The 'SaveOurPharmacies' roundtable held on Tuesday (21 March) to discuss severe challenges faced by the community pharmacies in England witnessed the support
of 15 MPs.
Janet Morrison, Chief Executive, Pharmaceutical Services Negotiating Committee (PSNC); Andrew Lane, independent pharmacy owner and Chairman, National Pharmacy
Association (NPA) and Ian Strachan, independent pharmacy owner and Board Member, Association of Independent Multiple Pharmacies (AIM) attended the summit, which
was chaired by Stephen Hammond MP, to brief MPs on the severe challenges facing the sector.
MPs in attendance were Stephen Hammond, Sally-Ann Hart, Peter Aldous, Anna Firth, Taiwo Owatemi, Bob Seely, Derek Thomas, David Rutley, Lilian Greenwood, Tulip
Siddiq, Hillary Benn, Sarah Olney, Christian Wakeford, Daisy Cooper (researcher) and Victoria Atkins (researcher)
The title of the event 'Community pharmacy's role in the Primary Care Recovery Plan' which is expected imminently, is set to include a variety of measures aimed at
helping primary care to recover from the impact of the pandemic.
PSNC has been pressing for the plan to include a fully-funded national Pharmacy First service as this is the best chance for getting significant additional funds
into community pharmacies.
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).
Representatives from the national community pharmacy bodies will brief the MPs on the severe challenges facing community pharmacies on Tuesday (21 March) at a
roundtable summit.
The roundtable summit will include discussions on the urgent action needed to address the current severe challenges being faced by community pharmacy, as well as the
sector's role in the upcoming Primary Care Recovery Plan, said PSNC.
The Parliamentary event this week has been coordinated by PSNC as part of the joint #SaveOurPharmacies campaign which exceeded 30,000 signatories in a week.
The Association of Independent Pharmacies (AIM), the Company Chemists' Association (CCA), the National Pharmacy Association (NPA) and PSNC will take part at the
event.
A spokesperson for the #SaveOurPharmacies campaign group said: "30,000 signatures in a week indicates a high level of underlying public support for community pharmacy
and it's a good start to the #SaveOurPharmacies campaign. A petition by itself won't change the world, but it works as a kind of drumbeat for the campaign, giving
forward momentum, and it's a really easy way to express your opinion.
We hope the new window poster - along with all the resources available at saveourpharmacies.co.uk - will help as many pharmacies as possible to drum up support from
their patients, and we're really grateful to Communications International Group for helping us to print and distribute this.
In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies
in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England,
Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period.
The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK
country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies,
while the total number of independent operators remained consistent with 2022.
According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies.
Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators
acquiring additional pharmacies through corporate disposal opportunities throughout the year.
Pharmacy bodies and MPs discussed on support needed to unlock the "full potential" of community pharmacy at the All Pharmacy Party Group (APPG)'s general
meeting held in Westminster on Tuesday (01 November).
The attendees of the meeting were Janet Morrison OBE, Chief Executive of Pharmaceutical Services Negotiating Committee; Malcolm Harrison, Chief Executive of The
Company Chemists' Association; Thorrun Govind, Chair of the Royal Pharmaceutical Society; Sanjeev Panesar, National Pharmacy Association Board Member, and Pharmacist
Superintendent and Owner of the Pan Pharmacy Group; and Sandeep Dhami, Association of Independent Multiple Pharmacies member and superintendent at MW Phillips Chemist
At the session, 18 parliamentarians were briefed on the myriad of ways pharmacies contribute to the health of the nation.
The panel of experts also highlighted that pharmacists are 'running out of fuel' with the growing challenges such as flat funding, workforce shortages and the
cost-of-living crisis impacting pharmacies' ability to deliver vital services.
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 pharmacy inquiry will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy
services.
It will also consider current challenges around funding, workforce and the digital infrastructure.
Planned developments within the profession will enable future pharmacists to be independent prescribers from day one of registration, giving them a greater role
within primary care teams.
Health and Social Care Committee Chair Steve Brine MP said: "It is clear that pharmacy has a central role to play in the future of the NHS. With a greater focus on
personalised and patient-centred healthcare, we will be asking what more must be done to make sure that the profession is in the best shape to meet demand.
"Better use of the pharmacy workforce would reduce pressures on general practice and hospitals. However, this will not happen without a planned workforce with the
funding, supervision and training to support it.
"At the end of the inquiry, the committee will be making recommendations to the government on what action needs to be taken to ensure the potential of pharmacy is
realised.
The General Pharmaceutical Council (GPHC), Royal Pharmaceutical Society (RPS), Company Chemists Association (CCA), Association of Pharmacy
Technicians UK (APTUK), National Pharmacy Association (NPA), Guild of Healthcare Pharmacists, Pharmacists' Defence Association (PDA), and Independent
Pharmacies Association (IPA) have released a joint statement in response to the far-right riots across the UK.
They emphasised their united stance, declaring zero tolerance for racism towards colleagues or the public in any form.
The joint statement reads: "We are shocked and saddened by the violent public disorder events in recent days.
"We acknowledge how all sectors of the pharmacy profession may be impacted and recognise the challenges that this level of overt aggression can have on
people's ability or willingness to live their daily lives.
"The pharmacy workforce deserves peace and safety, not fear and harm. We stand united in having a zero tolerance of racism towards our colleagues or the
public in whatever form it takes."
Meanwhile, Community Pharmacy England (CPE) has expressed concerns that protests and violent disorder in various towns and cities across England may impact
the ability of community pharmacies to operate.
The Association of Independent Multiple Pharmacies (AIMp) has called upon all pharmacy organisations to unite and collectively represent the sector. While
underlining the need for the sector to adopt a straightforward manifesto that can be presented to the public, politicians, and decision-makers, the association
also advocated for a revitalisation of the 'Save Our Pharmacies' campaign, injecting it with renewed energy and a stronger sense of purpose.
AIMp pointed out that a lack of cohesion is one of the factors contributing to the sector's struggle in gaining attention. "The current trajectory of community
pharmacy is unsustainable," said Dr. Leyla Hannbeck, Chief Executive of AIMp. "To tackle the significant challenges ahead, we must work together cohesively. The
most effective approach is to actively engage with Parliament, leveraging politicians from across the political spectrum to advocate for our cause."
Meanwhile, the association urged various pharmacy bodies to unite in support of the Pharmacy All Party Parliamentary Group (APPG) to enhance its effectiveness
and broaden its influence, rather than working independently.
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."
The Pharmacists' Defence Association (PDA) is bolstering its leadership team with the appointment of Jay Badenhorst as the Director of Pharmacy, a newly
created position aimed at fortifying its commitment to advancing pharmacy practice.
This move comes amidst a period of significant change and challenge for frontline pharmacists, prompting the independent trade union to enhance its influence
in the evolving healthcare landscape.
Mr. Badenhorst, who previously served Whitworth Chemists as the Managing Director and also has leveraged his extensive knowledge of the pharmacy practice and
organisational leadership as the Vice Chair of the National Pharmacy Association, reasons his "commitment to being at the forefront of positive change within
the pharmacy profession."
Mr. Badenhorst expressed his enthusiasm stating: "I am delighted to be joining an organisation that has so much vision, ambition and drive at a time when
pharmacists have so many opportunities to develop their roles for the benefit of patients."
According to Mark Koziol, Chair of PDA, the new position is a reflection of the union's commitment to pharmacy and described the new Director of Pharmacy
as "a senior level, proven and award-winning pharmacy leader."
An executive director of Day Lewis and also board director and member of Association of Independent Multiple pharmacies (AIMp) Jay Patel highlighted the key
issues and on ground challenges faced by the community pharmacies in a meeting hosted by Prime Minister Rishi Sunak and health secretary Steve Barclay in Downing
Street on Saturday (January 7) to tackle the NHS pressure.
In his interview with BBC, he said: "He (prime minister) was very engaging and trying to understand the key issues and practical challenges on the ground."
Patel described the meeting atmosphere as 'collaborative and proactive', and said, "people were genuinely asked their options and there were listeners too."
On BBC, answering to a question on 'how community pharmacies can alleviate the NHS pressure?', Patel said: "Pharmacies is the workplace for this. We have trust of
our patients; we have high skilled workforce both clinically and professionally. One of the opportunities we have is working around the acute treat
Patients are highly satisfied with the new Pharmacy First service, which enables pharmacists to assess and treat patients for seven common conditions,
according to a survey by the National Pharmacy Association (NPA).
Nearly 100 NPA members participated in the snapshot poll conducted at the end of the first full week of the service.
Nine in ten respondents (87 per cent) said that "most or all patients expressed satisfaction" with the service they received.
However, many independent community pharmacy owners are facing challenges in implementing the service.
While 56 per cent of pharmacy owners surveyed expressed feeling "motivated" by the new service, a larger proportion (70 per cent) indicated being "under
additional pressure."
More than 30 per cent of the respondents found implementation of the service "harder" than they had expected.
Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing
number of prescriptions, lack of funding and other existing challenges.
Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth.
She further spoke about the hub and spoke model, and how it is unable to solve the issues.
"Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said.
She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23.
When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.
The Association of Independent Multiple Pharmacies (AIMp) celebrated achievements of its members during the pandemic at its first annual 'ball and award' ceremony held last week in London.
To highlight the important role played by pharmacy teams, the association representing community pharmacy businesses with multiple branches, introduced two award categories - for patient safety and social care.
Stephen Walls from H I Weldricks won the Patient Safety Awards and Sandeep Dhami, Nadia Hussain and Sachin Basandrai from MW Phillips won the Social Care Award.
Congratulating the winners, Leyla Hannbeck, CEO of AIMp, said that community pharmacy teams "have worked tirelessly to deliver patient care throughout the pandemic." David McNicol, head of sales at AAH Pharmaceuticals, noted that the country and community pharmacy witnessed the toughest 18 months, and the gathering provided an opportunity to discuss ongoing challenges.
What skills does a pharmacist need these days? You'd think it would be sufficient to have a good understanding of pharmacy and the ability to offer a great
patient service. Whilst this is true of course, the reality of the day to day role demands skills which most pharmacists have not been trained for as part of their
formal qualification.
At the very least, pharmacists find themselves responsible for running the pharmacy, managing people, managing processes and dealing with issues relating to customers,
suppliers, surgeries, regulators and stakeholders. Even the most junior pharmacists quickly find themselves being accountable for the financial performance of their
department and having to work within budgets or deliver on targets.
Remarkably, despite the apparent lack of any formal training in these areas, pharmacists have been able to adapt and meet the challenges of whatever their job has
thrown at them.
Many pharmacists go even further, bringing out their inner entrepreneurial spirit to set up their own business. There are now over 6,000 pharmacy businesses owned by
independent pharmacists, with this segment growing.
Whilst pharmacists have historically adapted to their environments and picked up the necessary business skills, the rapidly changing landscape of pharmacy will
require pharmacists to establish new skills to help ensure their businesses survive and thrive.
Lack of appropriate funding is making survival a massive challenge for community pharmacy, a sector relied upon as a vital support system by both primary and
secondary care in England.
The Telegraph newspaper ran a story on Monday (August 22) which highlighted the dire straits community pharmacy finds itself in. Seasoned pharmacist Ian Strachan
told the paper: "Our four pharmacies were the only point of call that was open (during Covid). We were there every single day, even when the virus was prevalent and
people were dying."
Describing the current situation, he said: "What is happening is we're facing a system that's just not working at all in our favour." Strachan says the issue is that
pharmacists are "just not getting the help we need to be able to do this job properly".
The sector is hugely dependent on funding from the NHS. The government had agreed in 2019 to set £2.6bn as annual funding for the sector. However, according to a
report from EY that amount was already down £200m on the 2016 levels of government funding.
"We've been starved of appropriate funding since 2016," Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies told The Telegraph.
"It looks grim for businesses. The fees pharmacists get are going nowhere, but now, there's higher utility bills, higher staff fees and higher drug costs."
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 has published a medium-term prospectus for the development of pharmacy services, calling it a challenge to old ways of
thinking and an opportunity to redefine the sector's role in the NHS.
It follows months of dialogue with NPA members about what a clinical future could look like for the sector.
The document - Making Changes Meeting Needs - will be shared with the King's Fund and Nuffield Trust who are currently working on a new vision for the future on
behalf of Community Pharmacy England.
NPA chair, Nick Kaye, said: "Building out from the existing portfolio of services, there are some major opportunities within this decade, encompassing prevention,
medicines optimisation, long term medical conditions and urgent care.
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.