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Poverty not only takes a significant toll on people's health but also leads to additional costs for the National Health Service (NHS). Rise in deep poverty, cost-of-living crisis, and high pressure on NHS services have worsened the situation, according to a study published by The King's Fund this week. The report underscored that poverty and deprivation contribute to a greater prevalence of diseases, difficulties in accessing health care, late or delayed treatment, and worse health outcomes. These challenges could be seen across various NHS services, spanning from emergency care to dental services Additionally, it revealed that 30 per cent of people living in the most deprived areas have turned to 999, 111, A&E or a walk-in centre because they could not access a GP appointment. In 2016, the Joseph Rowntree Foundation (JRF) estimated the cost of poverty on health care at £29 billion (£34 billion in current prices). As the proportion of people living in deep poverty has risen, the situation has worsened. In 2021/22, six million people were living in very deep poverty, up from 4.5 million two decades ago. Currently, more than one in five people in the UK are estimated to be living in poverty, the report noted. Deprivation is linked to a range of diet-related health problems, including cardiovascular disease and diabetes, as well as mental illness. According to the report, the depression rate is two times higher among people living in the most deprived areas, compared to the least deprived areas.

The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce. The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit. Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited to general practice: community pharmacies are also suffering the consequences of it." "Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to make ends meet, not least given the rising staffing costs which are being driven up by workforce issues. Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

The National Pharmacy Association (NPA) has welcomed the Chancellor's commitment to increase the NHS budget, hoping that 'community pharmacies benefit from this investment'. The association is urging the government to address years of underfunding so that community pharmacies can avoid staff lay-offs to cover the increasing costs of the national living wage. The government's uplift of the National Living Wage was confirmed in its latest budget announcement to tackle the cost of living crisis. The NHS budget will also be increased in each of the next two years by £3.3bn. A recent NPA commissioned report by Professor David Taylor from University College London predicted that wage inflation and other cost pressures could combine with funding cuts to lead to cut-backs and pharmacy closures.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

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.

Long waits for an ambulance or surgery led to the death of 112 people, and nearly 8,000 more people suffered harm while waiting for help in England last year. The data from NHS England, obtained by The Guardian, show that patient deaths arising directly from care delays have risen more than fivefold over the last three years. In 2019, there were 21 patient deaths due to NHS care delays, and 96 people suffered "severe harm" as compared to 152 last year. Adult mental health care was mostly affected with 471 patients experiencing harm due to delays, followed by childbirth care (253), eye problems (221), and trauma and general surgery (207). There has been increase of 97 percent in the overall number of people suffering some degree of harm, from 3,979 in 2019 to 7,856 in 2022.

As the countdown to the next UK election begins, the King's Fund has identified three priorities to improve public health. The national action would be taken by the future government to fix the "NHS and social care" in the country. The health policy think tank said it would prioritise "improving access to out-of-hospital care", making "careers in health and social care" more attractive and tackling the biggest risk factors affecting people's health. It highlighted that workforce crisis is one of the biggest challenges faced by the National Health Service (NHS) and social care services in England while citing "years of poor planning and fragmented responsibilities" as the reason for widespread staff shortages. As per the King's Fund's data, there were more than 125,000 vacancies across the NHS workforce in England in October 2023, not including primary care vacancies such as GPs, and 152,000 vacant posts in the adult social care workforce.

Challenges in accessing the NHS waiting list are pushing more and more people toward private-funded alternatives for access, diagnosis and treatment, thereby increasing the demand for private health cover. According to a report published by health data provider LaingBuisson, the demand for private health cover, including medical and dental insurance and cash plans, has surged to its highest levels since 2008. The UK's overall health cover market reached £6.7 billion in 2022, an increase of £385 million from the previous year. During the period from 2020 to 2022, the market experienced annual growth rate of 6.1 per cent, a significant increase compared to the average annual growth rate of 1.7 per cent observed between 2008 and 2019, the research found. A total of 4.2 million people were subscribed to medical cover schemes in 2022. When dependents covered by these policies were included, the number reached 7.3 million - the highest count since 2008. LaingBuisson's analysis showed that medical cover volumes were steady through most of the 2010s, but began to increase alongside rises in the NHS waiting list from 2018.

A recent UNISON survey has unearthed disturbing findings regarding the prevalence of sexual harassment among NHS staff across the UK. With data collected from over 12,000 healthcare workers, the survey sheds light on the challenges faced by frontline workers in their workplace environments. Approximately 10 per cent of healthcare professionals reported instances of sexual harassment during their tenure, with nearly 29 per cent of those experiencing harassment also reporting incidents of sexual assault. Shockingly, 50 per cent of respondents reported being leered at or subjected to suggestive gestures, while a quarter faced unwelcome sexual advances or demands for favors. The most common complaint, voiced by 61 per cent of those affected, was the experience of unwanted crude banter or jokes in the workplace.

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.

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 community pharmacy bodies, along with England's largest pharmacy chains, have urged the Prime Minister, Rishi Sunak to resolve fund and workforce crisis in the sector. In the joint letter the Chief Executives of Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC), along with Boots, Lloydspharmacy, Well and Rowlands Pharmacy, said they are pleased to see Government now recognising the key role that community pharmacy' could have in alleviating the strain on other NHS services. However, the associations also warn that although the sector is ready to support, 'this will not be possible unless pharmacy is properly funded.' Janet Morrison, PSNC Chief Executive, said: "The Prime Minister should also know that community pharmacies are also facing a crisis. They need sustainable investment, urgently, if we are to avoid devasting consequences for pharmacies and for their patients." The letter calls on Government to help pharmacy to resolve the funding, workforce and capacity issues engulfing the sector. It said: "Community pharmacies are in crisis and after 7 years of 30% funding cuts have reached their limit."

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.

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."

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.

Trade bodies have reiterated the call for more funding in response to the reports that ministers are considering a Pharmacy First scheme amid the NHS strike. The Sunday Telegraph reported that pharmacies could be drafted in to help the NHS to cope when other healthcare workers take industrial action. But, a PSNC committee member has warned on Monday that the government suggestions are "categorically impossible" without extra funding. The Company Chemists' Association (CCA) has echoed the sentiment, saying pharmacy network is on the brink of collapse. "We welcome plans for a Pharmacy First scheme in England. However, after eight years of funding cuts, the pressures on community pharmacies are simply untenable," Malcolm Harrison, chief executive of the CCA, said.

National pharmacy bodies have welcomed two VAT changes related to community pharmacy services announced in the Spring budget on Wednesday (15 March) but were disappointed that the budget brought no further relief for the sector in a crippling funding crisis. It was announced that from 1 May 2023, VAT exemption on healthcare would be extended to include medical services carried out by staff directly supervised by registered pharmacists. The government will also extend zero rate on prescriptions to medicines supplied through Patient Group Directions. This measure will be introduced in autumn 2023. HM Treasury said these measures were being introduced to ensure that the VAT system keeps up with changes to how the NHS operates and how healthcare is delivered across the country. More widely, Chancellor Jeremy Hunt promised to halve inflation and said that the NHS would soon publish its long-term workforce plan.

As part of a new blueprint for primary care, the government today (May 9) announced an investment of £645 million over two years to expand community pharmacy services in England. In a statement, NHS England said: "For the first time ever, patients who need prescription medication will be able to get it directly from a pharmacy, without a GP appointment, for seven common conditions including earache, sore throat, or urinary tract infections." Prime minister Rishi Sunak hopes that the measures will help end the "all-too stressful wait on the end of the phone for patients" by freeing up 15 million slots at doctors' surgeries over the next two years. "We will end the 8am rush and expand the services offered by pharmacies, meaning patients can get their medication quickly and easily," he said Almost half a million women will no longer need to speak to a practice nurse or GP to access oral contraception and will instead be able to pop into their local pharmacy for it, according to the government announcement. Blood checks for people suffering from moderate risk of heart attack or stroke conducted in community pharmacies will more than double from 900,000 last year to 2.5 million next year. NHS chief executive Amanda Pritchard said the "ambitious package" would help transform how care is provided within the health service "with pharmacies playing a central role in managing the nation's health including providing lifesaving checks and medication for common conditions for the first time.

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."

Britain on Tuesday (January 4) faced warnings of an impending hospital crisis due to staff shortages caused by a wave of Omicron infections, as the country returned to work after Christmas. However, Britain's vaccine minister said hospitalised Covid-19 patients were showing less severe symptoms than before, adding that there was no need for further restrictions at this stage. Prime minister Boris Johnson resisted imposing stringent lockdown measures in England ahead of New Year as Omicron fuelled a spike in cases to record highs. While hospitalisations are rising they have not tracked the trajectory of daily cases, possibly reflecting the impact of vaccines and booster shots, the likely lower severity of Omicron and the time lag in people going into hospital. "At the moment, if you look at the people who have been hospitalised, they are going in with less severe conditions than before," minister for Vaccines and Public Health Maggie Throup told Sky News, adding that the "Plan B" Johnson brought in in December was working. "The numbers that are in hospital beds is about half what it was a year ago - and that just shows the power of the vaccine."