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Community Pharmacy England (CPE) highlighted the untapped potential of community pharmacies in the prevention and management of long-term conditions to Conservative MPs during an event last week. The roundtable discussion was attended by a select group of influential and supportive MPs alongside community pharmacy owners, the Chief Executive of Community Pharmacy England, the Director of NHS Services, and patient representative group Healthwatch. MPs in attendance included Steve Double, MP for St Austell and Newquay, who chaired the discussion; Will Quince MP, former Minister for Pharmacy, Derek Thomas MP, Sir Peter Bottomley and Peter Aldous MP. They talked about the current pressures and funding crisis in community pharmacy, exploring solutions on how this could be eased and the huge benefits that can be unlocked.

Shortage of pharmacists remains a big challenge for community pharmacies as the chief executives of the national community pharmacy bodies met with senior NHS England and NHS Improvement officials to discuss the precarious situation in October-end. In the last few months, several pharmacy contractors have reported increased staff shortages that caused difficulties in maintaining services, leading to temporary closures in some instances. The sector is also facing chronic shortage of other staff including van drivers and pharmacy technicians. During the meeting, NHS England's director for primary care, Ed Waller, and chief pharmaceutical officer Keith Ridge held talks with leaders from across the pharmacy sector on a variety of topics.

In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.

Those of us who work in community pharmacy know there is a workforce crisis created in large measure by PCNs actively recruiting pharmacists and pharmacy technicians from our sector. It is welcome, if long overdue, that this has now been officially acknowledged in a report commissioned by the English Health Secretary. PCN hiring 'exacerbates pharmacist shortage' says DH-commissioned report, which states such recruitment has "on occasion exacerbated the problem of a general shortage of pharmacists" which has compounded "the problem of community pharmacy closures." We have been telling the government this for years only to be told "problem? What problem?"- but now that Steve Barclay has his own official report sitting on his desk, he and NHSE cannot continue in denial mode. The facts are there for all to see. Time to act. No more dithering, delay or indifference. You asked if there was a problem and you have been told there is. In the absence of a holistic workforce strategy and cross-sector career pathways, PCNs poaching from community pharmacy is a zero sum game adding nothing to improving patient care.

Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching. More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice. Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit. The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists. Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.

There is a state of "emergency" across the community pharmacy sector, the National Pharmacy Association (NPA) has warned. The organisation is holding a day of protest action, called 'One Day to #SaveOurPharmacies', on 20 June to draw attention to the sector's growing crisis. During the protest, pharmacy teams across the UK are expected to take a range of symbolic actions - such as turning the lights out for a period, asking their staff to wear black, blacking out windows, using the day to engage with patients, inviting parliamentary candidates and using #saveourpharmacies on social media - signifying dark times for the beleaguered community pharmacy sector, the NPA said. The organisation decided to choose 20 June for the protest as it marks the day from which the average pharmacy across the four nations will be "lossmaking overall."

Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015. It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders. The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector. The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a result, maintaining prescription and medication adherence services is challenging to say the least. Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services since the start of COVID. This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported clinically by pharmacists. This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations a year - a staggering rise of 44 per cent in the last 24 months alone.

Labour MP Barry Gardiner has raised concerns that the £645 million cash injection announced by the government for community pharmacy is, in effect, 'frozen funding' for the next two years. Speaking on Tuesday (May 9) on the BBC's Politics Live, Gardiner said funding for community pharmacies "was cut before 2015, then it was frozen and now the latest announcement says that it's going to be frozen for a further two years." He said with a current national contract, which already represented a 25 per cent funding cut in real terms, it was not appropriate to ask for community pharmacy "to take on more work" without adequate support. "I heard the prime minister earlier this morning (May 9) on TV saying 'we are investing more in pharmacies'. "No you are not. You just concluded a contract that says for the next two years it will be absolutely flatlined." He added that "there will be no more money" for community pharmacy and that steeply rising costs due to inflation were "eating into that contract's health". Gardiner said community pharmacists "do a phenomenal job" but regretted that from a total of just 11,000, some 700 pharmacies have been lost due to funding cuts.

The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday (15 November). The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on the front-line and were briefed on the urgent need for action to address the pressures on the sector. Outline of the four-point plan: Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to get through this winter. Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free up capacity and freed from red tape that does not enhance patient care. Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.

Pharmaceutical Services Negotiating Committee (PSNC) has asked the government and the NHS to give more support to all community pharmacies as they gear up for "an extremely challenging winter period." During talks with NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC) last week, PSNC highlighted that contractors are already under pressure because of workforce crisis, capacity issues and escalated staffing costs. all these factors could pose a bigger challenge during the busy winter season, it said. Though PSNC supported the government's aim on booster vaccinations and approval of more pharmacy sites, it expressed concerns over the impact of the vaccination drive on all community pharmacies. To ease the pressure on pharmacies, the negotiator has sought additional support through regulatory measures, the removal of administrative burdens and changes to the current Pharmacy Quality Scheme (PQS).

The 14th Community Pharmacy Conference by Sigma Pharmaceuticals has been timely, prime minister Rishi Sunak said, noting that it coincided with the launch of Pharmacy First, a new initiative that enables patients to receive treatments for seven common conditions directly from a pharmacist without the need for a GP appointment or prescription. "We are all grateful for the tremendous contributions that pharmacists make to our NHS. The fantastic work you do is critical to the success of Pharmacy First and many other initiatives," Sunak said in a written message. The conference was organised from 25-29 February at Sun City in Johannesburg, South Africa, under the theme 'community pharmacy in an integrated NHS'. In a recorded video address to the Sigma Conference, shadow health secretary Wes Streeting said community pharmacies are 'critical' to the Labour party's mission to make the NHS 'fit for the future'. "You should be playing a much more significant role. Labour's reform agenda will get pharmacists working to the top of their licence. We want community pharmacists to play a greater role in healthcare, with more focus on their expertise in prescribing and medicines management," he said.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."

Pharmacies across Northern Ireland are in financial turmoil, reporting that they are dispensing prescription medicines at a loss due to inadequate reimbursement from the Department of Health (DoH). This crisis has led to the closure of almost a dozen pharmacies over the past 18 months, with many others struggling to stay open. Siobhan McNulty, who runs Melvin Pharmacy in Garrison, County Fermanagh, described the dire situation. "We're dispensing medicines at a loss," she said. "The reimbursement rates don't match the cost of the drugs, and we're left to cover the gap." McNulty relies on sales of non-pharmaceutical products to keep her business running.

A combination of factors, including the doctors' strike, medicine shortages, and funding scarcity, indicates that this upcoming winter could be the most challenging period for both community pharmacies and the NHS, Community Pharmacy England has said. In a September 4 blog post, CPE Chief Executive Janet Morrison emphasised that the relentless pressures show no signs of easing. "Pharmacy businesses, like numerous other sectors, are grappling with the challenges of staying afloat in the current economic climate, compounded by the detrimental effects of historical funding cuts." "The doctors' strike, despite ongoing assurances from the Health Secretary that their pay deal is final, will inevitably exacerbate the demand for both primary and secondary care, leading people to turn to their local pharmacies for assistance," she added. "This, in turn, will heighten the pressure on community pharmacies." "Whatever the coming winter brings I am sure of two things: that community pharmacies are going to be more critical to the health of the population than ever before, and that your representatives here will be fighting on all fronts to get you the help that you need."

The National Pharmacy Association (NPA) survey revealed that 93 per cent of respondents experienced 'at least one month' of negative cash flow across their pharmacy business in 2022. Nine out of 10 pharmacy owners responding to NPA survey said they made a net loss dispensing medicines for the NHS during 2022, for at least one month of the year. According to the poll, 48 per cent of them lost money on this core NHS service for six months or more. 45 per cent said their overall outgoings had exceeded overall income in at least six months of the year. NPA Chair Andrew Lane said: "This survey shows the bleak financial reality facing many independent pharmacies after years of underfunding. Dispensing at a loss and negative cashflow is clearly unsustainable." "This funding crisis must be addressed urgently or pharmacies will fall into a spiral of declining services and ultimately widespread closures, he added. "Tragically, the story is playing out very much in line with independent research commissioned by the NPA last year, which warned of a nationwide financial emergency in our sector."

Amid media speculations that a large pharmacy multiple was putting all its stores at risk of closure, PSNC supremo Janet Morrison said the sector was in crisis and in danger of a significant collapse. Addressing delegates via a video link at Sigma Pharmaceutical's 13th Annual Community Pharmacy Conference held last week (March 4 -9) in Punta Cana, Dominican Republic, she said while "a lot of consolidation or sales" would continue, a lot of the smaller, independently-owned community pharmacies - which had to work harder and harder to make ends meet - were just "hanging on in there". "But I don't know how much longer people can go on," she said, adding that the risk of actual closure was rendering the remaining pharmacies so fragile that "they may not be able to pick up the slack of many thousands of patients" who would need repeat prescriptions. "The disruption is frightful and awful. We have got 53 per cent of the population on repeat prescriptions, so that matters." Her comment on the opening day of the conference was a sober reminder that the sector - which relies heavily on income from prescriptions - couldn't afford to "carry on with the current format of a contract and the current amount of money" it was paid to deliver numerous tasks which have been heaped on it to share the burden of a crippling NHS.

The Pharmacists Defence Association (PDA) has expressed its interest to support pharmacists impacted with the latest announcement of the closure of Tesco pharmacies. "Tesco have followed ASDA and LloydsPharmacy (at Sainsbury's) to announce cost cutting changes to their stores, impacting hundreds of jobs," the association said. The PDA's interests in the announcement relate to the planned closure of eight in-store Tesco pharmacies and the impact of those closures upon pharmacists, however the union is of course concerned for all those impacted. The PDA Union will support individual PDA members impacted by the decision so that they are aware of, and can exercise, their rights at work in relation to this situation. Paul Day, PDA Union Director said, "In addition to the immediate impact on pharmacists employed at the stores marked for closure, this is the third instance in just twelve days of reductions in the overall access to a pharmacy for NHS patients. We expect those who represent communities to be concerned about the loss of a key part of their local NHS service."

The Pharmacy First service, set for launch in England at the end of January, is expected to help reduce some of the pressure on the National Health Service (NHS). But the question is - Are pharmacists ready to take the extra workload amidst many issues community pharmacies are currently facing? Nearly 50 per cent of pharmacy workers surveyed by ITV News said they do not feel confident they can provide the new services. Pharmacy leaders told the British news channel that the industry is already in crisis, and they are facing a "potentially fatal cocktail" of rising prices, major supply problems and a lack of funding.

Professor Harry McQuillan has said community pharmacists in the UK must change their focus from an 'accuracy of supply' to a 'safety of supply' model when it comes to dealing with patients. "The main take away message from tonight's lecture is for pharmacy professionals to really challenge themselves about whether they are focused on accuracy of supply or safety of supply," he said at this year's UCL School of Pharmacy Lecture in London on Thursday, 15 June. "For our community pharmacists it must be about safety, including prescribing, and ensuring patients and citizens get the maximum benefit from prescribed medicines. "To deliver this, we need to invest in our teams - harness technology and always be willing to take the next step in a more clinical future." The Chief Executive Office of Community Pharmacy Scotland, however, noted that at a time when the UK was grappling with an unprecedented national debt crisis exacerbated by severe cost of living and spiraling inflation, community pharmacy will need to make a "compelling case" of where the priority should be in the sector. Expanding on the financial woes of the country, he compared the current national debt of the UK, which stood at a staggering 270 percent of GDP in September 2022, with the previous record-breaking national debt of 250 per cent at the end of WWII.

As Prime Minister Rishi Sunak announces the forthcoming UK general election, pharmacy bodies are calling on all political parties to commit to solving the issues facing the sector. The next UK general election will be held on 4 July, Sunak announced it on Wednesday afternoon during a press conference outside 10 Downing Street. "As the election is called it's imperative that any incoming government addresses the crisis in primary care and the looming cliff edge facing pharmacies, which for millions of people are the front door to the NHS and a crucial source of frontline health care," said Paul Rees, Chief Executive of the National Pharmacy Association (NPA). Noting that the first responsibility of the government is to keep its people safe and healthy, he emphasised the importance of addressing the "deep funding gap that is pushing record numbers of pharmacies to the edge of closure and beyond, exacerbating the issues of waiting lists for GPs and hospital care."