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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.

"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 Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first' approach in England as mentioned by his predecessor on numerous occasions. "Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy First' to support patient access to care. I would urge the new Health Secretary to see this through to completion," said chair of RPS in England Thorrun Govind. Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery, including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers. Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures and organisations, and the need for long-term investment in the workforce. "With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.

The community pharmacy bodies, along with England's largest pharmacy chains, have urged the Prime Minister, Rishi Sunak to resolve fund and workforce crisis in the sector. In the joint letter the Chief Executives of Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC), along with Boots, Lloydspharmacy, Well and Rowlands Pharmacy, said they are pleased to see Government now recognising the key role that community pharmacy' could have in alleviating the strain on other NHS services. However, the associations also warn that although the sector is ready to support, 'this will not be possible unless pharmacy is properly funded.' Janet Morrison, PSNC Chief Executive, said: "The Prime Minister should also know that community pharmacies are also facing a crisis. They need sustainable investment, urgently, if we are to avoid devasting consequences for pharmacies and for their patients." The letter calls on Government to help pharmacy to resolve the funding, workforce and capacity issues engulfing the sector. It said: "Community pharmacies are in crisis and after 7 years of 30% funding cuts have reached their limit."

Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems. Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS. "It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework." Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector." "We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."

The 8th Pharmacy Business Conference, organised by Pharmacy Business, unfolded a dynamic narrative around the theme of 'Pharmacy of Tomorrow', highlighting the trajectory of innovation, adaptation, and the evolving landscape of pharmaceutical services. Attended by over 200 pharmacy owners, industry leaders, and stakeholders, the conference served as a medium for robust discussions and the exchange of valuable insights regarding the future of community pharmacy. Amidst the persistent challenges posed by an underfunded reimbursement system and negotiations with governmental bodies and the NHS for the new community pharmacy contractual framework 2024/25, the conference pivoted towards investing in staff, adapting to change by investing in new technology, and optimising commissioning as pivotal strategies. "Pharmacy professionals are playing increasingly important clinical roles in both primary and secondary care," shared David Webb, Chief Pharmaceutical Officer (CPO), NHS in a video message. He highlighted the NHS's commitment to empowering community pharmacy, with plans to expand services and deprescribe to align with the NHS's focus on preventive healthcare.

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 NHS plans to train hundreds of pharmacy staff, expanding their ability to provide advanced clinical services and assume wider roles in dispensing medicines. With a targeted launch in September, up to 840 pharmacy technicians can join in the training programme. The online modules will cover consultation skills, therapeutics, clinical decision-making, assessment skills, and service improvement. "Community pharmacies are pivotal in local communities, and this novel training scheme empowers them to extend their service offerings to a wider patient base," said Health Minister Neil O'Brien. "Through our investment in the workforce, we're bolstering the implementation of the Pharmacy First initiative with £645 million, ensuring patients have access to expert assistance for various common ailments, including urinary tract infections and earaches." NHS said the training will offer flexibility to align with the working schedules and prior experience of community pharmacy technicians. It will combine independent online e-course study, educational supervision, and clinical skills training. Facilitated workshops will concentrate on enhancing clinical assessment skills and applying knowledge and skills through case studies, practice activities, and group discussions.

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.

As part of a new blueprint for primary care, the government today (May 9) announced an investment of £645 million over two years to expand community pharmacy services in England. In a statement, NHS England said: "For the first time ever, patients who need prescription medication will be able to get it directly from a pharmacy, without a GP appointment, for seven common conditions including earache, sore throat, or urinary tract infections." Prime minister Rishi Sunak hopes that the measures will help end the "all-too stressful wait on the end of the phone for patients" by freeing up 15 million slots at doctors' surgeries over the next two years. "We will end the 8am rush and expand the services offered by pharmacies, meaning patients can get their medication quickly and easily," he said Almost half a million women will no longer need to speak to a practice nurse or GP to access oral contraception and will instead be able to pop into their local pharmacy for it, according to the government announcement. Blood checks for people suffering from moderate risk of heart attack or stroke conducted in community pharmacies will more than double from 900,000 last year to 2.5 million next year. NHS chief executive Amanda Pritchard said the "ambitious package" would help transform how care is provided within the health service "with pharmacies playing a central role in managing the nation's health including providing lifesaving checks and medication for common conditions for the first time.

The NHS has made major improvements across long waits, urgent and emergency services, and cancer care, latest performance figures published on Thursday (11) have shown. The number of patients waiting more than 18 months fell to 10,737 by April - down by more than 90 per cent from 124,911 in September 2021 and by more than four-fifths since the start of January when there were 54,882. Around half of NHS trusts in England have no patients on their elective care waiting lists apart from those who have chosen to wait longer. More than one in five (21%) trusts had completely eliminated 18-month waits. However, the overall waiting list has risen to over 7.3 million entries in England. "I promised I would cut NHS waiting lists and we are delivering," Prime Minister Rishi Sunak said. "Reducing 18-month waits by over 90 per cent is huge progress, and it is testament to the hard work of NHS staff who have achieved this despite one of the busiest winters on record. "We still have work to do, but backed by record government investment and the ongoing efforts of the NHS, I am confident we will get patients the care they need more quickly." Ambulance response rates have improved to their fastest in two years, with average category two response times now at 28.5 minutes and category one at 8 mins. The 62-day cancer backlog has fallen for the first time since before the pandemic, with those waiting two months or more down from 21,823 at the end of the last financial year (March 2022) to 19,248 at the end of this March (2023). This is down almost 15,000 from a peak of 34,000 in July 2022.

Health leaders have said that delivering faster and more productive patient care would be difficult unless NHS capital budgets are nearly doubled to at least £14.1 billion from the current spending of £7.7 billion. The NHS Confederation has highlighted the impact that low levels of capital investment have had over the last decade in its report published today (29 November). The report, 'Investing to save: The capital requirement for a more sustainable NHS in England', revealed that the UK has lagged behind other comparable countries in terms of health capital investment for more than five decades, resulting in less productivity. It revealed that the NHS now has the sixth lowest number of CT and MRI scanners per million people of the OECD countries.

The government has earmarked £200 million to enhance NHS resilience and expedite patient care during the upcoming winter season. This extra amount will bolster the health service during its busiest period, while protecting elective care so we can keep cutting waiting lists, Prime Minister Rishi Sunak has said. On August 13, the Prime Minister and Health and Social Care Secretary met with clinical leaders and NHS Chiefs to strategise and refine planning for urgent and emergency care, while prioritising the preservation of waiting list targets for the upcoming winter season. "Patients can be reassured that I will always back the NHS, so that those who most need help and support will get the care they need," Sunak said. "Winter is the most challenging time for the health service, which is why we've been planning for it all year - with huge government investment to fund new ambulances, beds and virtual wards." "This £200 million investment, assured by the Department of Health and Social Care as new and additional funding, should aid NHS leaders in their preparations and mitigation for what will be a seriously difficult winter period," said Matthew Taylor, Chief Executive of NHS Confederation. "The priority now is swift allocation of funding to local systems for optimal utilisation."

To help pharmacy owner to better understand the negotiating process, Community Pharmacy England (CPE) has published commentary and infographics. "Our work to negotiate fair funding, as well as changes to NHS pharmacy services, with the Department of Health and Social Care (DHSC) and NHS England is a crucial part of our role," said CPE. "Understandably the sector is eagerly awaiting an update on the progress of the current negotiations on the Government's pledge to invest £645m in community pharmacies and, as part of our ongoing efforts to improve transparency of our work, we have released materials to explain the negotiating process." Negotiating Team Member Stephen Thomas - who joined the team this year - has written a blog about his experiences. He has described both the complexity of the process and volume of work undertaken, and recognises the significance of his role on behalf of pharmacy owners across the country. Whilst speed is of the essence, even higher on the Negotiating Team's list of priorities is working through a large number of important questions - particularly around the funding and logistics that need to be put in place.

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.

The much-awaited Pharmacy First service has been launched in England, enabling patients to get treatment for seven common conditions from their community pharmacists without needing to see a GP. According to NHS England, a total of 10,265 community pharmacies, which is equivalent to more than nine in ten community pharmacies in the country, will be offering the ground-breaking initiative. The new scheme allows highly trained pharmacists to give advice and prescription-only medicines for minor ailments including sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women (under the age of 65). With this major expansion of pharmacy services, the NHS is aiming to free up 10 million GP appointments a year while giving the public more choice in where and how they access care.

The English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of community pharmacy as the third pillar of patient access to essential healthcare. Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC announces no new long-term investment to sustain the sector. Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners. Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated. Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances need open heart surgery not a couple of paracetamol tablets.

Community Pharmacy England (CPE) has asked community pharmacy owners to share their views on preparations for the new national Pharmacy First service, ahead of the next full Committee meeting at the end of January. The advanced service, which is set for launch from 31 January, will allow patients to seek advice and treatment for seven common conditions directly from their local pharmacy, without the need to contact their GP practice. It is expected to help NHS free up 10m GP appointments a year. However, CPE chief executive Janet Morrison has previously expressed that the Pharmacy First investment is not the panacea for pharmacy's funding woes. Pharmacy owners' feedback will be used in the Committee's campaigning and influencing work to press for an uplift to core funding, CPE said.

Community Pharmacy England (CPE) has expressed dissatisfaction with the spring budget as it brings "no specific relief" for the community pharmacy sector, which is grappling with "soaring costs and severe medicine supply and pricing issues." UK Chancellor Jeremy Hunt announced his Spring Budget on Wednesday, confirming an extra £2.5 billion in day-to-day revenue funding for the NHS in England in 2024-25 and a new NHS productivity plan worth £3.4bn to modernise IT systems. The Chancellor said that day-to-day spending would grow by 1 per cent per year on average in real terms, and the productivity plan is estimated to "unlock £35 billion worth of savings" from 2025-26 to 2029-30. However, CPE chief executive, Janet Morrison commented that the budget has "no obvious good news" for community pharmacies who need "urgent relief from the ongoing unsustainable funding and operational pressures" they are facing. Morrison described the investment in Pharmacy First as "the most significant investment in pharmacies in a decade", but emphasised the need for further support to stabilise the sector and its core contractual arrangements.

The health secretary, Steve Barclay was asked over the delay of 'Pharmacy First' model in England that was proposed by the Pharmaceutical Services Negotiating Committee (PSNC) last year, at the Health Committee evidence session held on Tuesday (31 January). Taiwo Owatemi MP (Chair of the Pharmacy APPG) asked whether he was adhering to his statutory responsibility to ensure continued access to medicines and cited the CCA's closures in areas of deprivation research. Barclay replied that the government is 'investing more'. He said, "We put an extra 100 million on top of the 2.6 billion a year we commit to community pharmacy to expand the range of clinical services. We've got over 2 million patients that have been referred to community pharmacy from NHS." He further added: "One of the issues I'm very keen on is to explore what more we can do in pharmacy not least given the pressures on GP and the opportunity to look at what it is currently people go to GPS for where potentially the risk to do more at the pharmacy and we're already doing that."