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In what could be the longest consecutive strike action ever taken in the history of the National Health Service (NHS), junior doctors are set to begin their six-day walkout from tomorrow (Wednesday 3 January) at 7am, until 7am on Tuesday 9 January. As the record industrial action has come in the middle of growing winter pressures, the NHS England has warned that this week could be one of "the most difficult starts to the year" for health services across the country. With consultant busy covering urgent and emergency cases, the strikes could have a significant impact on almost all routine care. NHS National Medical Director, Professor Stephen Powis said: "This January could be one of the most difficult starts to the year the NHS has ever faced.

The new NHS chief executive Amanda Pritchard acknowledged and thanked health service staff and volunteers for their "extraordinary team effort" while the country fights Omicron. Pritchard, who took up the post in July, praised the efforts of doctors, nurses, therapists, porters and other staff who have worked hard to recover services impacted by the Covid-19 pandemic. In her first Christmas message as the NHS chief, she praised all those involved in the NHS Covid vaccination programme which delivered more than 7 million jabs, including boosters, in the last 10 days alone. She said: "We've had another extraordinary 12 months. "From January when hospitals admitted 100,000 patients with Covid in a single month, while also delivering the world-class NHS covid vaccination programme; to receiving the George Cross during the summer, marked by a service at St Paul's, pulling out all the stops to make progress on recovering backlogs of care; and now facing the uncertainty of Omicron and winter pressures.

As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

NHS England is rolling out a range of tech and data solutions, including an artificial intelligence (AI) system, across the health service to tackle winter pressures. The AI system will be used to identify patients at risk of hospital admission so community NHS teams can get to them first and reduce pressures on A&E departments. On a trial basis, four GP practices in Somerset have started using the innovative technology which can highlight registered patients with complex health needs. Health coaches, nurses, or GPs will then reach out to the people most at risk, and provide them with a range of preventive care such as monitoring, food parcels, cleaning, shopping, as well as escalating care to specialist doctors.

The Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for their services. "Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide the right care for patients," said Govind. "As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health service are struggling to cope. The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams. Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures. "However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open long hours and at weekends."

Community pharmacy representatives and MPs from across all political parties discussed the impact of winter pressures on pharmacies in England during a parliamentary drop-in event held on Tuesday (5 December). As many as 34 MPs attended the event, including Bradford South MP Judith Cummins, who hosted the event. Members of the Community Pharmacy England (CPE) Policy Team and LPC leaders briefed the politicians about the current winter pressures that all NHS community pharmacies are grappling with, and asked them to help get more support. CPE Chief Executive Janet Morrison said: "Community pharmacies play an active role to support their patients throughout the winter period, but the sector needs fair and proper funding to enable its vital services to be delivered in the long term. This event came at a key moment for the sector as we work towards implementing the Pharmacy First service and negotiations begin for the 2024/25 Community Pharmacy Contractual Framework (CPCF).

Winter pressures are already mounting on NHS staff ahead of December, with high levels of demand in hospitals due to a significant increase in cases of norovirus infection. Norovirus is a highly contagious virus which spreads through contaminated food, water or surfaces and causes vomiting and diarrhea. New NHS figures revealed that an average of 351 people were hospitalised with diarrhoea and vomiting symptoms every day last week in England, almost triple the number during the same period last winter, which was 126. The number of children in hospital with the virus was also higher last week (13) compared the same week last year (an average of just three), according to the weekly winter update published by the health service on 30 November.

The Health and Social Care Secretary Steve Barclay has proposed a new £30 million fund to speed up the adoption of innovative medical technology in the NHS. He confirmed the plan today at the Conservative Party Conference 2023 in Manchester. Mr Barclay said that virtual wards will help healthcare professionals embrace new technology to improve patient care. He said: "It is vital that clinicians have access to the latest technology to save staff time, deliver high-quality care and help cut waiting lists - one of the government's top five priorities. "This investment will see the latest tech innovations rolled out across the NHS. From virtual ward beds to wearable medical devices, patients will be better supported, and we will ease pressures on hospitals this winter. "We're preparing for this winter earlier than ever before including delivering thousands more hospital beds and hundreds of new ambulances."

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."

A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

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).

Healthcare staff across England are facing increasing winter pressures amid junior doctor's strikes, as thousands of hospital beds are being occupied by patients with flu, norovirus and Covid-19. The number of flu patients in hospital has increased by almost two thirds in a week, according to the latest weekly update from the National health Service (NHS). New NHS figures published on Thursday showed an average of 648 patients were hospitalised with flu per day this week before the industrial action, up from 402 last week. This lasts number is four times the figure reported at the end of last month (160 per in the week ending 26 November).

NHS England is encouraging people to get their flu and Covid vaccines as hospitals dealt with the highest number of norovirus and flu cases this winter. An average of 688 patients with norovirus were in hospital each day last week, 75 per cent higher than the same time last year (393), according to the latest data from NHS England. The data also showed an average of 2,226 patients with flu in hospital each day last week, which is three-quarters higher than the same week last January (1,290). Compared to last month, there has been an 80 per cent increase in the daily count of norovirus cases and 70 per cent in flu cases. In the week ending Dec 31, NHSE recorded 1,312 hospital admissions due to norovirus and 376 and 1,312 flu cases each day.

Britain plans to launch a pilot programme exploring how new weekly weight-loss shots such as Novo Nordisk's Wegovy can be given to obese patients by general practitioners even as the drug's market launch remains unclear. The government's announcement on the £40 million pilot programme comes after drug cost-effectiveness watchdog NICE in March recommended the use of Wegovy in adults with at least one weight-related condition and a body mass index of 35, but only within the NHS specialist weight management scheme. The timing of Wegovy's launch in Britain - which would be only the fourth country to use it - is uncertain, however, after Novo last month rationed starter doses to secure supply to U.S. patients already on the regimen, after it was overwhelmed by demand there. British Prime Minister Rishi Sunak said on Wednesday (May 7) the pilot and fighting obesity-related diseases could reduce pressure on hospitals. It would also support "people to live healthier and longer lives, and helping to deliver on my priority to cut NHS waiting lists". The NHS endured a tough winter in England in particular, with waiting lists hitting record highs and staff striking for higher pay amid double-digit inflation.

British health officials on Wednesday (September 28) warned that increased circulation of flu and a resurgence in Covid-19 could lead to a difficult winter that increases pressure on the already stretched NHS. Warnings over a possible "twindemic" of Covid-19 and flu have been issued each winter since the start of the coronavirus pandemic in early 2020, but Covid restrictions that limited social contact have meant flu levels stayed low. However, the government ended coronavirus restrictions earlier this year, meaning that social contact rates have returned to near pre-pandemic norms while immunity to flu is relatively low. The UK Health Security Agency (UKHSA) said that given the risk it was important those eligible took up vaccines against Covid and flu. "There are strong indications we could be facing the threat of widely circulating flu, lower levels of natural immunity due to less exposure over the last three winters and an increase in Covid-19 circulating," said Susan Hopkins, chief medical advisor at UKHSA.

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.

Frontline doctors have sounded the alarm over the rising pressure on emergency departments in hospitals across the country as winter virus cases are "creeping up". An average of 234 people were in hospital with flu every day last week, a 53 per cent increase compared to the week before, according to new NHS data. Hospital norovirus cases increased by 15 per cent last week, with an average 406 people hospitalised each day, a 28 per cent increase from the same week last year. Measures to stop the spread of norovirus to other patients led to the closure of an average of 92 beds were closed each day last week.

To support NHS, clear the backlog created by the Covid-19 pandemic and help community pharmacies support more people, the Welsh government has announced an allocation of further £12.5 million funding. Of the total amount, £10mn will be distributed across the 22 local authorities to buy equipment to help people to live independently in their own homes post hospital stay. The remainder, £2.5mn, will be used to support community pharmacists and patients to improve access to treatment and advice for a range of common ailments. The move is aimed at alleviating waiting times and reducing winter pressures on the NHS. Commenting on the announcement, Elen Jones, Royal Pharmaceutical Society director for Wales said: "We are delighted that the Welsh government continue to recognise the value of pharmacists in patient care and we welcome this additional investment and support for Community Pharmacy teams across Wales.

Pendle MP Andrew Stephenson has been appointed as a Minister of State in the Department of Health and Social Care (DHSC) in the latest ministerial reshuffle. As the new 'Minister for Health and Secondary Care', Stephenson would be looking after elective care recovery and screening, as well as the fight against major diseases like cancer, diabetes and stroke, as reported by Burnley Express. "Helping NHS services recover from the legacy of the pandemic, whilst dealing with winter pressures and the challenges of inflation will not be easy, but it is a challenge I am looking forward to," Stephenson told Burnley Express. "I am also keen to ensure that significant manifesto commitments, such as the pledge to deliver 50,000 nurses and 40 new hospitals remain on track. Especially as one of those 40 new hospitals is Airedale, which is used by so many Colne and West Craven residents," he added.