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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.

The National Pharmacy Association (NPA) has called on the NHS England to uplift funding for pharmacy contractors to enable them to cover higher staffing costs along with a range of other cost-inflating factors. This follows latest data released by the recruitment platform Locate a Locum, which showed a huge increase in locum rates for pharmacists in 2021 and predicted the trend to continue. The report noted a 71 per cent surge in the cost of employing locum pharmacists in England, from the 2020 average to the second half of 2021. NPA chief executive Mark Lyonette said: "There is a heavy reliance on locums in community pharmacy to maintain continuity of services with the average pharmacy operating 50 hours per week. Consequently, increases in locum rates have a big effect on the cost base. "Pharmacies face a range of general cost pressures beyond locum rates, including much higher energy costs. We hear a lot about the cost of living crisis; our members are facing a cost of doing business crisis and it's every bit as real. "The underlying underfunding, significant general inflationary pressures and specific cost increases relating to the locum workforce together make a powerful and urgent case for new funding."

Community Pharmacy England (CPE) highlighted the untapped potential of community pharmacies in the prevention and management of long-term conditions to Conservative MPs during an event last week. The roundtable discussion was attended by a select group of influential and supportive MPs alongside community pharmacy owners, the Chief Executive of Community Pharmacy England, the Director of NHS Services, and patient representative group Healthwatch. MPs in attendance included Steve Double, MP for St Austell and Newquay, who chaired the discussion; Will Quince MP, former Minister for Pharmacy, Derek Thomas MP, Sir Peter Bottomley and Peter Aldous MP. They talked about the current pressures and funding crisis in community pharmacy, exploring solutions on how this could be eased and the huge benefits that can be unlocked.

Prime Minister Rishi Sunak was questioned whether he 'will take urgent action to prevent pharmacy closure'. At Prime Minister's Questions (PMQs) in Parliament held on Wednesday (26 April) he replied, "we will continue to do everything we can to support community pharmacies." Labour MP for Knowsley and All-Party Pharmacy Group member, George Howarth said: "Given the chronic lack of capacity in the NHS, the Prime Minister will be aware that community pharmacy can help deal with minor illnesses. But there is a problem on average 10 Pharmacy close every month in England." Prime Minister was further asked "will he take urgent action to prevent further closing and commission a properly funded 'Pharmacy First' service for minor illnesses? Sunak replied: "I've been a wholehearted champion and believer in the role that community pharmacists can play. we want to make sure that they can do everything to ease some of the pressures in primary care.

The trade bodies and four largest pharmacy chains in England, have jointly written to the Secretary of State for Health, Steve Barclay, warning that the sector needs urgent investment for sustainability. The letter from AIMp, CCA, NPA, PSNC, Boots UK, Lloyds Pharmacy, Well, and Phoenix UK, warned that the 30 per cent real terms funding cuts that pharmacies have faced over the past seven years have left many businesses in a cashflow crisis. The letter said that the government is facing a choice over the future of the country's 11,000+ community pharmacies, with permanent closures likely and medicines supply at risk if no urgent action is taken. "If the funding situation is not addressed, the sector is likely to move rapidly towards many permanent closures of pharmacies." The organisations say that once these closures start, they will be hard to stop, as the sector is now so fragile other pharmacies would struggle to pick up the slack.

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.

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."

There is a state of "emergency" across the community pharmacy sector, the National Pharmacy Association (NPA) has warned. The organisation is holding a day of protest action, called 'One Day to #SaveOurPharmacies', on 20 June to draw attention to the sector's growing crisis. During the protest, pharmacy teams across the UK are expected to take a range of symbolic actions - such as turning the lights out for a period, asking their staff to wear black, blacking out windows, using the day to engage with patients, inviting parliamentary candidates and using #saveourpharmacies on social media - signifying dark times for the beleaguered community pharmacy sector, the NPA said. The organisation decided to choose 20 June for the protest as it marks the day from which the average pharmacy across the four nations will be "lossmaking overall."

The UK has witnessed a nearly 50 percent increase in pharmacy closures this year compared to the same period in 2023, which was already considered the worst year in recent memory. A new analysis by the National Pharmacy Association (NPA) revealed that 177 pharmacies closed their doors between January and April 2024, compared to 116 in the same period last year. This is the equivalent of 10 local pharmacies shutting down every week. Analysis of NHS figures by the NPA showed that 403 pharmacies closed their doors last year, nearly five times higher than the number that closed in 2022. Since 2017, over 1,400 pharmacies have shut down across the UK. Rising costs and declining real terms funding have led to the fastest rate of closures in decades, said the NPA, highlighting that "real terms funding has decreased by 40 per cent over the last decade."

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

The 14th Community Pharmacy Conference by Sigma Pharmaceuticals has been timely, prime minister Rishi Sunak said, noting that it coincided with the launch of Pharmacy First, a new initiative that enables patients to receive treatments for seven common conditions directly from a pharmacist without the need for a GP appointment or prescription. "We are all grateful for the tremendous contributions that pharmacists make to our NHS. The fantastic work you do is critical to the success of Pharmacy First and many other initiatives," Sunak said in a written message. The conference was organised from 25-29 February at Sun City in Johannesburg, South Africa, under the theme 'community pharmacy in an integrated NHS'. In a recorded video address to the Sigma Conference, shadow health secretary Wes Streeting said community pharmacies are 'critical' to the Labour party's mission to make the NHS 'fit for the future'. "You should be playing a much more significant role. Labour's reform agenda will get pharmacists working to the top of their licence. We want community pharmacists to play a greater role in healthcare, with more focus on their expertise in prescribing and medicines management," he said.

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.

Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015. It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders. The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector. The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a result, maintaining prescription and medication adherence services is challenging to say the least. Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services since the start of COVID. This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported clinically by pharmacists. This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations a year - a staggering rise of 44 per cent in the last 24 months alone.

The Community Pharmacy England (CPE) has called the recent announcement of six per cent pay rise for the public sector workforce as 'unfair' for the community pharmacy sector. On Thursday (13 June), the Department of Health and Social Care (DHSC) announced that pay scales for most doctors and dentists will increase by at least a six per cent this year after the government accepted the recommendations from the independent pay review bodies in full. Responding to the recent announcement Chief Executive Janet Morrison, said: "The public sector workforce pay rise will be welcome news for its recipients given the huge inflationary pressures and the ongoing impact of the cost-of-living crisis. But for community pharmacy owners - who have faced 30% funding cuts in recent years and who are struggling to meet their rising wage costs - this feels unfair, and very far from good news. At Community Pharmacy England we are fully focused on the current financial and operational pressures and fighting hard for a sustainable long-term funding arrangement.

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."

The Pharmacy First service, set for launch in England at the end of January, is expected to help reduce some of the pressure on the National Health Service (NHS). But the question is - Are pharmacists ready to take the extra workload amidst many issues community pharmacies are currently facing? Nearly 50 per cent of pharmacy workers surveyed by ITV News said they do not feel confident they can provide the new services. Pharmacy leaders told the British news channel that the industry is already in crisis, and they are facing a "potentially fatal cocktail" of rising prices, major supply problems and a lack of funding.

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.

Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling it "the biggest dis-service ever done" to community pharmacy. The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years. This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector. The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework. The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she assured everyone that the committee was well aware of the pressures the sector was facing. "I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce crisis is critical, leading to temporary closures.

Anyone who has studied the finances of an independent pharmacy business knows that money is tight. In many cases, they are perilously close to failure. It's easy to assume they are retail businesses, cashing in on the higher public profile the sector has enjoyed during the pandemic years. But those have been mere words. Certainly, the pandemic represented a halcyon period for the profession. We engendered a feeling of normality, dependable and accessible to society. We played a substantive role in keeping people out of hospitals and giving the vulnerable the ability to live independently from their own homes for longer. We mobilised to smash flu vaccination records and deliver covid jabs. But despite the warm words of a new service based future and the incessant expressions of gratitude contractors desperately need the headroom to prepare, plan and invest. Platitudes, press releases and assurances of a bright clinical future are small comfort to what is needed and that's cash on the table. As the adage goes: "Talk is cheap, money buys houses." Cashflow crisis Since 2016, we have witnessed almost 650 pharmacies fall by the wayside. Some may have merged; the majority, however, have perished due to the relentless need for an increasing cashflow. It is cash, or rather the lack of it, which is killing independent pharmacies.

The Pharmacists' Defence Association (PDA) has written to the National Pharmacy Association (NPA) to highlight several important points regarding their proposed "day of action" on 20 June 2024. The NPA describes this initiative as a response to the "emergency across the community pharmacy sector." In a letter addressed to NPA Chair Nick Kaye and Chief Executive Paul Rees, the PDA's director of pharmacy, Jay Badenhorst stressed the need for NPA members to consider their obligations to staff and patients before participating in the planned actions. He stated, "We are supportive of a new contractual framework for the community pharmacy sector." "However, any actions taken must ensure the safety of patients and the operational integrity of pharmacies." The PDA's letter also expressed concerns over the safety and operational impact of the proposed symbolic gestures, including turning off lights and blacking out windows.