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In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels. PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community pharmacy contractual framework to ensure that the services are adequately resourced." Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular and accessible places for people to receive a range of vaccinations. "The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views on the topic. "In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS response to this consultation."

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."

I have always been passionate about Community Pharmacy and am proud of the way that the sector navigated itself through Covid-19 and is currently navigating itself through all the changes in the NHS landscape. When I started my role in Sep 2019 as the CEO of Kent LPC, I used to say that community pharmacy has changed more in the last five years than the 15 before that, however, I now believe community pharmacy has changed more in the last two years than the 20 before. The year 2019 saw the start of the five-year Community Pharmacy Contractual Framework which set out how community pharmacy would support delivery of the NHS long term plan. What PSNC (or any of us) when negotiating this deal had not envisaged was the Covid-19 pandemic. Whilst the world turned upside down, we saw high street shops close their doors and immense pressure flood the NHS. Community pharmacy did what they always do, they adapted, teams came together, worked through, and showed resilience in the face of adversity. In Kent, I saw us integrate into primary are and into the NHS structure very quickly, in the first few weeks after Covid-19. All the usual red tape was removed, we all worked together to implement services to help patients in a matter of weeks when they would have normally taken months.

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.

Community Pharmacy Wales and the Welsh government have entered an agreement on Thursday (December 16), enabling all pharmacies to deliver provision of contraception, treatment for common minor ailments, and access to repeat medicines in an emergency. Expansion of clinical community pharmacy service will be supported with an increased funding of £20 million a year by April 2024 from the current level of £11.4m. The two bodies have been negotiating the terms of agreement, which also includes plans to roll out a Wales-wide pharmacy prescribing service, allowing trained pharmacists to treat an extended range of conditions that currently require GP visits. The agreement will allow patients to access NHS services closer to home which in turn would free up GP and other NHS services for patients with more complex needs. Eluned Morgan MS, minister for Health and Social Services said: "I welcome the positive approach to negotiations taken by Community Pharmacy Wales, embracing our ambition for a reimagined community pharmacy service, which is an integral part of a strong primary care landscape."

The new board of the National Pharmacy Association (NPA) has adopted 10 principles for transforming the contractual framework in England. The board met for the first time in April, believes that the current Community Pharmacy Contractual Framework is failing NPA members, the wider sector, the NHS, Government and patients. The association's new vice chair, Jay Badenhorst, said: "We can't wait until the current framework limps to its finish line in 2024 before giving serious thought to the new race we must all run in the future." "Before negotiations for a new contract begin in earnest, we want to make our position clear to all of those who will be involved in its development. Years more of the same would be totally unacceptable. Tinkering at the edges of the current arrangements as the basis for a new deal could not achieve the transformation that is needed." Former chair of the NPA, Andrew Lane, listed some of the principles in a speech to industry leaders in January, but this is the first time the approach has been agreed in its entirety, following months of testing with NPA members.

Community pharmacy representatives and MPs from across all political parties discussed the impact of winter pressures on pharmacies in England during a parliamentary drop-in event held on Tuesday (5 December). As many as 34 MPs attended the event, including Bradford South MP Judith Cummins, who hosted the event. Members of the Community Pharmacy England (CPE) Policy Team and LPC leaders briefed the politicians about the current winter pressures that all NHS community pharmacies are grappling with, and asked them to help get more support. CPE Chief Executive Janet Morrison said: "Community pharmacies play an active role to support their patients throughout the winter period, but the sector needs fair and proper funding to enable its vital services to be delivered in the long term. This event came at a key moment for the sector as we work towards implementing the Pharmacy First service and negotiations begin for the 2024/25 Community Pharmacy Contractual Framework (CPCF).

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

The Health Select Committee Expert Panel has concluded in its report published on Tuesday (25 July) that the funding aspect in the community pharmacy sector 'requires improvement' based on the evidence received. The Expert Panel reviewed nine Government commitments, seven of which were from the Community Pharmacy Contractual Framework. It was found that available funding was not sufficient to keep pharmacies open, struggling financially with increased demand for dispensing, workforce pressures and rising costs due to inflation. One of the other commitments requiring improvement covered a scheme intended to protect access to local physical NHS pharmaceutical services in areas where there were fewer pharmacies. Professor Dame Jane Dacre, Chair of the Expert Panel, said: "Pharmacy plays a key role in the delivery of care so it's disappointing that progress overall to deliver on the Government's commitments was rated as 'requires improvement'.

The National Pharmacy Association (NPA) has commissioned Professor David Taylor of University College London to investigate the implications of all-time high inflation rates on community pharmacies in the UK. Professor Taylor's will assess rates of inflation affecting community pharmacy across the UK, using public data sources whilst examining inflated costs in the context of the current five year contractual framework in England (2019-2024). He would review the EY (Ernst & Young) report into pharmacy funding, to identify whether current inflationary pressures could change any of the findings and consider the policy implications and impacts of inflationary pressures, including pharmacy's ability to prepare for a more clinically focused future and maintain current core services. NPA chief executive Mark Lyonette said: "Inflationary pressures are eating into the limited funds provided by the NHS for pharmacy services. We believe the real level of inflation for pharmacy businesses could be higher than the CPI inflation rate, which itself is at a 40 year high. Staff and locum costs in the sector as well as medicines costs have risen dramatically.

The tripartite negotiations to set the arrangements for the Community Pharmacy Contractual Framework (CPCF) in 2022/23 - Year 4 of the five-year CPCF deal - have now begun, the Pharmaceutical Services Negotiating Committee (PSNC) said. The discussions, beginning ahead of the start of the financial year, are taking place between the PSNC and the Department of Health and Social Care (DHSC) and the NHS England and NHS Improvement (NHSE&I). It will cover issues related to service, funding and other arrangements for pharmacies in 2022/23, in line with the five-year CPCF deal. The three entities will also discuss the progress made to date, which has been partly impacted by the Covid-19 pandemic, and the recent joint Annual Review process, where PSNC raised serious concerns around the available capacity within community pharmacy.

The Community Pharmacist Consultation Service (CPCS) will be expanded to enable urgent and emergency care settings to refer patients to a community pharmacist for a consultation for minor illness or urgent medicine supply from Monday (15 May), the DHSC and NHSE said. The service builds on the progress made in GP referrals via the CPCS and hospital referrals under the Discharge Medicine Service. It was originally planned to launch in March, and fee for this service will be the existing CPCS fee of £14, as per the agreement for both year 4 and year 5 of the Community Pharmacy Contractual Framework (CPCF) 2019 to 2024 5-year deal. In an update on the CPCF, published today (12 May), the Department of Health and Social Care (DHSC) and NHS England (NHSE) has also committed to the 4 October 2023 launch date for the Tier 2 of the Pharmacy Contraception Service, subject to a positive evaluation of the pilot. The Tier 1 of the service was launched on 24 April, delayed by over three months. This new service enables community pharmacists to provide ongoing management, via a patient group direction (PGD), of routine oral contraception that was initiated in general practice or by a sexual health clinic. The fees for this service are as follows: a fee for each consultation of £18; and a set-up fee of £900, paid in instalments. The Tier 2 will "enable community pharmacists to also initiate oral contraception, via a PGD, and provide ongoing clinical checks and annual reviews," Alette Addison, deputy director for pharmacy, dental and optical at the DHSC and Ali Sparke, director for dentistry, community pharmacy and optometry at the NHSE, said in a letter.

The Company Chemists Association (CCA)'s workforce finding showed that by 2024 eight years' worth of growth of the pharmacist workforce will have been funnelled away from community pharmacies. "In 2019, when NHS leaders realised they were unable to find enough GPs to meet the public's needs, they hastily decided to recruit pharmacists and other healthcare professionals to fill the gaps. This was implemented without any corresponding efforts to increase the supply of pharmacists, creating huge shortages," said CCA. "The bulk of the NHS's recruitment drive was paid for using additional money ringfenced by the NHS - the £2.4bn Additional Roles Reimbursement Scheme (ARRS). We estimate over the life course of ARRS funding (2019-2024), the equivalent of eight years of growth in the number of pharmacists in England will have been funnelled directly into primary care at the expense of other sectors. At the current rate, CCA estimate that community pharmacy will have experienced the equivalent of three fallow years by 2024. To ensure the pharmacy network is protected and able to take pressure off other parts of the NHS, there are several urgent measures which must be implemented. Countering the impact of primary care recruitment: Community pharmacists should be commissioned to provide 'packages of care' on behalf of GPs, rather than taking pharmacists away from accessible high street settings.

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.

Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling it "the biggest dis-service ever done" to community pharmacy. The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years. This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector. The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework. The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she assured everyone that the committee was well aware of the pressures the sector was facing. "I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce crisis is critical, leading to temporary closures.

The Challenges There cannot be anyone working in or with community pharmacy that either feels or sees the pain that emanates from the current operating climate. Pharmacy closures; increased workload and operating costs; increased patient and commissioner expectations; and, more fundamentally, an inadequate, undervalued and poorly structured remuneration and reimbursement contractual framework. As important as they are, we will not focus on these points here as they are not in the control of pharmacy owners and managers. They are the responsibility of those organisations that represent them at a national and local level who must deliver a better outcome as difficult as that may be. However, there are matters which are in the control of pharmacy owners and managers. These include their premises, their team, their systems and processes, their relationships with other healthcare providers and the broader community, their NHS and private service offer, and how they promote and deliver them to give the best patient experience. In order to create the head space to develop and implement a business plan, pharmacy owners and managers must make time to work on their business as well as in it. Then it requires the capacity and capability within their team to deliver the services and that excellent patient experience.

A full CPE Committee Meeting was organised in London on April 17 and 18, 2024, to discuss crucial sectoral issues. Key topics discussed during the two-day meeting included intolerable pressures on pharmacy owners, the ongoing Community Pharmacy Contractual Framework (CPCF) negotiations, implementation of the Pharmacy First service, and governance changes. Committee Members reviewed the progress of CPCF negotiations with the Department of Health and Social Care (DHSC) and NHS England. These critical negotiations are being led by the Negotiating Team (NT), which includes independent pharmacy owners and representatives of CCA and non-CCA multiples. The CPE has been advocating for an uplift to the core global sum, margin write-offs, an agreed mechanism for regular funding increases linked to activity and inflation, annual uplifts to service fees, more fundamental reform of the margin delivery framework and an economic review of the medicines supply chain. The Committee also discussed the results of the 2024 Pharmacy Pressures Survey, which was conducted during March and April.

The Pharmaceutical Services Negotiating Committee (PSNC)'s members are seeking immediate rescue packages for the sector to help with energy bills and to ease capacity constraints. In a meeting held on 14th and 15th September, the committee members expressed their anger and frustration on the reluctance of NHS England and government to fund pharmacy sustainably. The meeting was held to consider practical steps to ease the pressures on the community pharmacy sector, and to oversee the progress of negotiations on the Community Pharmacy Contractual Framework (CPCF) and other work. Committee members, as pharmacy contractors, shared their experiences of the current pressures on all contractors, including the inability to deliver some services and to maintain core service levels; the capacity and workforce crises facing the sector; the critical need for funding support this winter; and the urgent need for Government to adapt the Price Concessions system to meet the needs of contractors. "The Price Concessions system is no longer working for contractors in the current volatile medicine supply environment and PSNC is clear this is not acceptable," said the committee.

Community Pharmacy England (CPE) CEO, Janet Morrison said that the negotiations for the £645 million investment pledged to community pharmacies in 2023-25 have concluded. The government's primary care recovery plan is to be announced in a "few weeks" and negotiations for the Community Pharmacy Contractual Framework (CPCF) from April 2024 will begin. She said: "We have finished the substantive discussions on the recovery plan but detailed discussions about implementation are ongoing and we are awaiting final clearance from the Government and the NHS. "We hope that we will be in a position to make an announcement in the next few weeks and that negotiations on the CPCF from April 2024 will commence soon after that." Morrison reminded attendees that the Primary Care Recovery Plan is "to improve access to primary care by investing £645 million over the remainder of the year".

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.