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Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

Community Pharmacy England (CPE) is inviting community pharmacy owners to share their insights and views about increasing Pharmacy First thresholds and the effects of GP collective action on their pharmacies. This feedback will be discussed at the upcoming Community Pharmacy England Committee meeting in September. During the meeting, the Committee members will also discuss urgent matters including the 2024/25 negotiations, collaboration with the new government, and their ongoing strategies. A key point of discussion will also be the effects of GP work-to-rule action on community pharmacies. CPE has raised concerns that many pharmacies might face challenges meeting the scheduled increases in the monthly Pharmacy First payment threshold, noting that pharmacy owners are already considering their options if they start failing to meet the threshold. In response to concerns from Community Pharmacy England, Ministers have recently agreed to lower the August threshold from 20 to 15.

Achieving the community pharmacy vision necessitates legal adjustments and additional funding beyond recent boosts, the pharmacy vision document published by Nuffield Trust and The King's Fund has revealed. It says community pharmacies in England must adapt to changing population needs amidst unprecedented health and care challenges. Commissioned by Community Pharmacy England, the report titled 'A Vision for Community Pharmacy', published on Sept. 19, is a result of almost a year of research and extensive consultation with the sector and wider stakeholders, advocating for community pharmacy. The think tanks detail a shift in the community pharmacy sector, highlighting how pharmacies can contribute to crucial policy objectives regarding population health, prevention, and the increasing demand in primary care. "The health and care needs of the population are evolving, and pharmacies in England, like all components of the health and care system, must adjust to address these changes," said Helen Buckingham, Director of Strategy at Nuffield Trust.

Representatives from the national community pharmacy bodies will brief the MPs on the severe challenges facing community pharmacies on Tuesday (21 March) at a roundtable summit. The roundtable summit will include discussions on the urgent action needed to address the current severe challenges being faced by community pharmacy, as well as the sector's role in the upcoming Primary Care Recovery Plan, said PSNC. The Parliamentary event this week has been coordinated by PSNC as part of the joint #SaveOurPharmacies campaign which exceeded 30,000 signatories in a week. The Association of Independent Pharmacies (AIM), the Company Chemists' Association (CCA), the National Pharmacy Association (NPA) and PSNC will take part at the event. A spokesperson for the #SaveOurPharmacies campaign group said: "30,000 signatures in a week indicates a high level of underlying public support for community pharmacy and it's a good start to the #SaveOurPharmacies campaign. A petition by itself won't change the world, but it works as a kind of drumbeat for the campaign, giving forward momentum, and it's a really easy way to express your opinion. We hope the new window poster - along with all the resources available at saveourpharmacies.co.uk - will help as many pharmacies as possible to drum up support from their patients, and we're really grateful to Communications International Group for helping us to print and distribute this.

Community Pharmacy England has submitted a full and detailed written response to the Health and Social Care Select Committee's pharmacy inquiry. The Committee is expected to hold oral evidence sessions when Parliament returns in the Autumn. The commencement of this inquiry follows on from those held on other primary care sectors, including Dentistry and General Practice. According to the Committee website this inquiry 'will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy services'. Key themes of CPE's submission include- Suggestions on future service provision; Challenges with the pharmacy workforce; Longstanding underfunding of the sector; and Current pressures. Janet Morrison OBE, Chief Executive of Community Pharmacy England, said: "This is an extremely important opportunity for all who work with and in the Pharmacy sector, to highlight not only the extreme challenges we face, but also ideas and suggestions for what more we can do to help patients and the public in the future.

A new report from Community Pharmacy England (CPE) has raised alarms about the severe financial challenges plaguing pharmacies across the sector, threatening their ability to provide even the core services for their patients. The findings are based on responses from over 6,100 pharmacy owners and 2,000 pharmacy staff who participated in the recent Pharmacy Pressures Survey 2024. The report reveals that spiralling costs and increased workloads, coupled with a 30 per cent funding cut in real terms since 2015, are putting countless pharmacies at risk of closure. "Nearly 1 in 6 may close within the next year," the report revealed. A vast majority (94 per cent) of pharmacy owners reported that they have seen significant increases in costs, with almost two-thirds (64 per cent) saying they are operating at a loss. Concerningly, these financial pressures are now affecting patient care, as 18 per cent of pharmacy staff reported severe impacts. The survey revealed that most pharmacies are experiencing longer prescription dispensing times (86 per cent), delays in responding to patient inquiries (80 per cent), and less time to spend with patients (79 per cent).

A harsh funding regime that hasn't adapted to changing macroeconomic realities means the viability of large parts of the pharmacy sector is at risk unless the model changes. Very simply, across the sector, revenue has remained largely fixed while costs have increased significantly, making it impossible for many pharmacies to sustain their business models. The sector has seen the closure of more than 1,500 community pharmacies since 2015, with 700 of these closures occurring since 2021. Larger pharmacy operators such as Lloyds, Boots, and Rowlands have seen the biggest decline in numbers, with smaller businesses operating between one and five pharmacies now accounting for almost 50% of the sector. Despite rising inflation and business costs, the NHS pharmacy funding model has remained fixed. Over the period of the current Community Pharmacy Contractual Framework (CPCF) - 2019-2024 - pharmacies have experienced a 30% real terms cut in core funding leading to an annual shortfall of over £750 million, equivalent to £67,000 per pharmacy in England. The current CPCF is due to end in 2024, and there is still no arrangement in place for future funding, leading to delayed and inefficient spending decisions and hampering the ability of the sector to plan and attract much-needed investment.

Stephen Kinnock, Minister of State at the Department of Health and Social Care (DHSC), discussed all primary care contracts, including those related to community pharmacy, during his meeting with Community Pharmacy England (CPE) Chief Executive and two members from the Negotiating Team. The pharmacy minister reiterated that community pharmacies will be central to the new government's health and wider missions. CPE Chief Executive Janet Morrison and her team updated Kinnock on the community pharmacy sector, highlighting the pressures throughout the summer. They underscored the critical challenges facing the sector and the urgent need for a funding lift. They also discussed Pharmacy First and emphasised the broader potential for pharmacies to further support the health of their local communities.

In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England, Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period. The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies, while the total number of independent operators remained consistent with 2022. According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies. Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators acquiring additional pharmacies through corporate disposal opportunities throughout the year.

This year has been another turbulent year for the UK pharmacy sector. The sector continues to undergo significant transformations, driven by evolving healthcare needs, regulatory shifts, and economic pressures. For pharmacy owners, staying abreast of these trends is crucial to navigating the challenges and seizing opportunities. IQVIA, a leading global provider of clinical research services, commercial insights and healthcare intelligence, delves into the key issues, challenges, and developments shaping the sector, drawing insights from the latest industry data and reports, supported with data released by NHS England (NHSE). The community pharmacy landscape remains unsettled, with disruptive market dynamics at play. The decline in the number of pharmacies, particularly within the Managed Chains channel, underscores the volatility of the market. The number of active pharmacy contractors in England has dropped significantly, with more closures than openings each month, exacerbated by the exit of Lloyds Pharmacy from the UK market which completed at the end of 2023. In the year ending June 2024, there was a net closure of 440 sites within NHSE which equates to a 4% decline in available pharmacies1. The increase in closures from June 2023 was driven by the closures of Lloyds in Sainsburys and the ongoing divestment of the Boots estate.

Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government addresses supply problems and resolves the critical financial state of community pharmacies. CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients. Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy businesses fighting for survival. "As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said. Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also face the consequences.

Pharmacy bodies and MPs discussed on support needed to unlock the "full potential" of community pharmacy at the All Pharmacy Party Group (APPG)'s general meeting held in Westminster on Tuesday (01 November). The attendees of the meeting were Janet Morrison OBE, Chief Executive of Pharmaceutical Services Negotiating Committee; Malcolm Harrison, Chief Executive of The Company Chemists' Association; Thorrun Govind, Chair of the Royal Pharmaceutical Society; Sanjeev Panesar, National Pharmacy Association Board Member, and Pharmacist Superintendent and Owner of the Pan Pharmacy Group; and Sandeep Dhami, Association of Independent Multiple Pharmacies member and superintendent at MW Phillips Chemist At the session, 18 parliamentarians were briefed on the myriad of ways pharmacies contribute to the health of the nation. The panel of experts also highlighted that pharmacists are 'running out of fuel' with the growing challenges such as flat funding, workforce shortages and the cost-of-living crisis impacting pharmacies' ability to deliver vital services.

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).

The General Pharmaceutical Council (GPHC), Royal Pharmaceutical Society (RPS), Company Chemists Association (CCA), Association of Pharmacy Technicians UK (APTUK), National Pharmacy Association (NPA), Guild of Healthcare Pharmacists, Pharmacists' Defence Association (PDA), and Independent Pharmacies Association (IPA) have released a joint statement in response to the far-right riots across the UK. They emphasised their united stance, declaring zero tolerance for racism towards colleagues or the public in any form. The joint statement reads: "We are shocked and saddened by the violent public disorder events in recent days. "We acknowledge how all sectors of the pharmacy profession may be impacted and recognise the challenges that this level of overt aggression can have on people's ability or willingness to live their daily lives. "The pharmacy workforce deserves peace and safety, not fear and harm. We stand united in having a zero tolerance of racism towards our colleagues or the public in whatever form it takes." Meanwhile, Community Pharmacy England (CPE) has expressed concerns that protests and violent disorder in various towns and cities across England may impact the ability of community pharmacies to operate.

Munira Wilson, the Liberal Democrat MP for Twickenham, highlighted the impact of the community pharmacy closures in the Hampton area, and the severe financial challenges facing community pharmacies across England during an adjournment debate in the House of Commons on Friday. She also raised concerns about the impenetrable bureaucratic processes surrounding new pharmacy license applications and closures. Wilson highlighted the closure of two Boots pharmacies in Hampton last autumn, including one in the deprived ward of Hampton North. The Tangley Park pharmacy closure left the entire ward, which lacks adequate public transport, without a pharmacy, severely affecting elderly and vulnerable residents. "The nearest pharmacy is now a mile away on foot, a distance which is difficult to cover for the elderly and those with mobility issues, certainly more than a 20-minute walk, the measure that previous ministers like to use to highlight pharmacy accessibility," she said.

In a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE), Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges. Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival. "There have been no years of financial and operational squeezes applied by the NHS and government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival," he said. Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative initiatives like the Discharge Medicine Service and Contraception Service.

The Royal Pharmaceutical Society (RPS) has urged people across Scotland to be kind to their pharmacy teams this winter through its campaign called 'Be Kind'. The pharmacies are facing lot of pressure and challenges during winter, RPS has heard from its members that abuse towards pharmacy teams, particularly those in community pharmacy, has 'unfortunately' risen. The campaign has been running throughout December, to promote 'be kind' message to the public at a time when pharmacy services are particularly stretched by winter pressures and other factors, including the recent shortages of antibiotics. "Throughout December, leading figures have provided a series of powerful videos, which all encourage the public to be kind to their pharmacy teams. The campaign has highlighted personal video messages from many figures including Jason Leitch, Scotland's National Clinical Director, Maree Todd, Minister for Public Health, Women's Health and Sport, and Andrew Carruthers, RPS Scottish Pharmacy Board Chair," said RPS.

Professional leadership bodies from around the world discussed workforce shortages in community pharmacy and other challenges affecting the sector at a global meeting held in Paris last month. Delegated from Denmark, Australia, Ireland, New Zealand, Portugal, Spain, US and the UK updated the conference on how the profession was progressing in practice, technology and workforce development in their respective countries. The UK was represented at World Pharmacy Council meeting by National Pharmacy Association chair Andrew Lane and chief executive at the Pharmaceutical Services Negotiating Committee Janet Morrison. Lane said: "It's very useful to be part of a global network of pharmacy bodies who are all going through similar challenges as we are in the UK. Sharing intelligence on other pharmacy systems around the world helps us to prepare the right strategy for engaging with the NHS at home. "Hearing some of the strides in services and digital technology in the profession gives us hope for the future of the sector. It's clear however that key challenges such as workforce shortages are starting to have an effect in other parts of the world too."

The National Pharmacy Association (NPA) highlighted the role played by community pharmacies during pandemic to provide urgent care and vital support to people with long-term medical conditions at its opening remark in the Covid-19 public inquiry held on Tuesday (28 February). NPA is the core participant in the Covid-19 public inquiry. lawyer Brian Stanton made an opening statement on the NPA's behalf which focused on three areas- health inequalities and the needs of vulnerable patients; the impact of medicine shortages and medicine price increases and the challenge that community pharmacy faced in responding to the pandemic and maintaining patient services following long-term under investment. Stanton said: "The UK's community pharmacies were on the frontline of efforts to limit the impact of coronavirus and to keep people well, and as well as handling a massive increase in demand for healthcare advice and medicines, they also continued to provide urgent care and vital support to people with long-term medical conditions. "However, there are now very many at risk of closure during to underfunding and when the Inquiry comes to consider its recommendations the NPA would encourage you [the presiding judge] to think about how resilience can be built into future plans." The statement included a compelling account of the commitment typical of so many pharmacies during the pandemic - from husband and wife Pete and Sukhi Johal, both NPA members and pharmacists, who co-own Calow Pharmacy in Chesterfield.

We have been specialising in community pharmacy sector for over 30 years and have helped many pharmacists acquire their first pharmacy. We have seen several of those first-time buyers transition into multiple pharmacy owners under our specialist guidance and support through the years. Acquiring the first pharmacy can be a challenge to most pharmacists especially when they do not have the necessary skill in reading the numbers presented in terms of the target pharmacy's performance and how to interpret these in order to arrive at a valuation for the purpose of submitting an offer. Without the guidance of a specialist accountant in community pharmacy, one of the major risks is that one could end up paying more than what the pharmacy is worth. Once the offer is accepted, there are other challenges to overcome to get the deal over the line. 1) Assessing the risk 2) Valuation of the business 3) The negotiation process 4) Asset or company purchase 5) Financial due diligence 6) Asset/share purchase agreement 7) Finance the purchase