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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.

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.

An executive director of Day Lewis and also board director and member of Association of Independent Multiple pharmacies (AIMp) Jay Patel highlighted the key issues and on ground challenges faced by the community pharmacies in a meeting hosted by Prime Minister Rishi Sunak and health secretary Steve Barclay in Downing Street on Saturday (January 7) to tackle the NHS pressure. In his interview with BBC, he said: "He (prime minister) was very engaging and trying to understand the key issues and practical challenges on the ground." Patel described the meeting atmosphere as 'collaborative and proactive', and said, "people were genuinely asked their options and there were listeners too." On BBC, answering to a question on 'how community pharmacies can alleviate the NHS pressure?', Patel said: "Pharmacies is the workplace for this. We have trust of our patients; we have high skilled workforce both clinically and professionally. One of the opportunities we have is working around the acute treat

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

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."

The National Pharmacy Association (NPA) has announced that the Chief Pharmaceutical Officer for England, David Webb will be among the keynote speakers at the Pharmacy Odyssey Conference on 13 October. He and other special guests will discuss the future of community pharmacy within the NHS, during a day of insight and practical advice for pharmacy teams. The NPA promises expert opinion on the current pressures in the sector and a thorough exploration of the long-term picture. NPA Director of Membership, Simon Tebbutt, explains: "With the NPA centenary in 2021 behind us, this will be a foray into the future - mapping the coming decade, and next half-century - as well as covering the many challenges of the present time." The theme of the conference, to be held online and sponsored by Novo Nordisk, is Pharmacy Odyssey: Services, Supply and Sustainability.

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."

Leaders from across the pharmacy sector and trade bodies dwelled on the challenges faced by the pharmacists at the Sigma Conference held on Sunday (2 October). "If the cost of carrying out regulation is higher than the benefits, it's time for all the bodies to sit together and talk on what can be adjusted accordingly," said Salim Jetha, Chairman, Avicenna. Jetha highlighted the challenges faced by the independent pharmacy and also raised the concern about the 'level playing field' for pharmacists compared to GPs. He said: "GPs get paid for energy cost, premises cost, the staffing cost. We don't get paid for that. So don't be misled by saying we are being exactly the same. Yes, on paper we are, but in reality we are not. I think also the rules of engagement are different." He called for better collaboration with GPs, and urged PSNC and other trade bodies to ensure a level playing field. Janet Morrison, CEO, Pharmaceutical Services Negotiating Committee(PSNC), warned that the pressure in the sector is building up to a 'breaking point'.

The Pharmaceutical Services Negotiating Committee (PSNC) has published an update on the work it is doing as part of the Transforming Pharmacy Representation (TAPR) Programme to take forward the mandate from contractors to deliver the Review Steering Group (RSG) recommendations. The update is primarily aimed at LPCs - with whom PSNC has been working closely on some of the TAPR work over the summer. The TAPR Programme is being undertaken in support of PSNC's work to address the severe challenges facing the community pharmacy sector at present. Alongside ongoing negotiations with Government and the NHS, two of the TAPR workstreams - focusing on Vision and Strategy, and on Influencing and Negotiation - are essential to supporting CPCF negotiations. "The workstreams are looking at the future of community pharmacy and how best to persuade policymakers to implement a shared vision, with their objective being to put the sector in a stronger position going into future CPCF negotiations," said PSNC.

MP Steve Brine, the chair of the health and care committee, said that the healthcare in the UK "doesn't work without pharmacy". The inquiry focuses on addressing current issues, particularly around the "funding model, digital infrastructure and workforce recruitment, training and retention." Brine said at the Sigma annual conference on Sunday, that he wants to "focus on the sector", and "drill down into some of the challenges and potential" that lies ahead. "The Health and Social Care Committee, we think about much of our work through the lens of pharmacy, what role it plays, the quality of care that it delivers, and the potential for it to do more," said Brine. He further said that he wants to "build on the groundwork" and to "cover as many of the different pharmacy services within the pharmacy sector as we can, so pharmacy in our communities, in hospitals and general practice".

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.

The National Pharmacy Association has published a medium-term prospectus for the development of pharmacy services, calling it a challenge to old ways of thinking and an opportunity to redefine the sector's role in the NHS. It follows months of dialogue with NPA members about what a clinical future could look like for the sector. The document - Making Changes Meeting Needs - will be shared with the King's Fund and Nuffield Trust who are currently working on a new vision for the future on behalf of Community Pharmacy England. NPA chair, Nick Kaye, said: "Building out from the existing portfolio of services, there are some major opportunities within this decade, encompassing prevention, medicines optimisation, long term medical conditions and urgent care.

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.

The Pharmaceutical Services Negotiating Committee (PSNC) has rejected Department of Health and Social Care (DHSC) and NHS England's proposal on price concessions reform and relief measures to ease pressure on pharmacies. The Committee called the proposal 'insufficient' to meet the sector's needs considering the impact of the current crisis, reflecting on the economic pressures that accelerated through the autumn and winter. The Ministers and other decision-makers have shown their interest in the potential role of community pharmacy, particularly in using a Pharmacy First approach and making use of PGDs and the skills of independent prescribers. But the Committee had made clear to them that without new money this is all a pipedream. "We need an urgent injection of funds into the sector, otherwise we will continue to see a degradation of services and eventual collapse of the network. The Committee is clear that there is no further place for warm words while pharmacy collapses," said PSNC. The Committee reflected that the 5-year CPCF agreement had been based on working together to create the capacity and context necessary to deliver the shift towards greater service delivery. Not only has that capacity-release not happened due to slow progress by Government, but pharmacies have also been burdened with these additional, and insurmountable, challenges.

The Company Chemists' Association (CCA) has raised concern that pharmacies may face challenges in providing placements to pharmacy students graduating in 2025 due to shortages of designated prescribing practitioners (DPPs). From the academic year 2025/26, all pharmacy students will be required to complete 90 hours of training with designated prescribing practitioners prior to their registration. However, the CCA has raised doubts regarding the availability of these healthcare professionals to provide such training. The association said: "We are concerned that pharmacies will be unable to secure DPPs. This will result in a significant reduction in the number of Foundation Pharmacist placements available within the community pharmacy sector. Consequently, a significant number of graduates leaving university next year will, unfortunately, struggle to find employment in their chosen career." As per the CCA, they have repeatedly raised their concerns with NHS England and cautioned them about the potential consequences arising from the lack of DPPs.

Victoria Atkins MP, the new Secretary of State for Health and Social Care, visited NPA board member Sukhi Basra (L) at CliniChem pharmacy in Central London on Thursday (16 November). Basra was accompanied by NPA Chief Executive Mark Lyonette. This was among Atkins' first appointments following her recent promotion in the recent Cabinet reshuffle. Atkins met with staff and patients to explore clinical services and discuss the evolving role of the community pharmacy sector. "Welcoming politicians and officials to my pharmacy is always a pleasure," Basra said. Basra highlighted the opportunity to brief the Health Secretary on the latest developments, including Pharmacy First.

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 and Social Care Select Committee (HSCC) on Tuesday held the first session in their pharmacy inquiry, with a panel of experts discussing the key issues facing community pharmacies in the country. Representatives from community pharmacy associations highlighted some of their biggest challenges and their vision for the future, as well as actions that government and NHS England can take to address those challenges for a better future for the sector. Opening the session, the Committee's vice-chair, Rachel Maskell MP, asked the representatives if they felt the government was ambitious enough in what it believes community pharmacy can do to address NHS pressures, or are pharmacists being held back by issues around workforce funding, contracting, and technological changes. Malcolm Harrison, Chief Executive, Company Chemists' Association (CCA), expressed that the government is not ambitious enough, saying "there's always opportunity to be more ambitious".

Now is the best time for community pharmacy to integrate its model of NHS representation and support to ensure better outcomes for contractors, said James Wood, director of Contractor & LPC Support, Pharmaceutical Services Negotiating Committee (PSNC). It is important for the sector to adapt to the new landscape and address challenges such as workforce, digital data, integration of pharmacy services, and medicines optimisation, he said during the first session of the sixth annual Pharmacy Business Conference held online on Tuesday, September 21. Under the new system, every part of England will be covered by integrated care systems (ICSs) from April 2022. ICSs have been created to bring about big changes in how health and care services in England are planned, paid for and delivered. They are a key part of the direction of travel for the NHS as outlined in the NHS Long Term Plan.

With the government gearing up and pushing community pharmacies in England to adopt the hub and spoke dispensing model, stakeholders of the sector and industry leaders analyse the pros and cons related to the new concept. The model rose to prominence in 2015 in community pharmacy and the medicine supply chain in the UK, and has undergone a few consultations and reviews at the professional and governmental level since then. From a broader perspective, the industry agrees that the model will bring in efficiency to the system, much needed amid community pharmacy's flat funding settlement in England, at the same time highlighting some real challenges. The National Pharmacy Association (NPA) has so far released three reports on this matter and a review of the challenges and enablers of the hub and spoke in the UK in 2016. Besides, a review of international evidence and the report of a roundtable meeting was brought together in the supply chain with government and regulators in early 2020.