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A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

The pharmacy bodies have expressed a deep concern over Lloyds Pharmacy's announcement on plans to close all pharmacy branches located in Sainsbury's before the end of 2023. Pharmaceutical Services Negotiating Committee (PSNC) Chief Executive Janet Morrison said: "This significant shrinkage by the second largest pharmacy chain is an extremely worrying development and one of the clearest signals yet of just how much all community pharmacies are struggling to make ends meet. We know that many are at breaking point." She added: "We understand that LloydsPharmacy will be in touch directly with affected staff and patients at this difficult time. As these pharmacies close, other pharmacies locally will be braced for even more pressures as they try to cope with increased demand." "The announcement by LloydsPharmacy will be of concern to staff, patients, the public and the community pharmacy sector alike," Malcolm Harrison, Chief Executive of the Company Chemists' Association (CCA). Pharmacists, and other employees, working at pharmacies owned and operated by LloydsPharmacy in Sainsbury's have been told that the group of more than 200 pharmacies will be closed this year as LloydsPharmacy will be ending their relationship with the supermarket chain.

NHS England has commissioned the Royal Pharmaceutical Society (RPS) to develop guidance that helps community and hospital pharmacy teams across Britain to reduce the impact of pharmacy services, pharmaceutical care and medicines on the environment. The RPS said the Greener Pharmacy Guidance will enable pharmacies to self-assess their impact against the standards, benchmark and improve through evidence-based activities and actions. "I'm delighted our strong commitment to helping pharmacy reduce its environmental impact can now be taken to the next level through developing guidance and accreditation for pharmacy teams," RPS president Professor Claire Anderson said. "Medicines account for 25 per cent of carbon emissions within the NHS and this initiative underscores our commitment to promoting sustainable healthcare and supporting the NHS's goal of achieving 'net zero' emissions by 2040." Peter Morgan, medicines assistant director at NHS England, commented: "Pharmacy staff are involved in the purchasing and dispensing of almost every medicine used in the NHS and the new Greener Pharmacy Guidance and Self-accreditation scheme will provide support for pharmacy professionals by outlining clear actions to deliver more environmentally sustainable pharmacy practices." The RPS said the guidance and digital self-assessment toolkit will integrate with carbon calculator tools to help pharmacy teams to measure their carbon footprint, action plan to reduce use of carbon and improve sustainability.

All pharmacy businesses are reporting that they are struggling to find the registered professionals needed to open their pharmacies, clarified the Company Chemists' Association (CCA) in response to an attack by the Pharmacists' Defence Association. Last week, PDA allegedly accused some large pharmacy chains of 'orchestrating' full or part-time closures of some of their shops due to the staff shortage. In its Open Letter published on Tuesday (July 19), PDA demanded urgent action "to protect patients by ensuring that essential community pharmacy services are provided safely and consistently". "All parts of the healthcare system are struggling to recruit staff and to assume that pharmacies would be immune to such pressures, seems fanciful," said CCA. "CCA members are working extraordinarily hard to prevent temporary closures, but recruitment and retention of pharmacists is becoming increasingly tough. The recent rise in Covid cases and the beginning of the summer holiday season in parts of the UK have only worsened the situation." The Association also showed data from the PSNC Pharmacy Pressures Survey (April 2022) which found that 91 per cent of pharmacies are experiencing staff shortages, clearly demonstrating that these shortages are affecting the entire sector.

A policy brief, developed by researchers from the University of Bath and University of Strathclyde with funding from Sigma Pharmaceuticals, has recommended the Department of Health and Social Care (DHSC) and NHS to increase community pharmacy funding to avoid damaging closures and diminution of quality. The report launched on Wednesday (12 June) at an event in the House of Commons, attended by Members of Parliament, senior policymakers and the pharmacy industry, analysed community pharmacy policies and spoke to stakeholders to explore their opinions of the future of community pharmacy. It was found that patients value their community pharmacies, but staff feel demotivated, insecure and undervalued. Stakeholders and policies suggested that in the future, medicines should be supplied by automated 'hub and spoke' dispensing, enabling community pharmacy staff to provide services that relieve pressure on GP surgeries, such as long-term conditions management, urgent care and public health.

Northern Ireland's chief pharmaceutical officer paid a visit to a community pharmacy in Belfast on Monday (November 7) - marking the end of this year's Ask Your Pharmacist week, an annual public awareness campaign launched by the National Pharmacy Association. Cathy Harrison interacted with patients and staff in the pharmacy before recording a video to promote NI's 'Pharmacy First' service in which she described community pharmacies as "one of the front doors to the health service" with over 500 outlets located across the country. "In our community pharmacies you can always rely on friendly staff, medicines expertise, and walk-in access to face-to-face advice," she said. First launched in Scotland, the NHS Pharmacy First service enables patients to have a consultation with a pharmacist for advice on minor ailments. Ms Harrison also drew attention to community pharmacy's role in cancer awareness and helping people to quit smoking, as well as managing patients with urinary tract infections, in addition to playing their part in delivering Covid-19 and flu vaccinations.

The NHS England has introduced a training programme for 1000 staff to broaden their community pharmacy roles, thereby improving patient access to services. Among them, 500 pharmacy staff will be trained to supervise pharmacists during prescription training, while the remaining 500 will provide support for various training, including pre and post-registration programmes for pharmacists and pharmacy technicians. According to the NHSE, pharmacist and pharmacy technician roles are rapidly evolving due to healthcare changes and increased demand for clinical services in community pharmacy. "There are 3,000 independent prescribing training spots available for 2023/24. Educational supervision is a crucial part of this to enable the ongoing transformation and skills development of the growing pharmacy workforce." The NHSE-funded training, scheduled to begin next month, will ensure that those involved in educational supervision, including Designated Supervisors (DSs), Pre-registration Trainee Pharmacy Technician education supervisors and Designated Prescribing Practitioners (DPPs), can effectively support learners.

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 community pharmacy staff in Scotland will not be required to work for a minimum of five full days if they test positive for Covid-19. The Scottish health secretary Humza Yousaf has clarified that health and social care employees, including community pharmacists, will have to follow the guidance on managing staff with symptoms of a respiratory infection, or a positive Covid-19 test. While responding to Jackie Baillie (Dumbarton) (Scottish Labour Party) written parliamentary question, Humza said, "If they work with patients or service users in face-to-face settings, they can return to work if they have had two consecutive negative LFD test results (taken at least 24 hours apart)." Jackie asked the Scottish government, "what its position is on the actions of Well Pharmacy, in light of reports that the company is insisting that staff who test positive for COVID-19 continue to work when they are in patient-facing roles and dealing with clinically vulnerable people?" The Pharmacists' Defence Association said: "This means that Well pharmacy will have to change their policy in Scotland and no longer allow Covid positive staff to work in their pharmacies."

Balmedie Pharmacy based in Aberdeenshire, Scotland has been purchased by local expanding multiple operator JMF Healthcare. Balmedie Pharmacy is a well-performing community pharmacy that dispenses an average of 5,255 items per month. It lies completely unopposed in the large Aberdeenshire village of Balmedie, which is circa eight miles north of Aberdeen City Centre. The pharmacy has been owned by Brian Arris since 2004 and was recently brought to market to allow him to pursue other pharmacy business opportunities. Following a confidential sales process with Christie & Co, JMF Healthcare to benefit from new housing developments in this area of Aberdeenshire such as 300 new homes planned in Balmedie, approved plans for up to 500 new homes in Trump Menie Estate, and 284 new homes planned in Blackdog Village. Brian Arris, previous owner of Balmedie Pharmacy, comments, "I'm sad to see the business go as the excellent staff have helped grow the pharmacy from scratch since 2004 and we've all put our hearts and souls into providing good pharmaceutical care for the village and surrounding area. I'm confident everyone is left in safe hands with John at the helm now."

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 Pharmacists' Defence Association (PDA) has raised concerns over "certain elements" of the Pharmaceutical Society of Northern Ireland (PSNI)'s consultation on pharmacy staffing levels. PSNI recently consulted on its draft guidance for pharmacy staffing levels which sets out to explain what pharmacy owners and superintendents must do to ensure that each pharmacy has enough skilled and qualified staff. This includes having an appropriate skill mix, to provide safe and effective pharmacy services which comply with the standards. PDA said that the role of the 'responsible pharmacist' has not been "fully acknowledged" and that more clarification is needed. The association has made a few recommendations to PSNI that includes: the guidance must explicitly recognise the statutory role of the responsible pharmacist and their authority in securing the safe operations within the pharmacy. "The guidance should specify that pharmacy owners and superintendents must ensure that they do not set incentives or targets which may compromise the professional judgement of staff." It also recommended that unregistered staff (including unregistered managers) are accountable firstly to the responsible pharmacist for any activity involving the clinical care of patients (for example unregistered managers must not interfere in diary bookings for vaccinations).

Prince Charles has praised the "dedication and professionalism of pharmacy staff" at an event held in London to celebrate the work of community pharmacists during the Covid-19 pandemic. Two hundred pharmacists, pharmacy staff and other health service representatives were invited to attend a special reception hosted by His Royal Highness at St James's Palace on Wednesday night (May 4). According to the National Pharmacy Association, the event was held, in part, to mark the NPA's recent centenary. In his closing speech, The Prince of Wales paid tribute to the work of pharmacies on the NHS frontline. He praised "the dedication and professionalism of pharmacy staff" during the Covid-19 pandemic and said: "I very much hope that this evening's event will help, a little bit, to highlight the marvellous work you do in your communities day in and day out."

Pharmaceutical Services Negotiating Committee (PSNC) has launched two surveys to gather data on the pressures that people working in community pharmacies are facing. Pharmacy teams have informed the negotiator about the ongoing financial and operational pressures and expressed concerns that these pressures could impact patients' care. The surveys would give a snapshot of the problems faced by pharmacies and the results will be used in ongoing discussions with NHS England & NHS Improvement and the Department of Health and Social Care. The results will also help PSNC to make pharmacy's case in conversations with the MPs, ministers and the national media. The two separate surveys are for: Pharmacy business owners/head office representatives - This survey covers the pressures faced by businesses, including financial and staffing pressures. Pharmacy teams - It covers the day-to-day pressures experienced by pharmacy teams including supply chain issues, patient interactions/experience and staff morale.

Preet Kaur Gill, Shadow Minister for Primary Care and Public Health, has paid a recent visit to a community pharmacy in Staffordshire to personally experience the services it provides to patients, while staying updated on the latest sector developments. Her visit to Eason's Pharmacy in Tamworth on September 22nd marked her first since assuming new responsibilities for pharmacy policy matters within Labour's health team. Gill was also joined by a member of the National Pharmacy Association staff. The Minister received a comprehensive briefing on Eason's Pharmacy from its third-generation owner, Kieran Eason (R). He outlined the NHS services, which include the New Medicines Service and blood pressure monitoring, and showcased two consultation rooms and an operational dispensary. "It's great that Preet came to learn firsthand about the challenges we face and the substantial potential of community pharmacies nationwide," Eason said. "As an independent prescriber, I have the expertise to provide even more convenient care, but the current funding levels severely limit our contribution."

Pharmacy leaders have called for reassurance that the workforce plan, expected by April 2023, will cover the entirety of the pharmacy workforce across the health service, including in community pharmacies. A joint letter has been signed by representatives from 14 pharmacy organisations which highlights that with continued pressures on services, it is more important than ever to support the pharmacy workforce so that the staff needed to deliver patient care now and into the future can be recruited, trained and retained. Mark Koziol, Pharmacists' Defence Association (PDA) Chairman said: "Our pharmacist members practise across the entire health system and have the potential to do far more to help patients and improve public health, but they can only do so safely if they are in appropriately staffed workplaces. This is a workforce issue, so it is important that the Government works with representatives of the pharmacist workforce, and of their employers, to get a suitably agreed plan in place." Thorrun Govind, English Pharmacy Board Chair, Royal Pharmaceutical Society (RPS), said: "It will be crucial to use the skills of all our health professions to support the NHS recovery, reduce health inequalities, manage the growing cost of long-term conditions, and deliver best value from medicines.

Digital pharmacy app Charac has raised over £1 million in debt and equity, bringing total funding to date for the London-based startup to £2.5m. Pharmacy Business understands while the majority of the new finance, worth about £1.2 million, comes from the National Pharmacy Association (NPA) coffer, the remainder is put forward by a number of individual pharmacy businesses. The pharmacy sector is in a state of crisis, experiencing nearly two closures per week over the past two years, Charac said in a statement. According to data from the NHS Business Services Authority, there are now only 11,026 community pharmacies in England, the lowest number since 2015. The current crisis is attributed to escalating operational costs, a shortage of staff, and diminished government financial support.

The Pharmacists' Defence Association (PDA) has reacted to the chief pharmaceutical officer (CPhO) for Wales's offer for community pharmacy contractors, offering a funding uplift for community pharmacy on the condition of an increase in pay for some staff by at least the amount currently being imposed upon NHS employees. The PDA has expressed a mixed reaction to the intervention being attempted by the Welsh government. "It is unusual for a government to be so closely involved in the pay of their suppliers' employees and those at some community pharmacy employers have a contractual right to a pay review at times of year that may not synchronize with the government's financial cycle, so this initiative may have different impacts at different employers," said the association. "In addition, the PDA negotiates pay at the largest two community pharmacy employers and works alongside other trade unions that organise other pharmacy workers. This government intervention must not disrupt or attempt to bypass those processes."

The proposed increase in the national living wage (NLW) is expected to impose an implementation cost of £150 million to £195 million on the community pharmacy sector, Community Pharmacy England (CPE) has warned. Chancellor Jeremy Hunt recently announced a 9.8 per cent increase in the national living wage, raising it from £10.42 to £11.44. "The Autumn Statement overlooks the knock-on effects these measures will have on small businesses like community pharmacies," CPE Chief Executive Janet Morrison said in a statement. "The majority of pharmacies employ staff on or around the NLW, which has increased nearly 40 per cent since the start of the current contractual framework." "This is at a time when pharmacies have faced a 30 per cent real terms reduction in funding since 2015," Morrison added. "No viable business can absorb these cost increases without significant support. This is just another cost pressure that pharmacies cannot control and must be addressed through a sustainable, long-term funding arrangement."

The National Pharmacy Association (NPA) has commissioned Professor David Taylor of University College London to investigate the implications of all-time high inflation rates on community pharmacies in the UK. Professor Taylor's will assess rates of inflation affecting community pharmacy across the UK, using public data sources whilst examining inflated costs in the context of the current five year contractual framework in England (2019-2024). He would review the EY (Ernst & Young) report into pharmacy funding, to identify whether current inflationary pressures could change any of the findings and consider the policy implications and impacts of inflationary pressures, including pharmacy's ability to prepare for a more clinically focused future and maintain current core services. NPA chief executive Mark Lyonette said: "Inflationary pressures are eating into the limited funds provided by the NHS for pharmacy services. We believe the real level of inflation for pharmacy businesses could be higher than the CPI inflation rate, which itself is at a 40 year high. Staff and locum costs in the sector as well as medicines costs have risen dramatically.