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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.

Community Pharmacy England (CPE) is inviting community pharmacy owners to share their insights and views about increasing Pharmacy First thresholds and the effects of GP collective action on their pharmacies. This feedback will be discussed at the upcoming Community Pharmacy England Committee meeting in September. During the meeting, the Committee members will also discuss urgent matters including the 2024/25 negotiations, collaboration with the new government, and their ongoing strategies. A key point of discussion will also be the effects of GP work-to-rule action on community pharmacies. CPE has raised concerns that many pharmacies might face challenges meeting the scheduled increases in the monthly Pharmacy First payment threshold, noting that pharmacy owners are already considering their options if they start failing to meet the threshold. In response to concerns from Community Pharmacy England, Ministers have recently agreed to lower the August threshold from 20 to 15.

In response to concerns raised by pharmacy owners, the government has decided to adjust the August threshold for the Pharmacy First service from 20 to 15 clinical pathways. The ability of pharmacy owners to achieve the thresholds for the monthly Pharmacy First payments has been a topic of great concern. Community Pharmacy England (CPE) has been actively discussing this issue over the last few weeks with the Department of Health and Social Care and NHS England. Ministers have now decided to adjust the August threshold for the Pharmacy First service to 15, CPE announced today (July 31). Commenting on this decision, Janet Morrison, CEO of Community Pharmacy England said: "We are pleased that Ministers have listened to our concerns and acted quickly to make an adjustment so soon after coming into office."

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."

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 Pharmacists' Defence Association (PDA) has undertaken an additional survey of pharmacists employed in the NHS, before deciding to hold their first-ever ballot for industrial action. The PDA has more than 7,000 NHS-employed pharmacists in membership and the union is actively considering balloting those members regarding strike action. The association said: "The experience of some other unions has shown that the government's restrictive rules, designed to make it difficult for working people to lawfully take industrial action, means trade unions should test members' strength of feeling before balloting." "Trade unions are not only forced to rely upon postal ballots, but for lawful industrial action to be taken, the result must also meet three tests- at least 50% of eligible voters must vote; at least 40% of eligible voters must vote 'yes' and a majority of votes must be for 'yes'." The association is asking members in England, Northern Ireland and, Wales to show if their collective wish, insignificant enough strength, is for strike action. PDA has emailed the survey to all its members in the NHS in the three nations and will close on Tuesday 3 January.