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The Pharmaceutical Services Negotiating Committee announced last week that it is in discussions with the Department of Health and Social Care (DHSC) and NHS England about relieving capacity pressures, such as a relaxation of pharmacy opening hours requirements. PSNC is also scheduling webinars to talk with contactors about the steps they might be willing to take in future, to cut costs, should emergency financial relief fail to materialise. The pharmacy regulator reported that many of its members felt that it was no longer tenable for pharmacies to keep offering all of the free and non-core services to patients that they would like to, and that all contractors should consider what steps they could take to try to safeguard their businesses and their core services for patients. PSNC is also keen to talk to contractors about their current situation and the steps they might be willing to take in future, should emergency relief not be forthcoming.

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 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.

In an oral parliamentary debate on community pharmacy held on Monday (20 March), the government was asked for an indication of 'how much it would cost to make the best use of community pharmacies'. A number of Peers at the House of Lords spoke out in support of pharmacies, while others asked when would the government address the current crisis in the sector. Kicking off the session, Baroness Hodgson asked the responding minister, Lord Evans, about recent pharmacy closures as well as underfunding. She asked whether the government would 'enter into discussions with PSNC to look at introducing a fairly funded pharmacy first service as soon as possible which will help relieve the work load on GPs'. The minister responded: "We have already introduced and funded a range of service in community pharmacy that make use of the clinical skills of pharmacy teams… we continue to discuss with PSNC how the government can best support the sector to provide support to patients." The House of Lords oral questions session was opened by Baroness Hodgson on behalf of Baroness Cumberlege as follows: "To ask His Majesty's Government what plans they have for making the best use of community pharmacies".

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information. Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of Services (DoS) profile information is kept up-to-date. The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been introduced to make the process as quick as possible and it can be done on either a smartphone or computer. PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacy contractors that they have two weeks left to claim an Aspiration payment for the Pharmacy Quality Scheme (PQS) 2022/23. The window for claiming the payment will close at 11.59pm on 4 November 2022. "The Aspiration payment is optional; if contractors do not want to claim it, it will not impact on the contractor's ability to claim a PQS payment during the declaration period. There is also no requirement to have claimed for a previous PQS to claim an Aspiration payment for PQS 2022/23," said PSNC.

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 Pharmaceutical Services Negotiating Committee (PSNC)'s North-East and Cumbria regional representative, Mark Burdon, has resigned from his role. The Committee has invited all eligible independent contractors to fulfil the post. The new regional representative will be asked to hold the position until the end of the current term for all Regional Representatives which is now March 31, 2023. "A representative of independent contractors in the following Local Pharmaceutical Committee (LPC) areas will be sought: · Community Pharmacy County Durham · Community Pharmacy Cumbria · Gateshead & South Tyneside LPC · North of Tyne LPC · Sunderland LPC · Tees LPC," said PSNC. Eligible independent contractors from these LPC areas are invited to express their interest in the role and then, if an election is triggered, to vote to select their new regional representative in due course - PSNC will issue a full briefing on this process. Further information, including details about the role of regional representative, the election process, actions required for those seeking to stand for election and timescales, will be shared by the committee with the relevant LPCs and contractors in due course.

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 Pharmaceutical Services Negotiating Committee (PSNC) has shared materials to help community pharmacy in communicating relevant advice to people during this heatwave. The UK Health Security Agency (UKHSA) has issued a heat-health alert for the next few days. It has also published a beat the heat poster, along with its heatwave guidance, which could be used in pharmacies to raise awareness. "During this heatwave, the public may turn to community pharmacy teams for advice about staying well during the hot weather or to seek assistance when feeling unwell because of the heat," PSNC said. It has previously developed materials that may be used by community pharmacy teams to communicate relevant messages contained in the Heatwave Plan for England and the NHS website guidance on how to cope in hot weather.

The specification for the Pharmacy Contraceptive Service has been launched for pharmacy contractors to download from the NHSBSA website. However, the service will not start on 11th January 2023, as originally planned, but it is expected to commence in early 2023, revealed the Pharmaceutical Services Negotiating Committee (PSNC). It added: "The exact start date is yet to be agreed, as now the service specification has been published, community pharmacy IT system suppliers need time to develop support for the service, so this is available to contractors from the service commencement date." Commenting on the publication of the service specification, Alastair Buxton, Director of NHS Services, at PSNC said: "When time in their busy professional lives allows, the publication of the service specification ahead of the start of the new service provides contractors and their teams with an opportunity to learn more about it and to consider whether it is something they will have the capacity to provide in due course.

The new Flat Fee payment to roll out in April 2023 to all pharmacy contractors who dispense at least 101 items a month, up to a national total of £70m on an annual basis. "The value of the Flat Fee payment has now been determined at £533 per month and will be introduced in the April 2023 Drug Tariff," said the Pharmaceutical Services Negotiating Committee (PSNC). "As with all payments, the Flat Fee payments are subject to change throughout the year depending on the overall level of funding delivery to Community Pharmacies. This will be carefully monitored by PSNC and DHSC, and any funding changes will be communicated to pharmacy contractors as soon as they are known," said PSNC.

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 Pharmaceutical Services Negotiating Committee (PSNC) has notified that it is now mandatory to attend face-to-face training for both injection technique and basic life support training periodically for pharmacists and other vaccinators providing the annual flu vaccination service. "Community pharmacy contractors are required to demonstrate that all vaccinators, including pharmacists, providing the flu vaccination service in their pharmacy have the skills needed to do so," said PSNC. Prior to this change, pharmacists and other vaccinators needed to undertake a refresher face-to-face training for both injection technique and basic life support, including administration of adrenaline, every three years. Vaccinator needs to evidence competence PSNC said: "Contractors and vaccinators will now need to consider when it would be appropriate to attend refresher training or if ongoing competence of an individual vaccinator can be evidenced, without the need for face-to-face training. "An individual's continued competence may be influenced by their prior experience vaccinating patients, including the overall number of vaccines administered and the regularity with which they administer vaccines."

The pharmacy bodies have expressed a deep concern over Lloyds Pharmacy's announcement on plans to close all pharmacy branches located in Sainsbury's before the end of 2023. Pharmaceutical Services Negotiating Committee (PSNC) Chief Executive Janet Morrison said: "This significant shrinkage by the second largest pharmacy chain is an extremely worrying development and one of the clearest signals yet of just how much all community pharmacies are struggling to make ends meet. We know that many are at breaking point." She added: "We understand that LloydsPharmacy will be in touch directly with affected staff and patients at this difficult time. As these pharmacies close, other pharmacies locally will be braced for even more pressures as they try to cope with increased demand." "The announcement by LloydsPharmacy will be of concern to staff, patients, the public and the community pharmacy sector alike," Malcolm Harrison, Chief Executive of the Company Chemists' Association (CCA). Pharmacists, and other employees, working at pharmacies owned and operated by LloydsPharmacy in Sainsbury's have been told that the group of more than 200 pharmacies will be closed this year as LloydsPharmacy will be ending their relationship with the supermarket chain.

The government has extended VAT exemption from Monday (1 May) on healthcare services carried out by pharmacy staff under the supervision of pharmacists. HM Revenue and Customs has issued a note detailing the change to the VAT treatment of medical services. The Government said this will bring the VAT treatment of pharmacists in line with other registered health professionals providing medical services to the public. The Pharmaceutical Services Negotiating Committee (PSNC) said: "This is something that PSNC has been seeking Government agreement on for a long time, including in recent CPCF negotiations." PSNC believes that the extension of this VAT exemption will help as community pharmacy businesses try to make better use of the skill mix in their teams both now and in the future. "Not only does it enable contractors to review the VAT status of any locally commissioned services currently provided by non-registered pharmacy staff but also, in time, it could be used to amend nationally commissioned services to allow support staff to provide certain parts. For example, following a recent amendment to the service Directions, pharmacy technicians are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service.

Along with pharmacists, pharmacy technicians in England are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service (SCS). The government has amended Drug Tariff and includes the amendments to The Pharmaceutical Services (Advanced and Enhanced Services) (Amendment) (England) Directions 2023. Pharmaceutical Services Negotiating Committee (PSNC) said: "The service specifications for both services are currently going through NHS England's publication process; when these are published PSNC will alert contractors through their normal communication channels. PSNC resources for both of these services are also currently being updated."

The Pharmaceutical Services Negotiating Committee (PSNC) has issued a revised guidance for the dispensing of controlled drugs in instalments on 19 September that has been declared as a bank holiday for Her Majesty The Queen's state funeral. PSNC said: "Many instalment prescriptions have already been issued in advance of the upcoming Bank Holiday. Where they contain the Home Office approved wording "Please dispense instalments due on pharmacy closed days on a prior suitable day" then you will need to plan to make these supplies at an appropriate time. This wording would also permit the supply of the initial dose of a prescription starting on the Bank Holiday Monday where the date of the signature is before this." However, PSNC is aware that not all prescriptions will contain such a direction to support the supply, in advance, of a dose for Monday 19 September where the supplying pharmacy is closed. "We recognise that this client group are often vulnerable with multi-morbidities and that the risk to them may be significant. You should therefore exercise your professional discretion in determining when to make an instalment supply for the Bank Holiday Monday. Make the care of the patient your first priority and consider the potential impact of both making the supply in advance and of not making the supply in your decision making process. The exceptional circumstances that led to the Bank Holiday and its short notice may inform your decision."

The Pharmaceutical Services Negotiating Committee (PSNC) has appointed Sunil Kumar, an independent contractor from Darlington, as the Regional Representative for the North East and Cumbria region. "Kumar will represent all independent contractors in the region at the PSNC Committee until 31st March 2023, which is the end of the current term for all Regional Representatives," said PSNC. PSNC's North East and Cumbria region covers the areas of Community Pharmacy County Durham; Community Pharmacy Cumbria; Gateshead & South Tyneside LPC; North of Tyne LPC; Sunderland LPC and Tees LPC.

The National Pharmacy Association (NPA) is calling on NHS England and its member to pause and reflect before further implementing the pharmacy contraception service. NPA board met on Tuesday (25 April) to discuss the Pharmacy Contraception Service and the board decided that - with the community pharmacy sector at breaking point - it cannot support the immediate roll out of this service. The association believes that with no new funding for the service, and all existing funds in effect already allocated to other pharmacy activity, any payments to the sector for delivery of the oral contraception service will ultimately be clawed back by NHS England. Tweeting after the meeting yesterday, the NPA said: "We can't tell pharmacy owners what they can and can't do. But we can tell them the facts; fact number one is that with no new funding currently available everyone will be a loser from the implementation of this service on the current terms." NPA Vice-Chair Jay Badenhorst added: "We cannot be expected to take on more and more services without the increase in funding necessary to deliver them effectively. Meanwhile, taking on additional work when current workload already exceeds capacity risks impacting negatively on the overall quality of care people experience in pharmacies. We still believe this could, in future, be a great new pharmacy service, but not without the extra funding necessary to deliver it safely and effectively. We want to offer women this extra support, but if it's worth doing it's worth doing properly."