterations. Just over 700 people in England would be eligible to receive tepotinib as either a first or second-line treatment.

In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England, Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period. The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies, while the total number of independent operators remained consistent with 2022. According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies. Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators acquiring additional pharmacies through corporate disposal opportunities throughout the year.

Nine in ten people surveyed by Ipsos on behalf on NHS positively rated the advice they received from their local pharmacies. The results from Ipsos found that the vast majority of patients (91%) who had used a community pharmacy in the previous year for advice about medicines, a health problem or injury, or what health service they should use said they received good advice. The research comes as more than 11,000 pharmacies in England can now access training to spot signs of cancer as part of a new drive to catch tumours earlier when they are easier to treat. Thorrun Govind, Chair of the Royal Pharmaceutical Society English Pharmacy Board, said: "Community pharmacists are working exceptionally hard to make sure that the public gets the right advice at the right time. This new data shows the public appreciate both the accessibility and quality of advice they receive from community pharmacists. "I am delighted that the Royal Pharmaceutical Society is working with the NHS to deliver professional development for community pharmacists to further enhance their clinical consultation skills.

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

The Royal Pharmaceutical Society (RPS) in England has published a review of its 10-year Vision for Pharmacy Professional Practice that was launched in December 2022 in collaboration with The King's Fund. The 'one year on' vision report highlighted key milestones achieved in the first 12 months since its publication as well as opportunities for further progress. It identified the publication of the NHS Long Term Workforce Plan, which recognises the significant role that pharmacists play in healthcare and commits to growing and expanding the pharmacy workforce, as one of the positive policy developments made since the launch of the vision. The development of a Vision for Community Pharmacy by Community Pharmacy England, the Nuffield Trust and The King's Fund; work on digital integration to enable community pharmacists to update a clinical record; the launch of Pharmacy First scheme; and the publication of the public consultation of pharmacy supervision were other key milestones mentioned in the report.

The Department of Health and Social Care (DHSC), led by Victoria Atkins MP and Maria Caulfield MP, has unveiled proposed updates to the NHS Constitution for England, aiming to fortify the principles of privacy, dignity, and safety for all patients. Martha's rule was prompted by a campaign led by the parents of 13-year-old Martha Mills who tragically succumbed to sepsis after staff at King's College Hospital failed to escalate her care to intensive care, despite her family's pleas regarding her worsening condition in 2021. Under the new guidance is the introduction of Martha's Rule, empowering patients to request intimate care from someone of the same biological sex ensuring that the distinct needs of men and women are recognized and addressed. Patients and their loved ones can exercise the right to "access to a rapid review from outside the care team if the patient is deteriorating." The consultation on the proposed updates is set to run for eight weeks, inviting feedback from patients, healthcare professionals, and stakeholders for a review