Community Pharmacy England has submitted a full and detailed written response to the Health and Social Care Select Committee's pharmacy inquiry.
The Committee is expected to hold oral evidence sessions when Parliament returns in the Autumn. The commencement of this inquiry follows on from those held on
other primary care sectors, including Dentistry and General Practice.
According to the Committee website this inquiry 'will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and
hospital pharmacy services'.
Key themes of CPE's submission include- Suggestions on future service provision; Challenges with the pharmacy workforce; Longstanding underfunding of the sector;
and Current pressures.
Janet Morrison OBE, Chief Executive of Community Pharmacy England, said: "This is an extremely important opportunity for all who work with and in the Pharmacy
sector, to highlight not only the extreme challenges we face, but also ideas and suggestions for what more we can do to help patients and the public in the future.
Achieving the community pharmacy vision necessitates legal adjustments and additional funding beyond recent boosts, the pharmacy vision document published
by Nuffield Trust and The King's Fund has revealed. It says community pharmacies in England must adapt to changing population needs amidst unprecedented health
and care challenges.
Commissioned by Community Pharmacy England, the report titled 'A Vision for Community Pharmacy', published on Sept. 19, is a result of almost a year of research
and extensive consultation with the sector and wider stakeholders, advocating for community pharmacy. The think tanks detail a shift in the community pharmacy
sector, highlighting how pharmacies can contribute to crucial policy objectives regarding population health, prevention, and the increasing demand in primary care.
"The health and care needs of the population are evolving, and pharmacies in England, like all components of the health and care system, must adjust to address
these changes," said Helen Buckingham, Director of Strategy at Nuffield Trust.
Pharmacy bodies have urged the Health Select Committee to hold the government to account on pharmacy funding and workforce challenges.
In a show of unity, leaders from the sector came together to write a joint letter to the chair of the committee and former health secretary Jeremy Hunt and bring to
his attention how financial pressures worsened by nearly a decade of a real-term decrease in funding have made the sector virtually untenable.
The Pharmaceutical Services Negotiating Committee (PSNC)'s recently published 'Pharmacy Pressures Survey' confirms how this has had an impact on pharmacy contractors,
their teams as well as patients.
The survey found that 91 per cent of pharmacies are experiencing staff shortages. At the same time, demand for community pharmacists has risen - nine in ten pharmacy
teams reported a significant increase in phone calls from patients about prescriptions, and 86 per cent reported a rise in requests for healthcare advice.
The letter to Jeremy Hunt is signed on behalf of the four chief executives of the PSNC, the Association of Independent Multiple Pharmacies (AIMp), the Company
Chemists' Association (CCA) and the National Pharmacy Association (NPA).
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.
The 'SaveOurPharmacies' roundtable held on Tuesday (21 March) to discuss severe challenges faced by the community pharmacies in England witnessed the support
of 15 MPs.
Janet Morrison, Chief Executive, Pharmaceutical Services Negotiating Committee (PSNC); Andrew Lane, independent pharmacy owner and Chairman, National Pharmacy
Association (NPA) and Ian Strachan, independent pharmacy owner and Board Member, Association of Independent Multiple Pharmacies (AIM) attended the summit, which
was chaired by Stephen Hammond MP, to brief MPs on the severe challenges facing the sector.
MPs in attendance were Stephen Hammond, Sally-Ann Hart, Peter Aldous, Anna Firth, Taiwo Owatemi, Bob Seely, Derek Thomas, David Rutley, Lilian Greenwood, Tulip
Siddiq, Hillary Benn, Sarah Olney, Christian Wakeford, Daisy Cooper (researcher) and Victoria Atkins (researcher)
The title of the event 'Community pharmacy's role in the Primary Care Recovery Plan' which is expected imminently, is set to include a variety of measures aimed at
helping primary care to recover from the impact of the pandemic.
PSNC has been pressing for the plan to include a fully-funded national Pharmacy First service as this is the best chance for getting significant additional funds
into community pharmacies.
The All-Party Parliamentary Group (APPG) on Pharmacy published a new report on Monday (January 23) that calls for "urgent action" to relieve funding pressure
so there are "opportunities" for community pharmacy teams to deliver even more for their patients.
The report highlights the need for a new "strategic vision" for pharmacy and highlights opportunities for the network to be empowered to deliver even more for
patients.
However, the manifesto also underlines that there are the very real risks that this opportunity may be lost if significant and ongoing pressures are not addressed.
The recommendations are based on written and oral evidence gathered from frontline pharmacists, GPs, professional bodies and healthcare experts.
To harness the potential of pharmacy, the report recommends the Government must take urgent action to relieve the funding pressures on the community pharmacy sector
in the short term and review the long-term funding model for pharmacy.
It also suggested the Government must harness the power of pharmacy to help the NHS deal with the COVID-19 backlog and the UK's growing healthcare challenges.
It further recommended that future commissioning and funding must recognise that community pharmacy is the front door to the NHS for many patients.
We're approaching that time of year where the sun is supposed to be shinning and things are supposed to quieten down over the summer holidays
(note I said supposed to. . . well we have the sun at least).
The elections are over, and a new party is in power. Wes Streeting is the Secretary of State for Health and Social Care. He's met with GPs and Dentists and has
great ambitions for Primary Care but when will he meet with community pharmacists?
To be fair to Wes, he did visit a local pharmacy in his constituency, with CPNEL last year as Shadow Health Secretary (and was a guest speaker at the Pharmacy
Business Awards 2023). He has also had meetings with NPA and CPE, so we know he understands the value of Community Pharmacy. The question is, do we as a sector
and profession need to shout louder so that we aren't forgotten about, as healthcare plans are being drawn up?
Community Pharmacy is a humble sector, not unlike most other HC sectors. The difference is that we often get forgotten. I have lost count of the times I've heard
in meetings or conversations "Primary care and community pharmacy. . ." totally disregarding the fact that we are part of primary care.
The Association of Independent Multiple Pharmacies (AIMp) has called upon all pharmacy organisations to unite and collectively represent the sector. While
underlining the need for the sector to adopt a straightforward manifesto that can be presented to the public, politicians, and decision-makers, the association
also advocated for a revitalisation of the 'Save Our Pharmacies' campaign, injecting it with renewed energy and a stronger sense of purpose.
AIMp pointed out that a lack of cohesion is one of the factors contributing to the sector's struggle in gaining attention. "The current trajectory of community
pharmacy is unsustainable," said Dr. Leyla Hannbeck, Chief Executive of AIMp. "To tackle the significant challenges ahead, we must work together cohesively. The
most effective approach is to actively engage with Parliament, leveraging politicians from across the political spectrum to advocate for our cause."
Meanwhile, the association urged various pharmacy bodies to unite in support of the Pharmacy All Party Parliamentary Group (APPG) to enhance its effectiveness
and broaden its influence, rather than working independently.
We have been specialising in community pharmacy sector for over 30 years and have helped many pharmacists acquire their first pharmacy. We have seen several
of those first-time buyers transition into multiple pharmacy owners under our specialist guidance and support through the years.
Acquiring the first pharmacy can be a challenge to most pharmacists especially when they do not have the necessary skill in reading the numbers presented in terms
of the target pharmacy's performance and how to interpret these in order to arrive at a valuation for the purpose of submitting an offer.
Without the guidance of a specialist accountant in community pharmacy, one of the major risks is that one could end up paying more than what the pharmacy is worth.
Once the offer is accepted, there are other challenges to overcome to get the deal over the line.
1) Assessing the risk
2) Valuation of the business
3) The negotiation process
4) Asset or company purchase
5) Financial due diligence
6) Asset/share purchase agreement
7) Finance the purchase
At last Friday's Clinical Congress Conference, the NHSE Chief Pharmaceutical Officer for England at NHS England, David Webb, announced the upcoming launch
of the Pharmacy Stakeholder Forum- an initiative led by NHS England aimed to improve pharmacy professional leadership and foster collaboration within the sector.
Webb highlighted the forum's significance as a platform for driving transformative change in pharmacy leadership.
"The aim is to deliver collaboration to develop a stronger and more united voice for pharmacy professionals," Webb emphasised.
Highlighting the need to drive transformative change in pharmacy leadership, he underscored that "the overarching goal is to address key challenges facing the
pharmacy profession and chart a course for future development and innovation."
Scheduled to commence in June, the Pharmacy Stakeholder Forum will provide a space for diverse organisations and networks with a vested interest in pharmacy
professional leadership to converge.
Data crunched by an online pharmacy delivery company paints a concerning picture for the pharmacy sector in England.
Gophr's 'Prescription For Pressure' initiative reveals a challenging time for the sector and is supported by separate analysis by the BBC showing that the number
of pharmacies in England is at its lowest since 2010.
In addition, new powers being introduced for pharmacists to prescribe common prescription drugs and perform routine tests create an even greater workload for already
overstretched pharmacists.
Gophr's data reveals that:
* Each pharmacy in England serves an average of 6,078 people.
* In 2022, pharmacists dispensed 1.043 billion prescriptions, 26.3 million more than 2021.
* A single pharmacy in England dispensed 248 prescriptions a day on average in 2022.
Based on the most up-to-date statistics from the Office for National Statistics, NHS England and Statista, Gophr's calculations show that pharmacists have around 116
seconds to dispense a prescription, which is less time than the 180 seconds it takes to make a Quarter Pounder at McDonald's.
In a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE),
Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges.
Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival.
"There have been no years of financial and operational squeezes applied by the NHS and
government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival,"
he said.
Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative
initiatives like the Discharge Medicine Service and Contraception Service.
The General Pharmaceutical Council (GPHC), Royal Pharmaceutical Society (RPS), Company Chemists Association (CCA), Association of Pharmacy
Technicians UK (APTUK), National Pharmacy Association (NPA), Guild of Healthcare Pharmacists, Pharmacists' Defence Association (PDA), and Independent
Pharmacies Association (IPA) have released a joint statement in response to the far-right riots across the UK.
They emphasised their united stance, declaring zero tolerance for racism towards colleagues or the public in any form.
The joint statement reads: "We are shocked and saddened by the violent public disorder events in recent days.
"We acknowledge how all sectors of the pharmacy profession may be impacted and recognise the challenges that this level of overt aggression can have on
people's ability or willingness to live their daily lives.
"The pharmacy workforce deserves peace and safety, not fear and harm. We stand united in having a zero tolerance of racism towards our colleagues or the
public in whatever form it takes."
Meanwhile, Community Pharmacy England (CPE) has expressed concerns that protests and violent disorder in various towns and cities across England may impact
the ability of community pharmacies to operate.
Professional leadership bodies from around the world discussed workforce shortages in community pharmacy and other challenges affecting the sector at a global
meeting held in Paris last month.
Delegated from Denmark, Australia, Ireland, New Zealand, Portugal, Spain, US and the UK updated the conference on how the profession was progressing in practice,
technology and workforce development in their respective countries.
The UK was represented at World Pharmacy Council meeting by National Pharmacy Association chair Andrew Lane and chief executive at the Pharmaceutical Services
Negotiating Committee Janet Morrison.
Lane said: "It's very useful to be part of a global network of pharmacy bodies who are all going through similar challenges as we are in the UK. Sharing intelligence
on other pharmacy systems around the world helps us to prepare the right strategy for engaging with the NHS at home.
"Hearing some of the strides in services and digital technology in the profession gives us hope for the future of the sector. It's clear however that key challenges
such as workforce shortages are starting to have an effect in other parts of the world too."
Pharmacy bodies have welcomed the new minister in charge of the profession amid warnings that he will find the sector in a state that is "more fragile that
ever" due to "untenable funding and workforce pressures".
Neil O'Brien was re-appointed as parliamentary under secretary of state in the Department of Health and Social Care (DHSC) on October 25 and was later assigned the
pharmacy brief.
The Conservative MP for Harborough - who will have a wide-ranging portfolio of responsibilities, including primary care and pharmacy - has taken over the position
from Will Quince MP, who had a brief stint as pharmacy minister but remains at the department on a different role.
O'Brien was was handed a junior minister's job at DHSC on 7 September 2022 in the government led by Liz Truss but fellow Conservative Quince was assigned primary
care duties including pharmacy.
Welcoming him to his new role, The Company Chemists' Association said that the minister would find that the community pharmacy sector was "more fragile than ever"
with untenable pressures over funding and workforce.
The Department of Health in Northern Ireland has advised pharmacies to continue providing rota services on Easter after learning that many pharmacies are
unwilling to provide the services on Easter holidays.
"It is extremely regrettable that community pharmacy representatives have advised that access to rota pharmacies in some parts of Northern Ireland will be reduced
over the Easter holidays," department said.
They have also stated that despite a commitment of recurrent investment, support for new patients assessed by Trusts as requiring blister packs may be restricted.
These actions have the potential to impact on patients and other parts of the Health and Social Care system.
The department has also called the CPNI's demand to increase the funding up to 50 per cent in the sector "unrealistic" in the current financial climate.
It said: "Financial pressures across the entire NI public sector are severe with an extremely challenging health budget anticipated for 2023/24."
"The Department is therefore facing a significant funding gap just to maintain existing services and the whole Health and Social Care system is an extremely
unpredictable and fragile position. The core funding envelope available to community pharmacies in NI has increased by 16% over the past three years."
Preet Kaur Gill, Shadow Minister for Primary Care and Public Health, has paid a recent visit to a community pharmacy in Staffordshire to personally experience
the services it provides to patients, while staying updated on the latest sector developments.
Her visit to Eason's Pharmacy in Tamworth on September 22nd marked her first since assuming new responsibilities for pharmacy policy matters within Labour's health
team. Gill was also joined by a member of the National Pharmacy Association staff.
The Minister received a comprehensive briefing on Eason's Pharmacy from its third-generation owner, Kieran Eason (R). He outlined the NHS services, which include
the New Medicines Service and blood pressure monitoring, and showcased two consultation rooms and an operational dispensary.
"It's great that Preet came to learn firsthand about the challenges we face and the substantial potential of community pharmacies nationwide," Eason said. "As an
independent prescriber, I have the expertise to provide even more convenient care, but the current funding levels severely limit our contribution."
The Pharmacy Supervision Practice Group consisting of members from AIMp, APTUK, CCA, NPA, PDA, PFNI and RPS held its fourth workshop to continue discussions
on the future modelling of pharmacy practice.
The ideas around 'supervision' shared by the organisation earlier formed the basis of the discussion during the workshop and helped to expand understanding of where
there was consensus and disagreement.
Examples of ideas explored during the workshop include: the extent to which a pharmacist should supervise the medicines assembly process, the purpose and extent to
which a pharmacist might be absent from the pharmacy and how this might affect patient safety as well as the nature of whether fixed rules versus a broad framework
were preferable for future practice.
Chair of the group, Dr Michael Twigg, Associate Professor of Primary Care Pharmacy, University of East Anglia, said "Once again the sector bodies have come together
in a collaborative and positive manner to explore the concept of 'supervision' in the context of current and future community pharmacy practice. This session provided an opportunity to constructively challenge assumptions and viewpoints within the group with the aim of moving the discussion forward."
As part of the session, the DHSC, GPhC and PSNI gave an overview of the difference between legislation, regulation and guidance which was helpful to inform the
group's thinking. Each of the organisations have been asked to use the conversation to refine the ideas presented in advance of the next workshop.
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."
Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health
and Social Care Committee Steve Brine has said.
Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility
into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a
parliamentary debate focused on the future of community pharmacies on September 14.
From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible
solutions for a sustainable future in the sector.
Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs
Taiwo Owatemi and George Howarth among others.