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The Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for their services. "Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide the right care for patients," said Govind. "As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health service are struggling to cope. The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams. Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures. "However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open long hours and at weekends."

Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs and A&E. It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years. If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to consider. Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional? What is the vision for community pharmacy delivering patient care in the next decade? The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.

The Royal Pharmaceutical Society (RPS) has called pharmacy employers and pharmacy trade unions to come together to a round table meeting to agree on principles for a way forward that ensures patients benefit consistently from access to high quality, adequately staffed, safe pharmacy services. It has also urged the governments, NHS organisations and individual pharmacy teams to define clear prioritisation plans, which can be embedded in organisational business continuity plans which set out the pharmacy services that are essential and must always be provided and can be de-prioritised at specific levels of pressures. The challenges for pharmacies are compounded by the escalating cost of living crisis. With unprecedented levels of burnout among pharmacists, pharmacy closures and the potential for strike action, RPS has called for three things- 'professionalism, respect and prioritisation.'

The Department of Health in Northern Ireland has announced an immediate intervention worth over £5.3m in value, and a commitment to progress wider reform arrangements in collaboration with the Community Pharmacy NI (CPNI) to support pharmacies to deal with the ongoing pressure. The Minister and Department are 'very aware of the pressures facing community pharmacies'. They discussed the situation with CPNI representatives at a meeting last week. The scale of the unprecedented budgetary pressures and uncertainty currently facing the Department were spelt out. The Department said: "Notwithstanding these pressures, CPNI were informed that a support package for their sector was being finalised. This package includes immediate interventions worth over £5.3m in value, plus a commitment to progress wider reform arrangements in collaboration with CPNI." Recently, the CPNI highlighted that community pharmacists have issued a stark warning that shortages and skyrocketing prices of many medicines could result in pharmacies being unable to supply important prescription medicines to patients.

A new report commissioned by the National Pharmacy Association (NPA) has revealed harsh financial realities faced by community pharmacies in England. The report by Professor David Taylor of University College London warned that 1000s of community pharmacy closure might take place by 2024 in England if the sector was not supported with additional funds. At the launch of the report titled 'Protecting UK Public Interests in NHS Community Pharmacy', Prof Taylor said: "There will be several 1,000s of closures over the next few years unless we take appropriate action, which doesn't mean to pour money all over it, but it is to fund appropriately when necessary. "At the moment, if we got a partial collapse in the pharmacy network it would disrupt medicine supply and increase health inequalities… For me, it's missing out on the future development of better and more accessible care, which would be the tragedy of reducing, harming and damaging the pharmacy network unnecessarily."

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.

The British Generic Manufacturers Association (BGMA) on Monday alerted the Health and Social Care Committee that medicines shortages have increased and are "around double what they were a year ago." BGMA chief executive Mark Samuels told the committee that they have been highlighting the medicine shortage risk to ministers since July 2021 and the association is "very concerned" about the current situation. "We've been monitoring it for several years now, and as you saw in the written evidence, shortages have increased. They're around double what they were a year ago. We have them at 101 shortages in February this year," said Samuels. Dr Rick Greville, director of distribution and supply at the Association of the British Pharmaceutical Industry (ABPI), highlighted that the problem of drug shortages in the UK is a "long-standing issue" and the scarcity of certain medications "continues to be challenging".

Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health and Social Care Committee Steve Brine has said. Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a parliamentary debate focused on the future of community pharmacies on September 14. From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible solutions for a sustainable future in the sector. Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs Taiwo Owatemi and George Howarth among others.

Adding to the growing evidence of global medicine shortages, a new study has revealed that the European generic medicines market is "not in shape" to help Europe meet its public health priorities. In the past decade, the rate of generic medicines withdrawals has risen by 12 per cent, while there has been a three per cent decrease in the launch of generic products, as per Teva Pharmaceuticals' recent analysis of IQVIA data. Within the mental therapeutic area, seven per cent of generic products disappeared between 2013 and 2023, while there was a seven per cent decrease in the availability of generic cancer medicines in just six years (2017-2022). These medicines were listed on the Union List of Critical Medicines to help avoid potential shortages, as the European Commission (EC) said this could cause "significant harm to patients and pose important challenges to health systems." While mature generic products constitute the majority of the List, they remain susceptible to withdrawals, despite containing products crucial for safeguarding Europe's public health, the Teva analysis report noted. Since 2013, the number of generic products for the treatment of schizophrenia and bipolar disorder has declined by 25 per cent, with Hungary and Bulgaria experiencing the biggest loss at 83 per cent and 58 per cent respectively.

In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising issue of medicines supply. "Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary. In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area." The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why will they not do so?

A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst nationwide drug shortages. According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients. "They've got to know when they can get the medications they need," he added. Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system. "Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the tariff price, which is significant and builds up over lots of items," he explained.

The National Pharmacy Association (NPA) has asked the Secretary of State for Health and Social Care to convene a 'medicines supply taskforce', following weeks of problems with antibiotics supplies. The NPA's chief executive Mark Lyonette wrote a letter to Steve Barclay this week. It cited the precedent of the HRT Taskforce which this summer brought together representatives from across the supply chain after months of supply problems affecting women. "We strongly believe that this situation calls for a similar response from the government. It is imperative that we resolve this supply situation urgently and therefore we request that you convene a Medicines Supply Taskforce, with all the relevant stakeholders in the supply chain, to urgently discuss and agree practical solutions to address the disruptions to the supply of medicines. HRT and antibiotics are the most visible examples of a wider problem with medicines supply which needs to be addressed." NPA board members Olivier Picard and Reena Barai were among the stakeholders joining meetings convened by the HRT Taskforce this summer.

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.

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies has said pharmacists have been "struggling to obtain the very basic, most common cold and flu medicine." She told the PA news agency that the shortage wasn't around "just the branded medicines" but "also simple things like throat lozenges, cough mixtures or pain killers - particularly the ones that are soluble." Stating that the sector was finding it very difficult these shortages she said "those people who are in charge of supporting us with it are denying it." "The demand has been high because this season we've seen higher cases of colds and flu and people are obviously trying very hard to look after themselves and making sure that they use the relevant products to manage the symptoms.

While Northern Irish business groups has welcomed the certainty a new EU-UK deal on post-Brexit trade rules for the region provided, the pharmaceutical industry too has expressed cautious optimism. In his speech on the Windsor Framework on Monday (February 28) Prime Minister Rishi Sunak said the agreement "delivers a landmark settlement on medicines". "From now on, drugs approved for use by the UK's medicines regulator will be automatically available in every pharmacy and hospital in Northern Ireland," he announced. The National Pharmacy Association's Northern Ireland manager Anne McAlister expressed a sense of cautious optimism. She said: "While the devil may yet be in the detail, the Windsor Framework would appear to be good news for pharmacies in Northern Ireland. It seems to address the main concerns we have expressed about medicines supplies to NI, but we want to examine the small print to ensure the new arrangements meet the needs of our members and the patients they serve.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed its concerns over sustained pressures on medicines supply that are having a very serious impact on community pharmacy teams and their patients. It has asked contractors and their teams to continue using its regular reporting tools to help them demonstrate the scale of the problems to the Department of Health and Social Care (DHSC) and to support escalations as needed. The committee said: "The sustained increases in price concessions that we have seen so far in 2022 - with more than 100 concessions being granted in some months - show no signs of abating, and we know that many pharmacies now find themselves in a critical situation trying to source medicines in timely manner and facing significant financial risk due to greater uncertainty around expected reimbursement prices for a large number of medicines." "We know that some concessions being imposed by the Department do not match contractors' experience on the ground, and we would ask all contractors to continue reporting pricing issues to us on a regular basis to support our representations: Report product over Drug Tariff price."

Following Community Pharmacy England's Parliamentary drop-in event on medicines supply issues last week, several MPs have since raised questions to the Health Secretary during a Health Questions session on July 18th. According to CPE, MPs from all Parties displayed great engagement with the current pressures facing community pharmacies, particularly regarding medicines supply issues. During last week's event, Mike Amesbury, the MP for Weaver Vale, was present and directed a question to the Health Secretary: "Eighteen community pharmacists in my constituency are reporting challenges with medicine supplies. What further actions will the Minister take to address and resolve this situation effectively?" In response, Health Secretary Steve Barclay MP stated, "We have a dedicated team in the Department that focuses on medical supplies, which are an ongoing concern. Challenges in this area are a routine part of our business."

Health and Social Care Secretary Sajid Javid and Madelaine McTernan, head of the HRT supply taskforce, continue to take urgent action to resolve the shortage of HRT medicines by meeting the drug manufacturers and representatives from community pharmacies on Thursday (May 5). In the meeting, manufacturers outlined the steps they're taking to boost supply, and pharmacists shared their experiences on the frontline, as well as sharing their thoughts on wider solutions including improved communications. Aspen Pharmacare, Besins-Healthcare, Gedeon Richter, Novartis, Novo Nordisk, Orion, Pfizer, Theramex, Viatris, and representatives from community pharmacies were part of the meeting. As the government confirmed its intention to work with industry to do what is necessary to fix the HRT supply issue, Javis said he wanted to understand the issues facing suppliers and what can be done to address them. "We will leave no stone unturned in our national mission to boost supply of HRT. Along with appointing Madelaine McTernan as head of the HRT supply taskforce to implement lessons learned from the pandemic, and ensuring prescriptions are issued in shorter cycles for now, we are working collectively with the sector to urgently resolve this issue," he commented. The Association of Independent Multiple Pharmacies (AIMp) said the meeting discussed 'why we got into this position' and the way forward.

The General Pharmaceutical Council (GPhC) has urged health and care professionals to meet relevant regulatory standards amidst the shortage of GLP-1 receptor agonists (GLP-1 RAs). The council said: "We are concerned to hear that people with Type 2 diabetes are experiencing problems accessing GLP-1 receptor agonists (GLP-1 RAs). We know that these are being widely prescribed for weight loss purposes and in some cases prescribed off-label." "We recognise the adverse impact that shortages and supply chain issues can have on patients, the public and wider health and care teams. The Council understands that health and care professionals are using their professional judgement and making decisions in challenging situations, balancing a range of factors such as individual patient needs, wider public health and pressures and limitations on available resources such as medicines shortages or other supply chain issues.

Carolyn Harris, Labour MP for Swansea East and co-chair of the Menopause Taskforce, has raised concerns over overcharging of HRT medicines by some online pharmacies, The Telegraph reports. Carolyn, according to the newspaper, has claimed that some HRT products are being sold online for up to "three times as much as they're worth". She has also accused the companies of "profiteering" from HRT shortage. Carolyn has vowed to raise this issue in parliament and will also ensure that health secretary Sajid Javid is aware. She also intends to write to Javid to make sure he is up to date with the alleged "profiteering" taking place. "Get your act together, this is just exploitation. Anybody who thought it was a good idea to hike the price up because there was a shortage… it's awful, it's just complete profiteering, and making a profit off the back of somebody's desperation is never a good look," she told The Telegraph.