A survey of over six thousands pharmacies has revealed that the community pharmacy sector is buckling under growing cost and capacity pressures.
The survey conducted by the Pharmaceutical Services Negotiating Committee, which also involved two thousand community pharmacy confirms, rising costs, patient
demand and
medicine supply issues continue to grip the sector.
PSNC's 2023 Pharmacy Pressures Survey, run as a follow up to the 2022 pressures survey, provides clear comparative data showing the worsening situation across
the sector.
Govt must act now
The result of the survey indeed paints a bleak picture for community pharmacies and it is clear that without urgent action from government and the NHS this will
only get worse: more community pharmacies will either be forced to reduce the number of services they provide or, in the worst-case scenario, will be left with
no option but to close their doors for good.
The PSNC has urged the government to act now "to save our pharmacies, before it is too late for patients, the public, and the rest of the NHS".
"This year's survey clearly shows that community pharmacies are buckling under growing cost and capacity pressures," said PSNC Chief Executive Janet Morrison.
The Pharmaceutical Services Negotiating Committee (PSNC) has launched Pharmacy Pressures Survey 2023 to make case against the 'unprecedented financial and
operational challenges' faced by the community pharmacies in England.
The Committee has urged those working in or owns a community pharmacy to 'take part' in the survey.
"The survey results will be critical to help us to show Government and the NHS how difficult things now are for pharmacies, and to persuade them to take action. We
will be using the results in our negotiations, in our conversations with MPs, Ministers and in national media work as part of the joint #saveourpharmacies campaign,"
said PSNC.
The Pharmacy Pressures Survey is once again comprised of two surveys to give insight into both financial and operational pressures.
Together with the other national pharmacy organisations PSNC are working both to show policy makers the severity of the problems and to lobby for Government and NHS
action to ease the pressures.
The Pharmaceutical Services Negotiating Committee (PSNC) chief executive Janet Morrison has assured contractors that PSNC will continue to raise with the new
prime minister all concerning issues that are bothering pharmacy businesses.
She felt the "fixed five-year funding settlement that is declining in real terms" was one of the serious factors that is putting a lots of pressure on contractors.
PSNC has provided a compelling portfolio of evidence on the impact that pressures are having on the sector, and requested urgent additional funding, she said.
Morrison, in her video message shared yesterday (August 24), urged contractors to keep sharing and sending evidences to act on their behalf.
She said she is aware "this one of the toughest periods for the businesses" and "I believe that it demands more action from the government."
Morrison assured the sector she was aware that contractors were also facing difficulties in "dealing with global medicines market and the challenges on been able to
procure medicines within the drug tariff."
"I know how hard it is to see the future sustainability of your businesses. I can see you are facing serious workforce pressure, rising cost, shortage of pharmacists,
inflation pressure. I know your using facing increase in demand from the patients who has given up on their GPs and turning to you for support and advice."
The Pharmaceutical Services Negotiating Committee (PSNC) has called for improved workforce planning to be undertaken by the government and NHS.
However, for this to happen, it added, "high quality workforce data for community pharmacy needs to be available."
For this reason, the Department of Health and Social Care (DHSC), NHS England and PSNC have agreed that it will be a Terms of Service requirement for contractors
to complete the annual Health Education England (HEE) community pharmacy workforce survey, which will then provide a full picture of the community pharmacy workforce,
including identifying the number of vacancies and regions where these are particularly hard to fill.
PSNC said: "It is acutely aware of the challenges that contractors and their teams are currently facing, so in recognition of the workload associated with completing
the annual workforce survey, we have negotiated with DHSC and NHS England that the requirement to undertake an annual patient satisfaction survey will be removed from
the Terms of Service from 1st October 2022."
This means that contractual requirement will no longer apply to contractors in 2022/23 and going forward.
Pharmaceutical Services Negotiating Committee (PSNC) has launched two surveys to gather data on the pressures that people working in community pharmacies are facing.
Pharmacy teams have informed the negotiator about the ongoing financial and operational pressures and expressed concerns that these pressures could impact patients' care.
The surveys would give a snapshot of the problems faced by pharmacies and the results will be used in ongoing discussions with NHS England & NHS Improvement and the Department of Health and Social Care.
The results will also help PSNC to make pharmacy's case in conversations with the MPs, ministers and the national media.
The two separate surveys are for:
Pharmacy business owners/head office representatives - This survey covers the pressures faced by businesses, including financial and staffing pressures.
Pharmacy teams - It covers the day-to-day pressures experienced by pharmacy teams including supply chain issues, patient interactions/experience and staff morale.
The Pharmaceutical Services Negotiating Committee (PSNC) has invited pharmacy contractors, LPCs and others in the sector to share their views on an open
consultation on the "future of community pharmacy".
"The consultation - which takes the form of an online survey - is the first opportunity within PSNC's vision project for individuals and organisations to share
their thoughts with Nuffield Trust and The King's Fund," said PSNC.
The survey is happening in addition to an extensive programme of research, interviews and initial meetings of the vision Steering Group, Advisory Panel, and Working
Groups, all of which have contractors, LPCs and other representatives of the sector at their heart.
The online survey, asks five questions on topics such as Future policy goals; Why previous reviews and policies may not have fully achieved their objectives; Design
principles that should underpin the service offer made by community pharmacy; and Blocks and enablers for change.
The results of the Community Pharmacy IT Group's (CP ITG's) IT arrangements survey revealed that 83 per cent of the respondents support the goal of going
paperless.
The Pharmaceutical Services Negotiating Committee (PSNC) asked community pharmacy teams to complete the survey between late 2021 and October 2022.
The survey was designed to gather information on frontline pharmacy teams' perspectives about community pharmacy IT and their pharmacies' IT arrangements.
It was found that more than half of pharmacies experience at least one IT outage per month (lasting at least one hour). Over 40% reported poor mobile phone signal
and limited internet connectivity options at their pharmacy. 80% agreed that mobile devices would help working within pharmacy, but most reported no laptop and no
tablet device available for use in the pharmacy
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."
National pharmacy bodies have expressed their disappointment on the launch date for Tier 1 of the Pharmacy Contraception Service which has been announced by
NHS England (NHSE) as '24th April 2023′.
Pharmaceutical Services Negotiating Committee (PSNC) said that this start date for the service has not been agreed with PSNC and is in direct contradiction of our
warning to Ministers that no new or expanded services can be rolled out in 2023/24 unless extra funding is put into community pharmacies.
Responding to this announcement, PSNC Chief Executive Janet Morrison said: "This is despite our warning last month that without additional funding, the roll-out of
Year 5 additional services and the Pharmacy Quality Scheme is neither feasible nor affordable. Community pharmacies are having to work harder and harder for less
money and many are at breaking point. And just this week the results of our 2023 Pharmacy Pressures Survey have confirmed the worsening situation.
Clearly our view is not because contractors don't see the benefit of the service. This is a much-anticipated service that could deliver real benefits to patients and
community pharmacies are always eager to support public health initiatives. But capacity in the sector is now so stretched that more money is needed to safely
resource additional work.
We have repeated our concerns to the Department in recent days and reminded them of the potential for a properly funded community pharmacy sector to play a greater
role in providing clinical solutions and relieving pressures elsewhere in primary care."
Majority of the pharmacies are facing aggression from patients due to the medicine supply chain issue, a PSNC survey has revealed.
The Pharmacy Pressures Survey by the trade body has seen nearly 83 per cent of pharmacies reporting a significant increase in medicine supply issues in the past year,
leading to extra work and additional stress for staff.
The survey of over 5,000 pharmacy premises and 1,000 pharmacy team members in England took place in early 2022.
Two-thirds of respondents said that medicines supply chain issues are a daily occurrence, with 97 per cent reporting that this led to frustration from patients.
"The results of PSNC's Pressures Survey make distressing reading for anybody in the sector - they tell a story of teams under immense pressures, and of businesses at crisis point," said Janet Morrison, PSNC chief executive.
The Pharmaceutical Services Negotiating Committee (PSNC) has announced the margin delivery rates will increase from October as the agreed £100m write off is
implemented.
"The baseline margin allowance will remain £800m per year in 2022/23 and 2023/24," said PSNC.
"Margin levels in the last two full years (2020/21 and 2021/22), as measured by the Margin Survey of independent pharmacies, were in excess of the baseline allowance,
meaning that an excess was accrued."
As new services have been introduced and take up of these has accelerated, the amount of unallocated funding left in the CPCF is now less than it previously was.
As such, the value of the Transitional Payments will decrease from its current level. Some of the unallocated funding remaining in 2023/24 will be repurposed into
a Flat Payment for all contractors (see details below).
Over the course of the second half of 2022/23, the value of the Transitional Payments will be phased down. This will start in October 2022 with a reduction in payment
levels to approximately 85% of the current level, as shown in the following table:
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).
Only a day is left before community pharmacy contractors are required to complete Health Education England's Community Pharmacy Workforce Survey for 2022.
The survey closes on Wednesday (November 30).
The completion requirements are mandatory and particularly pertinent at a time when workforce challenges have become a major issue within the sector. These pressures
are being acutely felt within community pharmacy, with serious consequences for pharmacy contractors.
PSNC and the other national pharmacy bodies have called for improved workforce planning to be undertaken by the government and NHS, but for this to happen, high
quality workforce data for community pharmacy needs to be available, which will then provide a full picture of the sector's workforce, including identifying the
number of vacancies and regions where these are particularly hard to fill.
Tough times for community pharmacies in England are far from over as the industry continues to grapple with major gaps in the workforce.
Even though the latest figures released by the Health Education England (HEE) Community Pharmacy Workforce Survey 2021 showed doubling of pharmacist vacancy rate in England to 8 per cent between 2017 and 2021, it flagged the contractors' difficulty level in filling up these positions.
The survey report showcased changes in the size and make-up of the community pharmacy workforce since the last survey conducted in 2017.
It revealed that 56 per cent of pharmacy contractors reported high difficulty level in recruiting pharmacists, up from 21 per cent in the earlier survey.
Moreover, a greater proportion - 60 per cent of contractors found filling up the pharmacy technician role 'fairly' or 'very' difficult.
Other roles in the sector considered difficult to fill included accuracy checkers and trained dispensing assistants, both at 58 per cent.
All pharmacy businesses are reporting that they are struggling to find the registered professionals needed to open their pharmacies, clarified the Company
Chemists' Association (CCA) in response to an attack by the Pharmacists' Defence Association.
Last week, PDA allegedly accused some large pharmacy chains of 'orchestrating' full or part-time closures of some of their shops due to the staff shortage.
In its Open Letter published on Tuesday (July 19), PDA demanded urgent action "to protect patients by ensuring that essential community pharmacy services are
provided safely and consistently".
"All parts of the healthcare system are struggling to recruit staff and to assume that pharmacies would be immune to such pressures, seems fanciful," said CCA.
"CCA members are working extraordinarily hard to prevent temporary closures, but recruitment and retention of pharmacists is becoming increasingly tough. The recent
rise in Covid cases and the beginning of the summer holiday season in parts of the UK have only worsened the situation."
The Association also showed data from the PSNC Pharmacy Pressures Survey (April 2022) which found that 91 per cent of pharmacies are experiencing staff shortages,
clearly demonstrating that these shortages are affecting the entire sector.
The Royal Pharmaceutical Society (RPS) has called its member to to express their views and fill out the Department of Health and Social Care's hub and
spoke survey on the proposed model of dispensing.
The Society has urged its members to fill out the survey before May 20.
RPS president Claire Anderson said: "It is vital that RPS members have their say on issue that impact you in your roles. Currently only single legal entities
can make use of this model of dispensing.
"Our survey, which opened today, seeks your views and comments and will help to inform the RPS submission to this consultation."
The consultation on the proposals to enable all community pharmacies to access hub and spoke dispensing published by the Department of Health and Social Care
(DHSC) will run for three months and will close on June 8, 2022.
Community Pharmacy England (CPE) to host a Parliamentary drop-in event in July to brief MPs and Peers about the ongoing medicines supply chain issues that
are negatively affecting pharmacies and their patients across the country.
CPE's Pressures Survey earlier this year highlighted the extent of both the operational and financial impacts of medicines supply issues on pharmacy businesses,
therefore it has continued to hear from both pharmacy owners and others about the problems.
The event aims to ensure that MPs understand the problems and their impact on pharmacies.
Peter Dowd MP is hosting the event, joined by representatives from Community Pharmacy England, the Nuffield Trust, patient groups and more.
The event will also be another opportunity to talk to MPs from across the political spectrum about the very serious situation that community pharmacies still find
themselves in and the need for further investment in the sector.
Janet Morrison OBE, Chief executive of Community Pharmacy England said: "The results of our Pressures Survey earlier this year showed just how much supply issues
are continuing to negatively impact pharmacy businesses and all those who work in them. The survey found that almost all pharmacy owners (97%) are facing
significant increases in wholesaler and medicine supply issues, with 71% saying this was leading to delays in prescriptions being issued.