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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.

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."

Teva UK has alerted the Secretary of State for Health and Social Care to the problem posed by steep energy prices. Teva's UK General Manager Kim Innes wrote to the minister seeking assurances that the distribution of medicines to patients will be safeguarded over what's likely to be a difficult winter. The problems posed by steep energy prices and the potential for power rationing is putting pharmacies under pressure from increased costs and the risk of losing power supplies as a 'non-domestic' energy user, said the company. Kim said: "In our letter to the Secretary of State we acknowledged that the government knows that medicines manufacture is strategically important and that it's a vital component in maintaining patient health." "But I wanted to make sure that the Secretary of State also realises the consequences of the energy crisis further down the supply chain - for example, the need for a pharmacy to have a fridge switched on at all times for storing cold chain products."

Well Pharmacy has announced a new partnership with RangeMe, a product discovery, sourcing and purchasing platform, as it looks to increase the diversity of products available to its customers. The independent pharmacy chain said the partnership will provide new, emerging and diverse brands increased access to its buying teams. There are already over 200,000 suppliers registered on the RangeMe platform. "We pride ourselves on being at the heart of the communities we serve and are delighted to be working with RangeMe to increase the diversity of the products we are able to offer to our customers across the UK," Reena Takhar, head of OTC & NHS buying at Well Pharmacy said. "Given the ongoing cost-of-living crisis, we're keen to do all we can to give businesses of all sizes the opportunity to connect with our buyersto allow us to offer new and interesting great value products to our customers." RangeMe helps retailers and their buying teams scale product sourcing efforts with streamlined submissions, simplified discovery tools, and the industry standard digital sell sheet.

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.

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.

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 ongoing pharmacist workforce crisis has posed a significant risk to patients' access to care, medicines and advice - particularly affecting the elderly and vulnerable living in areas with health inequalities. Many from the sector have raised concerns about this issue with the Company Chemists' Association (CCA) recently acknowledging the shortage of pharmacists or pharmacy technicians in the country to meet the needs of patients and the NHS. The trade body representing almost 50 per cent of the community pharmacy sector said that pharmacy teams are exhausted after working tirelessly during the pandemic, adding that Covid, Brexit and NHS reforms have exacerbated the shortage. Covid and winter-related sickness absences are adding to the strain and with Brexit it has become difficult to attract overseas pharmacists to the UK.

The Royal Pharmaceutical Society (RPS) has informed the Welsh Parliament about the workforce crisis in the pharmacy sector and the need to prioritise staff well-being and training requirements to help Covid recovery plans. Providing evidence to the Senedd's Health and Social Care Committee's inquiry into waiting times, the RPS director in Wales Elen Jones emphasised that the pandemic brought the pharmacy workforce under immense pressure. She emphasised on "the need for workforce planning that allows pharmacists enough time to learn, teach and embed new skills," which would help in maintaining a motivated and sustainable workforce. Jones presented the evidence alongside colleagues from the Royal College of General Practitioners, Community Pharmacy Wales and the Royal College of Nursing.

The Department of Health and Social Care (DHSC) in recent response to the questions asked by members of the House of Lords addressed the concerning trend of pharmacy closures in rural areas across the UK. Led by The Bishop of St Albans, inquiries focused on the number of community pharmacies that had ceased operations over the past five years and the ongoing financial challenges faced by those remaining in rural regions. Lord Markham, the Parliamentary Under-Secretary for Health and Social Care, provided insights into the stark reality confronting rural communities. Highlighting data as per Guide to applying the Rural Urban Classification to data (2019-2023) Markham illustrated the significant closure rates of rural pharmacies compared to the limited number of new openings between 2019 and 2023. The figures revealed a fluctuating trend over the past five years, indicating a dynamic landscape within rural pharmacy provision.

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

The Pharmacists' Defence Association (PDA) has written to the National Pharmacy Association (NPA) to highlight several important points regarding their proposed "day of action" on 20 June 2024. The NPA describes this initiative as a response to the "emergency across the community pharmacy sector." In a letter addressed to NPA Chair Nick Kaye and Chief Executive Paul Rees, the PDA's director of pharmacy, Jay Badenhorst stressed the need for NPA members to consider their obligations to staff and patients before participating in the planned actions. He stated, "We are supportive of a new contractual framework for the community pharmacy sector." "However, any actions taken must ensure the safety of patients and the operational integrity of pharmacies." The PDA's letter also expressed concerns over the safety and operational impact of the proposed symbolic gestures, including turning off lights and blacking out windows.

National pharmacy bodies have welcomed two VAT changes related to community pharmacy services announced in the Spring budget on Wednesday (15 March) but were disappointed that the budget brought no further relief for the sector in a crippling funding crisis. It was announced that from 1 May 2023, VAT exemption on healthcare would be extended to include medical services carried out by staff directly supervised by registered pharmacists. The government will also extend zero rate on prescriptions to medicines supplied through Patient Group Directions. This measure will be introduced in autumn 2023. HM Treasury said these measures were being introduced to ensure that the VAT system keeps up with changes to how the NHS operates and how healthcare is delivered across the country. More widely, Chancellor Jeremy Hunt promised to halve inflation and said that the NHS would soon publish its long-term workforce plan.

National Pharmacy Association (NPA) urged the NHS England to make local impact assessment a key requirement prior to any recruitment into Primary Care Networks (PCNs) and Clinical Commissioning Groups (CCGs), to help tackle workforce crisis. With inputs from LPCs, PCNs and CCGs should consider the impact of the creation of new roles on all health care providers in the area and on their ability to deliver their objectives on behalf of the NHS, it said. The NPA believes that creation of the Additional Roles Reimbursement Scheme (ARRS) programme is impacting community pharmacy services in some areas and contributing to the ongoing workforce shortage. In a letter addressed to Ed Waller, director of Primary Care for NHS England, NPA chief executive Mark Lyonette highlighted the challenges emerged following a shortage of pharmacists and other members of staff.

From over-the-counter flu tablets to crucial antibiotics and antidepressants, medicines are running scarce in UK pharmacies this year, causing concerns among patients, the government, and the wider pharma industry. Drug shortages have accelerated over the past year due to a clutch of problems including the after-effects of the pandemic on supply chains, the war in Ukraine, and soaring input costs weighing on manufacturers. More recently, a sudden spike in respiratory infections - another by-product of Covid-19 that neither pharma companies nor the government were able to predict - has deepened the crisis, with 70 commonly taken drugs out of stock in Britain as of February. The problem is not unique to the UK. In a recent survey of groups representing pharmacies in 29 European countries, three quarters said shortages were worse this winter than a year ago, with a quarter reporting more than 600 drugs in short supply. The US is also facing significant shortages of popular prescription drugs like amoxicillin and Adderall, an ADHD medication. To some extent, the current disruption is laying bare wider challenges facing the industry for several years that were only exacerbated by the pandemic. The over-reliance on foreign suppliers for most active pharmaceutical ingredients (APIs) is one of them. This model has left companies more susceptible to supply shocks, which have in turn increased in frequency and severity due to pandemic lockdowns, the war in Ukraine and other issues such as the shortage of shipping containers. Pharma's long and opaque supply chains, alongside regulatory complexities, also mean it is taking longer for drugmakers to reconfigure manufacturing and distribution in times of additional need.

"Not improving our funding is not an option, if they want to continue to deliver anything like the level of patient care we have done in recent years," he emphasised as he prepares for the NPA'S Save Our Pharmacies Day of Action (June 20). Over the past two years, McElrea has navigated crises stemming from NHS Scotland policies, particularly concerning medicines price inflation and delayed payments. "The cost of medicines increased rapidly compared to inflation," McElrea stated, noting NHS Scotland's slow response in adjusting tariff prices. "This wiped out £50,000 of cash reserves and forced us into £30,000 of additional borrowings." Delayed payments further strained operations, with McElrea highlighting the impact of payments based on outdated pricing.

The lessons from Covid crisis applied in the future through collaboration can create a better integration between GP practices, hospitals and community pharmacies, Pharmacists Defence Association (PDA) has proposed. Stating that a more integrated healthcare system could enable pharmacists to provide effective and more efficient care to patients, the PDA proposed a model where at least two pharmacists would be working in each community pharmacy, empowered, and enabled with two-way referral pathways, having more clinical input and full access to patient records. "Such an environment could not only help to improve communications between health professionals and increase access to services for patients, but would support the NHS to operate more effectively."

A new study has revealed that public trust in services provided by local pharmacies ranks highest in the UK, although confidence in the NHS has nosedived following the pandemic. The 2022 Edelman Trust Barometer report published on Wednesday (April 21) found that around 78 per cent of respondents trust their local pharmacies, the highest for any provider cited in the survey. Besides, 72 per cent said pharmacists are among the most trusted to tell the truth about health matters and protect public health, almost similar to 'my doctor' (75%) and health experts (74%). Just under half of them said the pandemic has decreased their confidence that the NHS is well-equipped in handling major health crisis. The survey also revealed that 60 per cent think they lack access to high-quality healthcare.