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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.

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).

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.

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.

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

The Department of Health in Northern Ireland has advised pharmacies to continue providing rota services on Easter after learning that many pharmacies are unwilling to provide the services on Easter holidays. "It is extremely regrettable that community pharmacy representatives have advised that access to rota pharmacies in some parts of Northern Ireland will be reduced over the Easter holidays," department said. They have also stated that despite a commitment of recurrent investment, support for new patients assessed by Trusts as requiring blister packs may be restricted. These actions have the potential to impact on patients and other parts of the Health and Social Care system. The department has also called the CPNI's demand to increase the funding up to 50 per cent in the sector "unrealistic" in the current financial climate. It said: "Financial pressures across the entire NI public sector are severe with an extremely challenging health budget anticipated for 2023/24." "The Department is therefore facing a significant funding gap just to maintain existing services and the whole Health and Social Care system is an extremely unpredictable and fragile position. The core funding envelope available to community pharmacies in NI has increased by 16% over the past three years."

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.

Professor Harry McQuillan has said community pharmacists in the UK must change their focus from an 'accuracy of supply' to a 'safety of supply' model when it comes to dealing with patients. "The main take away message from tonight's lecture is for pharmacy professionals to really challenge themselves about whether they are focused on accuracy of supply or safety of supply," he said at this year's UCL School of Pharmacy Lecture in London on Thursday, 15 June. "For our community pharmacists it must be about safety, including prescribing, and ensuring patients and citizens get the maximum benefit from prescribed medicines. "To deliver this, we need to invest in our teams - harness technology and always be willing to take the next step in a more clinical future." The Chief Executive Office of Community Pharmacy Scotland, however, noted that at a time when the UK was grappling with an unprecedented national debt crisis exacerbated by severe cost of living and spiraling inflation, community pharmacy will need to make a "compelling case" of where the priority should be in the sector. Expanding on the financial woes of the country, he compared the current national debt of the UK, which stood at a staggering 270 percent of GDP in September 2022, with the previous record-breaking national debt of 250 per cent at the end of WWII.

The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists are able to reap the benefits from it. Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies. Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just delighted to have easier access to care," he said. In its first month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an average of 200 interventions per week. "That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a week - that's a huge capability and capacity bump for the NHS," he added. Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.

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 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.

A recently published report on medicines optimisation highlights the urgent need for transformative changes across all pharmacies to unlock their full potential in delivering integrated care. The report by Public Policy Projects (PPP) is first of the four in the series that emphasises the significant benefits that medicines optimisation can bring to integrated care systems (ICSs). This includes reducing health inequalities and improving population health. Pointing to the "untapped opportunity" that medicines optimisation presents for ICSs facing financial challenges, the report underscores the vital role of pharmacies in enhancing patient outcomes. The launch of the Pharmacy First services has already demonstrated the essential contribution of pharmacies to the health and care system. With "medicines being the second highest cost to the NHS," the report recommends ways "to achieve better value for money while improving patient outcomes".

The Pharmaceutical Services Negotiating Committee (PSNC) has published a guidance for community pharmacies to help them in the implementation of the new Prescription Prepayment Certificate (PPC) for hormone replacement therapy (HRT). The new policy will rollout from 1 April 2023, patients who are not already exempt from NHS prescription charges will be able to purchase an annual HRT PPC for the cost of two single prescription charges Major concern raised by PSNC is that the NHS systems have not kept pace with policy, as the certificate is launching without the IT in place to support it. PSNC has been clear that this is totally unacceptable, including raising this with Ministers directly and warning them that introducing the PPC without this infrastructure risks causing confusion for some patients and adding to the burden for pharmacy teams. "Government recognises the challenges but is determined to move forwards with the policy, said the committee. "DHSC has recognised the impact this will have on pharmacies and we are still pressing for appropriate financial compensation. We have also sought guidance for GPs, and now published our own guidance to try to make the launch go as smoothly as it can for pharmacy teams."

A second day of action has been announced by the National Pharmacy Association (NPA) to support the cross-sector #SaveOurPharmacies campaign. This campaign aims to bring attention to the severe financial challenges facing community pharmacies due to ongoing cuts. Scheduled for September 19, the day of action coincides with the political party conference season, aiming to emphasise the urgent need for government intervention to ensure continued patient access to pharmacies. The NPA's initiative follows the successful One Day to #SaveOurPharmacies event in June. Approximately 6,000 pharmacies participated by dimming their lights, wearing black, and engaging on social media to spotlight the issues facing the sector.

A member of the English Pharmacy Board and RPS Assembly, Sharon Isobel Tait Buckle (also known as Sibby) has been elected unopposed as the treasurer of the Royal Pharmaceutical Society (RPS). Sibby takes over the role from Andre Yeung, whose tenure ended in June 2022. Sibby was first elected to the English board in 2012 and is the first woman to hold the post since RPS became the professional leadership body in 2010. She is already part of the Finance and Investment Committee, where RPS budgets, pensions, assets, financial priorities and performance, reserves and investment policies are scrutinised and agreed. Commenting on her new role, Buckle said: "I want to build on the great contribution made by our previous Treasurer. Over the next two years of my tenure I will monitor and challenge our financial performance, our focus on Environmental, Social and Governance factors (ESG), investment strategy and performance and our financial governance.

The NHS is facing a range of long term challenges which needs to be countered with prevention, enhance personalised care and sustainable performance, health and social care secretary Sajid Javid said on Tuesday (March 8). In his speech on healthcare reform at the Royal College of Physicians in London, he said: "We face some long-term challenges: how to keep the NHS focused on delivery while futureproofing it for changing demographics and disease; how to meet rising patient expectations and address the injustices of widespread disparities; and how to deal with an unsustainable financial trajectory while backing the brilliant people who work in health and care." Javid emphasised on three key points for healthcare reform - prevention, personalisation and performance. He said, prevention is not just about building a 'national hospital service' but a true 'National Health Service'.

The Royal Pharmaceutical Society (RPS), professional membership body for pharmacists and pharmacy, has published its manifesto for the general election, highlighting key issues facing the next government after the election on July 4. Local candidates are urged to recognise and support the vital role pharmacists play in supporting people's health. The RPS teams are gearing up to influence government policy in various crucial areas. Their key asks include: Ensuring Secure Patient Access to Medicines Supporting a Better-Connected NHS Enhancing Accessible Prescribing in Local Communities Maximizing Health Improvement through Locally Accessible Pharmacy Teams Supporting the Workforce to Deliver Patient Care Unlocking the Potential of New Advances in Medicines Supporting the UK's Global Position in Science and Research Acknowledging the efforts of pharmacists and their teams, Professor Claire Anderson, President of the RPS, noted that they are "working incredibly hard to maintain patient access to care amid workforce challenges, medicines shortages and financial pressures."

Whether it's the effects of the coronavirus pandemic and those suffering with long Covid, or the financial pressures of rising living costs, these hard times can affect absolutely anyone's mental health. Mental health problems have worsened across all age-groups in the last few years, from lack of social interaction, unexpected bereavements or the significant impact of a physical injury or long-term illness taking its toll on mental wellbeing - these challenging experiences and situations that we face throughout life leave a big strain on the population. Ultimately, there is an urgent need to reduce rising levels of mental ill-health in our society. As a pharmacist with 25 years' experience in healthcare, I feel I have an obligation to my patients to support them with their healthcare needs, and mental health should be treated just the same as physical health. Despite efforts to improve NHS mental health services, patients may still not be receiving the appropriate immediate care as they are often provided with online counselling or an App for long-term support (online support introduced since the pandemic). Community pharmacists are in a unique position to be advocates for patients with mental illness as they are the healthcare professionals' patients see most often. This is a good opportunity for pharmacists to speak to patients face-to-face and give them advice in a more practical way rather than potentially waiting weeks for an GP appointment.