The Pharmacists' Defence Association has called on the Scottish government to end unnecessary pharmacy closures and introduce emergency regulations to force
companies that operate Scotland's pharmacies to open on the days and hours they have agreed.
It is concerned that decisions made by some health boards in Scotland have now allowed pharmacy owners to close their pharmacies on Saturdays.
The PDA is worried that a pharmacy closure could have negative impact on patients and other parts of the NHS, including neighbouring pharmacies, addiction and mental
health services, and minor injury and A&E units.
The association claims that there are record numbers of registered pharmacists who are available to work and therefore a decision to close a pharmacy over staff
shortages is misleading.
"The business owners may claim there is a shortage of pharmacists, but when they actively cancel agreed hours of work it does not suggest there is a shortfall of
workers," said the PDA, adding: "These business decisions often include closing their pharmacies at very short notice, even when pharmacists are available and willing
to work."
The Company Chemists' Association (CCA)'s analysis on permanent closures of community pharmacies in England showed that there has been a net loss of 670
pharmacies between 2015 and 2022.
The analysis highlighted that 37 per cent of permanent closures of pharmacies and GP practices have occurred in the 20 per cent most deprived parts of England.
Current trends indicate that primary care 'cold spots' could soon emerge - areas where there is significantly reduced or inadequate access to a pharmacy or a GP.
The CCA's analysis shows that some of the most deprived neighbourhoods concentrated in the North West, the West Midlands and Yorkshire have faced the highest losses
of local pharmacies and GP practices since 2015.
It demonstrates that the trend of permanent closures amongst pharmacies and GP practices is worsening. Moreover, this burden is likely to be felt unevenly with
permanent closures occurring disproportionately in areas of high deprivation. Without action, deprived communities, where need is typically greater, may no longer
be able to access the GP and pharmacy services they require.
The Pharmaceutical Services Negotiating Committee (PSNC) has urged the pharmacy contractors to follow appropriate procedures for unplanned temporary closures
due to current workforce pressure, to avoid a breach of terms of service.
"If the temporary closure is not for reasons beyond the contractor's control, this may be a breach of the terms of service," said PSNC.
The committee also informed that in some areas, NHS England regional teams may ask contractors to complete a new notification form for any temporary closures that
request more information than the standard form, for example, on the mitigating actions taken by the contractor.
It added: "Completion of these forms is voluntary but may help to show NHS England that the closure was for reasons beyond the contractor's control, or that the
overall circumstances of the closure, including time closed and steps taken to ensure patient and public needs are met, indicate that there is no public interest
in taking any regulatory/performance action (such as a breach notice) against the contractor."
The Pharmaceutical Services Negotiating Committee (PSNC) has urged community pharmacy to plan and ensure patients are able to access their prescription if they
have to close in an emergency situation for a short period.
It has prepared a guidance which can be undertaken by pharmacy in the event of a closure and the contractor's business can resume easily and effectively once the
emergency has passed.
In its guidance, PSNC has stated a few actions that can be taken by pharmacy in advance:
Plan ahead - be ready before a closure is needed. Don't wait until your pharmacy needs to be closed before you consider how you will manage and what you can put in
place to mitigate the impact.
Make sure your business continuity plan is up to date and relevant to the current situation. For example, try not to rely on family and friends as part of your plan;
if you're having to isolate because of infectious illness, your close contacts may need to do so as well.
Ensure your SOPs are accurate, up to date and easy-to-find for someone completely unfamiliar with your pharmacy. Emergency numbers will be crucial. Normal, everyday
business continuity issues are still going to arise and anyone on-site needs to know how to address them:
The NHS England and Improvement has announced the emergency provisions introduced during pandemic to provide flexible opening hours for pharmacy contractors end today.
The flexibilities were enacted in March 2020 when changes to the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 were made following a declaration of emergency at the height of the Covid-19 pandemic.
Since March 2020, the flexibilities have permitted temporary opening hours and closures during a specified period due to a genuine Covid-19 related emergency. NHS
England and Improvement has advised pharmacy contractors that the emergency declaration will not be extended further and will expire on 31 March 2022.
Pharmacy contractors will therefore no longer have the option to close pharmacies within their agreed contracted hours with the NHS.
The Pharmaceutical Services Negotiating Committee (PSNC) has advised pharmacy contractors to use emergency provisions to avoid and reduce temporary closures amid shortage of pharmacists and other staff.
The provision was introduced at the start of the pandemic to enables flexible provision of pharmaceutical services by pharmacies.
It has been extended several times, currently until January 31, 2022.
The negotiator noted that self-isolation requirements and a lack of available pharmacists led to a spike in short-notice closures/late opening/early closing incidents in the community pharmacy sector.
However, it reminded contractors that they have a clear duty to provide services in line with their contractual arrangements.
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.
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."
Pharmacists on the temporary register will be automatically removed on April 1, unless they have applied to rejoin the permanent register, the General
Pharmaceutical Council has said.
The government asked the GPhC and other pertinent health professional regulators to close temporary registers by March 31, 2024.
According to the GPhC, this decision is based on the anticipation that the emergency conditions justifying the establishment of these temporary registers will
cease after the approaching winter.
The temporary register was established after the Health and Social Care Secretary asked the Council to utilise its emergency powers to swiftly register pharmacy
professionals for their essential role in the national COVID-19 response.
Pharmacists and pharmacy technicians who had previously opted to withdraw from the GPhC register or failed to renew their registration are now eligible for
immediate re-registration, the regulator added.
The emergency provision of pharmaceutical services, introduced to help maintain pharmacy services during the Covid-19 pandemic, has been extended to March 31, 2022.
The provision allows contractors to make temporary changes to opening hours or temporary closures in condition of adequate reasons for these changes.
Before making such changes contractors have to give 24 hours' notice to the NHS England and NHS Improvement (NHSE&I), and take approval from the department.
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.