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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 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.

In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.

Prime Minister, Rishi Sunak, has backed pharmacists to play a greater clinical role in the health and well-being of the nation, describing them as "valuable and trusted" members of the community. Pharmacists have faced a difficult year with 222 community pharmacies closing in just the first six months. Boots alone will be closing 300 branches over the next 12 months. Sunak, however, insisted that his government knows the "hard work of pharmacy teams", and that he wants to "enable them to do more to support the NHS." Speaking at the annual Sigma Conference in London on Sunday (5 November), the prime minister reiterated that community pharmacy is in line for a much-needed boost in funding. "Earlier this year, the government announced plans for further investment of up to £645 million over the next few years to support the Pharmacy First service for patients," Sunak said in a letter read out at the conference by Lord Dolar Popat. "This means that community pharmacies will be able to assess patients and provide some options to protect them without a GP appointment."

The recent announcement that Royal Mail will be partnering with distance selling pharmacy (DSP) giant pharmacy2U highlights how standards of regulatory enforcement are being ignored to accommodate the DSP model. The brunt of these double standards hinges around the levelling down of temperature enforcement standards by the Medicines and Healthcare products Regulatory Agency (MHRA) which demands mapping must be audited from the point of dispensing to the patient. The MHRA has a well recognised duty to ensure medicines reach patients in a safe condition. The current anomaly appears to turn a blind eye to this step in the supply chain at the point the wholesaler releases goods to the pharmacy hub. Equally the training on delivering medicines safely and effectively direct to patients should apply fully to all hubs including DSPs. Why is it that DSPs are being treated differently to bricks and mortar pharmacies? It's essentially the same patients receiving the same medicines from the same wholesalers. A further regulatory disparity exists around how parcels must be "tracked and signed for" to be reasonably certain medicines are delivered into the hand of the intended recipient, as per existing regulations. Clearly an untracked, unsigned package cannot be guaranteed to finish in the hands of the intended recipient. There is a very real possibility that such omission could lead to community pharmacy closures which will, in turn, lead to unemployment and a reduction in the care services. At a time when integrated care systems have just gone live, the removal of vital support services leading to further inequalities is the wrong message for both providers and patients alike.

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."

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."

At the recent 'Locum Matters' online event held on June 25, 2024, members of the Pharmacists' Defence Association (PDA) discussed critical issues facing locum pharmacists, with a disturbing trend taking center stage: employers pressuring locum pharmacists to accept lower rates under the threat of potential pharmacy closures. The event, organised in response to feedback from PDA locum members, addressed a range of significant topics including training for the recent Pharmacy First Services, respect for professional autonomy, and the need for adequate rest breaks. However, the issue of rate pressure and pharmacy closures was a focal point. Several locum pharmacists reported that some employers were leveraging the possibility of pharmacy closures to coerce them into working for lower pay. This unethical practice has raised alarm within the locum community, highlighting the precarious working conditions many face.

In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising issue of medicines supply. "Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary. In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area." The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why will they not do so?

The Company Chemists' Association (CCA) says the data from the 'Locate a Locum's annual report' has revealed that the average locum rate rose by 124 per cent in Scotland in 2021 compared to the previous year and that the trend seems to have continued since. According to the report, in Scotland, the average rate has risen from £20.08 to £44.89 which is a massive £24.81 difference. This was in response to the pharmacists Defence Association (PDA)'s statement on 15 times more closure of pharmacy in Scotland by a CCA member. "This clearly demonstrates that demand for pharmacists in Scotland is outstripping supply," said the association. Explaining further, it said: "Our members have been serving Scottish communities and patients without issue for decades. Recent pressures, however, are unprecedented. Workforce challenges are affecting all parts of healthcare across the UK - and community pharmacy is no different. Pharmacists remain on the Home Office's shortage occupation list for this reason."

Over a century-year-old Boots pharmacy in St James's Street, Brighton shut its doors permanently on Saturday (20 January) leaving the communities disappointed. The branch in Kemp Town, which was opened to the public for the first time in 1914, was supposed to close on November 19 last year but continued trading into the new year, The Argus reported. Locals are not happy with the retailer's decision to close the store as some say it used to be "always busy with prescriptions and people buying things." Another person recalled that Boots had earlier closed two pharmacies, one on Lewes Road, Brighton, and another on Church Road, Hove. The American-owned health and wellbeing chain is in the process of closing more UK branches in the coming months as it's targeting to reduce its store portfolio to 1,900 from 2,200.

Pharmacies lead among the list of 16 'most essential' services required for a neighbourhood, as revealed by the 2023 Community Barometer survey commissioned by the Association of Convenience Stores. In June, ACS commissioned Yonder Consulting to conduct a poll surveying the opinions of 1,000 people across the UK. The survey assessed how these individuals value 16 different services in their local area, defined as the region within a 15-minute walk from their homes. The survey's essential services included pharmacies, post offices, convenience stores, banks, petrol stations, restaurants, coffee shops, pubs, specialist food shops, non-food shops, fast food shops, vape shops, charity shops, pawnbrokers, hairdressers, and gyms or sports facilities.

Tesco, one of the leading pharmacy chains in the UK, has been allegedly accused of forcing some locum pharmacists to accept lower rates or it will cancel their booking. The issue has been brought to the notice of the Pharmacists' Defence Association (PDA) by some of its locum pharmacists members. "Some locum pharmacists who had existing confirmed bookings at Tesco stores have reported to the PDA that the company has contacted them to say that if they do not agree to accept lower rates than have already agreed, the company will cancel their booking," said PDA. "The reported messages follow a communication from Tesco setting self-imposed so-called "wage rates" for locums. This is confusing as locums are self-employed and therefore should be able to negotiate rates with their clients just as any other independent supplier can do. Using terminology such as "wage rates" is more indicative of an employer-employee relationship and could undermine the status of the locum market in community pharmacy. Employees are also entitled to various extra benefits and have greater employment rights."