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Health leaders have said that delivering faster and more productive patient care would be difficult unless NHS capital budgets are nearly doubled to at least £14.1 billion from the current spending of £7.7 billion. The NHS Confederation has highlighted the impact that low levels of capital investment have had over the last decade in its report published today (29 November). The report, 'Investing to save: The capital requirement for a more sustainable NHS in England', revealed that the UK has lagged behind other comparable countries in terms of health capital investment for more than five decades, resulting in less productivity. It revealed that the NHS now has the sixth lowest number of CT and MRI scanners per million people of the OECD countries.

The Department of Health and Social Care (DHSC) has proposed a 2.8% pay uplift for NHS Agenda for Change (AfC) staff, including hospital pharmacists, for the 2025/2026 pay round. This recommendation was detailed in the DHSC's submission to the NHS Pay Review Body (NHSPRB), which described the figure as "a reasonable amount to have set aside based on the macroeconomic data and forecasts and taking into account the fiscal and labour market context." NHS England also supported the 2.8% pay increase, stating that its proposal reflects "the likely NHS budget from discussions to date with DHSC and what was set out by HM Treasury in the Autumn Budget 2024." "We propose to set allocations for NHS planning on the basis of a 2.8% pay settlement. Every 0.5% increase above that costs around £700m; which is the equivalent to around 2% of elective activity (greater than 300k completed patient pathways)," it added. However, Unite the Union, representing NHS staff, condemned the DHSC's recommendation, called the proposed increase "an insult."

A groundbreaking research project has revealed that the public is urging the government to prioritise primary and community care over hospitals. The study also found a strong public willingness to pay higher taxes to enhance NHS services. The Health Foundation and Ipsos UK conducted the research, combining nationwide polling with in-depth public deliberative workshops. These workshops, held in King's Lynn, Leeds, and London, constitute one of the most comprehensive public consultations about the future of the NHS in England. The study published on 16 May underscores the public's desire for a redistribution of NHS resources. If the NHS budget remains unchanged, 60 per cent of those polled believe the government should focus on improving access to community-based services like general practice and dentistry.

A new report from the Company Chemists' Association (CCA) is calling on NHS England to commission a community pharmacy-based national Type 2 diabetes screening service, which could save the NHS £50m each year. The CCA report, titled 'Increasing Access to Diabetes Screening and Prevention Through Community Pharmacy', highlights the urgent need for a national patient pathway for diabetes detection and management. It outlines how NHS-commissioned diabetes screening in community pharmacies across England could deliver numerous health benefits each year, including: Screening 1.5 million adults and identifying 180,000 prediabetics; Detecting 45,000 undiagnosed cases of diabetes and preventing them from developing serious complications Preventing nearly 7,000 heart attacks and strokes, and thus improving patients' quality of life Avoiding severe sight loss in around 15,000 people over their lifetime Saving the NHS £50 million annually by reducing diabetes-related costs. Type 2 diabetes and its complications are currently estimated to account for 10 per cent of the NHS annual budget, and this figure is projected to rise to 17 per cent by 2035/36.

A new analysis by the Nuffield Trust has revealed that NHS trusts in England are experiencing their worst financial deterioration in a decade, raising concerns that the government's reform plans could be at risk. The report found that the NHS trust sector, which makes up three-quarters of NHS day to day spending, recorded a £1.2 billion overspend last year, amounting to 0.9% of income in 2023/24. This is double the previous year's overspend, recorded at £448 million, and significantly worse than the modest financial surpluses seen in 2020/21 and 2021/22. The sector is in "as precarious a position it was in immediately prior to the pandemic," the report said. NHS trusts in the most deprived areas suffered the worst financial deterioration in 2023-24, with North West and Midlands reported the deepest deficits, accounting for 2.2% and 1.5% of revenues, respectively. The North East and Yorkshire have also seen the steepest declines in financial health since 2022/23. The underlying gap between stable incomes and outgoings across the provider sector was at least £4.5 billion last year.

The Department of Health and Social Care (DHSC) has published Lord Darzi's report on the state of NHS England, which revealed that the health service is in "serious trouble." Lord Darzi pointed out that the NHS has failed to meet key promises made to the public since 2015 and patient satisfaction is now at its lowest ever level. Rising waiting times and difficulties accessing GPs were highlighted as major concerns. "There are huge and unwarranted variations in the number of patients per GP, and shortages are particularly acute in deprived communities," the report said. Darzi described the state of A&E as "awful", noting that nearly 10 per cent of patients wait 12 hours or more today. Additionally, Lord Darzi's investigation found that the NHS budget is not being optimally allocated, noting that "too great a share is being spent in hospitals, too little in the community, and productivity is too low."

Community Pharmacy England (CPE) has expressed dissatisfaction with the spring budget as it brings "no specific relief" for the community pharmacy sector, which is grappling with "soaring costs and severe medicine supply and pricing issues." UK Chancellor Jeremy Hunt announced his Spring Budget on Wednesday, confirming an extra £2.5 billion in day-to-day revenue funding for the NHS in England in 2024-25 and a new NHS productivity plan worth £3.4bn to modernise IT systems. The Chancellor said that day-to-day spending would grow by 1 per cent per year on average in real terms, and the productivity plan is estimated to "unlock £35 billion worth of savings" from 2025-26 to 2029-30. However, CPE chief executive, Janet Morrison commented that the budget has "no obvious good news" for community pharmacies who need "urgent relief from the ongoing unsustainable funding and operational pressures" they are facing. Morrison described the investment in Pharmacy First as "the most significant investment in pharmacies in a decade", but emphasised the need for further support to stabilise the sector and its core contractual arrangements.

Trust leaders involved in the New Hospital Programme (NHP) have warned that further delays in the government scheme will lead to more patient harm, disappointment among staff, and higher costs for taxpayers. According to NHS Providers, delays in the government scheme that promised 40 new hospitals in England by 2030 are draining millions of pounds from scarce NHS funds every month. Some trusts are compelled to spend over £1 million a month from their under-pressure budgets due to spiraling cost pressures, on-hold building projects, and the bill for having to patch up deteriorating sites. While there has been some progress over the past year, trust leaders remain apprehensive that "uncertainty over funding and shifting timetables risks putting their promised buildings further out of reach."

The NHS is on track to miss out on savings of over a billion pounds as patents for a new lineup of 85 biologics are set to expire within the next five years, the British Generic Manufacturers Association has revealed in its new study. The government's Voluntary Scheme for Branded Medicines Pricing and Access is expected to lead to a cost of more than £1 billion for the NHS in the coming years. The BGMA research found that more than 85 biological medicines will experience loss of exclusivity during the upcoming VPAS Scheme period from 2024 to 2028. "This includes blockbuster products like the cancer medicine Keytruda and wet macular product Eylea, which together generate approximately $25 billion in global sales," BGMA said. "The molecules coming off-patent also cover other disease areas including oncology, diabetes, arthritis, and asthma." While biological medicines dominate the medicines budget, constituting the largest cost and cost growth sectors, NHS England aims to expedite biosimilar availability, yielding substantial savings and expanding patient access to vital treatments. Yet, the report found that "this is jeopardised by the influence of the VPAS Scheme".

The Royal College of GPs (RCGP) has warned that patients in deprived areas could face even greater difficulty accessing GP services if funding for the Targeted Enhanced Recruitment Scheme (TERS) is withdrawn. In a letter to NHS England, the College is calling for confirmation that TERS will be extended for 2025/26 and beyond. The scheme, launched in 2016, was designed to attract GP trainees to economically disadvantaged areas, where healthcare provision has historically been inadequate. TERS offers a one-off payment of £20,000 to GP trainees who commit to working in hard-to-recruit-to locations. Over the years, the scheme has successfully recruited over 2,000 GPs. However, with funding for 2025/26 yet to be confirmed, the RCGP is worried that it could be cut from April. The College has expressed concern that discontinuing the scheme could "make it even more difficult to recruit GPs to work in deprived and under-doctored areas where patients are already significantly disadvantaged compared to those in more affluent areas of the country."

The British Generic Manufacturers Association (BGMA) has warned that England's 42 integrated care boards (ICBs) may need to allocate an extra £37 million from their budgets annually for the next five years due to the spiralling tax rates. The government's Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) rebate rate increased more than five-fold in the past two years, the BGMA said in its white paper released on Monday (October 30). The report, conducted by consultancy firm Conclusio in consultation with local NHS leaders, examined the potential effects of the VPAS on ICB budgets. BGMA said that due to the elevated VPAS rate, each ICB in England will experience significant increases in expenses for branded generics and biosimilars annually - a consequence of reduced competition.

Major health, care and research bodies, including the Department of Health and Social Care and the Office for National Statistics, should establish a national health data service in England to improve patient care and research - an NHS-commissioned review has recommended. Professor Cathie Sudlow's independent review of the UK health data landscape concluded that "complex and inefficient" data systems prevent and delay crucial analysis of health conditions affecting millions of people across the UK. The review - 'Uniting the UK's health data: a huge opportunity for society', published on 8 November 2024 - stressed the need for coordinated action across multiple organisations and stakeholders to ensure the greatest benefits for patients and the public from health-relevant data. They identified several barriers to using health data for public benefit and set our five recommendations for overcoming these barriers and transforming the national health data ecosystem. These include the establishment of a national health data service for England, embedded within existing organisational structures but with accountable senior leadership and a ring-fenced budget. Professor Sudlow said: "We are simply not maximising the benefits to society from the rich abundance of health data in the UK.

The National Pharmacy Association (NPA) has disclosed alarming figures on pharmacy closure in England, attributing them to the impact of funding cuts. According to NPA analysis of NHS Business Services Authority (NHSBSA) data, 222 pharmacies permanently closed their doors in 2024, marking the second-highest annual closure rate on record. This equates to an average of four pharmacies closing each week. Nearly 90 per cent of council areas have seen at least one pharmacy shut permanently in just the last two years. NPA chair Nick Kaye voiced concern that pharmacies have been "pushed to breaking point" by 40 per cent real terms cuts to their budgets and the ones still open are left "hanging on by their fingertips" and could be forced to close without "an urgent increase in their funding." "It is patients that have lost out the most, with more people in isolated areas having to travel further for vital medication as well as access to medical advice convenient to them," he said.

There is no doubt that the pandemic has changed the way healthcare professionals work within the primary care setting. The advent of Covid-19 meant that we all had to rapidly modify the way we supported and met the needs of patients, some of whom saw the services they usually took for granted, virtually cease overnight. There are around 15 million people in England living with long-term health conditions including asthma. These people have the greatest healthcare needs of the whole population with 50 per cent of all GP appointments and 70 per cent of all bed days taken by this cohort of patients, and their treatment and care absorbing 70 per cent of acute and primary care budgets in England. This situation isn't going to improve any time soon. In the past, most people had a single condition, today multi-morbidity is becoming the norm. At the start of the pandemic, the Royal College of General Practice and British Medical Association issued guidance to practices on prioritising workload. This included the importance of maintaining long-term condition reviews in asthma, COPD and diabetes, along with appropriate transition of at-risk warfarin patients. These reviews were deemed as essential workstreams for patients considered to be at high risk. Traditionally, the unique skills set of a pharmacist has meant that we have played a major role in supporting these patients. I work with a team of over 90 clinical pharmacists who, in partnership with individual practices, PCNs, CCGs and STPs, help with the long-term management of people with chronic conditions. But the onset of Covid-19 meant that we now had to plug a potential gap in service provision, and quickly.

The National Pharmacy Association (NPA), the Company Chemists' Association (CCA), Community Pharmacy England (CPE), and the Independent Pharmacies Association (IPA) have united in urging the government to shield community pharmacies from the impact of the Budget increases. In a joint letter to the health secretary Wes Streeting MP, they have highlighted that rises in employers' National Insurance contributions and the National Living Wage could cost community pharmacies £200 million a year in unplanned costs. They have warned the government that 'without mitigation, these additional costs will push many pharmacies more towards insolvency', leading to more closures and cuts to vital health services for patients. From April 2025, the national living wage will increase by 6.7 per cent to £12.21 per hour, and the national minimum wage for 18-20-year-olds will increase by 16.3 per cent to £10 per hour.

Awareness weeks, such as National Self-Care Week (18-24 November 2024), are crucial for spreading important public health messages. At the Self-Care Forum, we believe these weeks are essential for encouraging better health choices. Pharmacists: Key Players in Self-Care Pharmacists are uniquely positioned to support self-care. They can provide advice on managing common ailments, medication adherence, and lifestyle changes. During National Self-Care Week, pharmacists can promote self-care practices and educate the public on preventive health measures. And the Self-Care Forum has a variety of free self-care aware fact sheets that are perfect resources to support people's health. Impact of Preventable Illnesses Preventable illnesses significantly impact lives and healthcare systems: In 2021/22, there were 125,612 avoidable deaths in England and Wales. Cardiovascular disease causes 168,000 deaths annually in the UK. Preventable conditions consume 40 per cent of the NHS budget. Long-term sickness cost the UK economy £21 billion in 2022/23.

Janet Morrison, CEO of Community Pharmacy England (CPE) has emphasised that stabilization of the sector is essential before any solutions can be delivered to fix the "struggling" health service. Speaking at the recent SIGMA UK Community Pharmacy Conference 2024, Janet described the current contract as "unaffordable" and warned that pharmacies are becoming "unsustainable." "Without an urgent funding uplift, the sector is facing a 'house of cards' collapse that will seriously impact communities, patients, and the safety of medicine supply. "So, first of all, we have to secure the stabilization. We have to make sure you can keep the lights on and the doors open, and that's critical," she stated. Janet pointed out that if the sector is stabilized and a fair deal is achieved, community pharmacies could effectively deliver solutions for the government that meet their policy goals. However, she noted that negotiations for the Community Pharmacy Contractual Framework (CPCF) for 2024-2025 cannot resume until the budget is published on October 30.