The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the NHS ad campaign highlighting how community pharmacies can support patients
with non-health advice amidst the growing pressure on pharmacies.
It believes the campaign will only 'worsen' the pressure on pharmacies.
"It is always deeply concerning to see campaigns directing people to pharmacies without any regard for the pressures they are under: it is irresponsible and extremely
unhelpful," said PSNC Chief Executive Janet Morrison.
She called the campaign 'particularly irritating' just weeks after the committee rejected a series of proposals from NHS England and DHSC on relief measures to ease
pressure on pharmacies as being totally inadequate.
"NHS England Board Members have noted the pressure on pharmacies - so why are their teams so often acting to make these pressures worse? We need to see a radical
change in how NHS England treats pharmacies and we're continuing to press for that via our influencing and campaigning work," she added.
The NHS launched the new campaign on Monday (27 February) to highlight how high-street pharmacies can support patients with non-urgent health advice for minor
conditions including coughs, aches and colds.
The leading pharmacy bodies have come together to launch the 'Save Our Pharmacies' campaign which highlights the pressure and untapped potential of the sector.
Pharmacy bodies- Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical
Services Negotiating Committee (PSNC) have agreed to work together on a programme of activities to lobby for fair NHS funding for pharmacies in England, including
co-ordinating efforts to mobilise public support.
The campaign will focus on highlighting both the pressures that pharmacies are under and the huge untapped potential of the sector - including to offer a Pharmacy
First service - if appropriate resourcing is made available.
Mark Lyonette, NPA Chief executive, said: "Together we will be cranking up the noise to persuade Government and NHS to make the right choices and back the community
pharmacy sector with decent funding. Maintaining patient and public support is critical to our campaigning success, so this will be a key focus in the months ahead.
Our joint message is very clear: pharmacies can help get the NHS back on its feet, but not while the sector itself is on its knees."
The pharmacy bodies will develop shared resources for effective parliamentary lobbying and mobilising public opinion, in the face of chronic underfunding that
threatens further pharmacy closures. They will also work hard to show off the value of pharmacy and to continue pushing for a fully funded Pharmacy First service.
As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that
this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of
the pandemic and is still ongoing today.
I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for
community pharmacy, without sufficient funding we will see more pharmacies close.
We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North
East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly.
I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a
day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley.
The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to
the NHS and that we have so much to offer in terms of ill health prevention.
Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which
has launched well across NEL.
The Local Pharmaceutical Committees (LPCs) has rebranded to be known as Community Pharmacy to present a strengthened and unified identity to the
local NHS, local government and other stakeholders, as the local voice of community pharmacy.
"There are now 58 LPCs in England. The number of LPCs has reduced from 69, with further consolidation expected by April 2024 to a network of 48 local organisations,"
said Community Pharmacy England.
"The changes mean there will be better alignment between LPCs and the 42 NHS Integrated Care Systems in England, who have taken on the responsibility for
commissioning pharmaceutical services delegated by NHS England."
"This marks a significant milestone, as similar to Community Pharmacy England, LPCs have been undergoing changes to respond to the Review Steering Group (RSG)
recommendations on pharmacy representation. The sector voted in favour of the RSG proposals in the summer of 2022, and since then progress has been made on many
of the changes at both local and national level as part of the Transforming Pharmacy Representation (TAPR) Programme."
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.
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 Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information.
Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of
Services (DoS) profile information is kept up-to-date.
The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been
introduced to make the process as quick as possible and it can be done on either a smartphone or computer.
PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our
feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."
NHS England has urged the pharmacy owners to continue to voluntarily submit New Medicine Service (NMS) quarterly summary data to the NHS Business Services
Authority (NHSBSA) for Quarter 4 (Q4) 2022/23 (January to March 2023).
Community Pharmacy England have agreed with NHS England that the quarterly returns will continue to be on a voluntary basis, with Q4 (January to March 2023) as the
second quarter to be reported.
It has thanked all the members that submitted NMS quarterly summary data for Quarter 3.
The mandatory requirement to submit this data has been suspended since 2020, due to the COVID-19 pandemic.
"NHS England wants to continue collection of the quarterly returns to provide baseline data to support a long-term evaluation that will be conducted as part of
ongoing work to expand the scope of NMS," said Community Pharmacy England.
Voluntary submissions can be made via the NHSBSA website, where an updated reporting spreadsheet is also available for head offices to use who are able to submit
data on behalf of multiple pharmacies.
The new data from NHS England has revealed that more than 100,000 patients were treated for minor illness by their high street pharmacist in just one month.
According to new NHS figures, in June, 118,123 people with minor illnesses such as a sore throat or constipation, or those in need of medicine urgently, received
a same-day consultation with their local pharmacist after calling NHS 111 or their GP practice - an increase of more than four-fifths (83%) on the number in the same
month last year (64,512).
The data comes alongside expanded roles for community pharmacies ahead of winter, announced at the NHS England board meeting today.
"From this week, NHS 111 online can directly refer people to their high street pharmacist for a same-day consultation, rather than patients needing to call the
phone line," said NHS England.
Amanda Pritchard, NHS chief executive, said: "Our local pharmacies ensure hundreds of thousands of people every week get the support and medication they need and
today's figures show that in just one month, over 100,000 patients have also had consultations with their local pharmacist for minor illnesses - this means patients
are getting the care they need quickly but also in a convenient way that can fit in with their busy lives.
The Pharmaceutical Services Negotiating Committee on Tuesday (June 30) renamed itself as Community Pharmacy England, promising a "strengthened commitment" to
champion and engage with the sector.
"The name Community Pharmacy England better reflects the breadth of work that we do to both represent and support community pharmacies in England. We are their
champion," the pharmacy negotiator said.
Explaining that the rebranding exercise was in line with proposals put forward by the Review Steering Group (RSG), it said the rebrand was part of its Transforming
Pharmacy Representation (TAPR) work and that it would signal the beginning of a "new engagement strategy" to build stronger relationships with pharmacy owners.
"Becoming Community Pharmacy England is much more than a name change or a new logo, it is a driver for cultural change across our organisation.
"Our members want us to be more authoritative, representative, and influential, and rebranding gives us a clearer and stronger voice, helping us to better speak out
for community pharmacy."
Eighty-five per cent of adults responding to a survey commissioned by the National Pharmacy Association (NPA) have agreed that community pharmacies are
underfunded and that the sector needs more investment to be able to do the work it does.
The survey of 1,000+ adults in England was carried out online between August 26 and 30 by an agency called Research Without Barriers (RWB) on behalf of the NPA.
Pharmacies in England are now paid less for providing NHS services than they were before the Covid-19 pandemic, after years of real terms cuts.
Seventy-four per cent respondents think it's unfair that community pharmacies in England have had no increase in funding for eight years, despite rising business
costs.
When asked whether it's fair or unfair that pharmacies in England are now paid less for providing NHS services than they were before the pandemic, 81 per cent of
people replied that it's unfair.
"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of
their business."
Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and
the larger role pharmacies play in complementing traditional NHS facilities.
Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain
information from NHS England regarding protocols and procedures.
She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were
desperate to take part in the vaccination scheme" in her constituency.
Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy
closures "should be a real wake up call for the government."
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.
To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the
community pharmacists to to establish a robust relationship between community pharmacies and local general practices.
The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services.
According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to
participate at all in the "groundbreaking" Pharmacy First scheme".
In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer
patients to the Pharmacy First and other community pharmacy services where appropriate.
Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy
First will likely require sustained effort over several months or longer.
The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million
a year - are now being carried out by community pharmacy teams in England.
This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year.
PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations
were recorded, with the average pharmacy completing 19 consultations per day.
This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week.
The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy
coming from these routes; grossed up to a national level that means 117,000 cases per week.
These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).
Politicians, researchers and pharmacy leaders called on the government to make community pharmacy a fundamental part of clinical services at an event at the
House of Commons on Wednesday (13).
At the launch of a research publication carried out by the University of Bath in conjunction with Sigma Pharmaceuticals, community pharmacy was described as
an "essential pillar of health care provision" in the UK.
The aim of this research was to provide evidence to support a strategy for the future developments of community pharmacy to ensure the sector continues to meet
the needs of the public in the NHS.
Researchers analysed 25 health and community pharmacy related policies published by the department of health, the NHS, the pharmacy profession, and spoke to
stakeholders from a wide range of backgrounds, including patients, pharmacists, NHS commissioners and GPS.
England's chief pharmaceutical officer (CPhO) David Webb has promised his "wholehearted support" for the community pharmacy sector at the board meeting of the National Pharmacy Association (NPA) on 28 June in St Albans.
After hearing the CPhO at the meeting, NPA chair, Andrew Lane, later declared: "David is someone we can do business with."
Webb thus listed his priorities as head of profession: integration of independent prescribing as part of pharmacy practice by 2026; promotion of inclusive pharmacy
practice for all pharmacy professionals; assurance of post-registration practice; developing the role of pharmacy technicians; support for Integrated Care Systems
and Primary Care Network pharmacy teams (including community pharmacy); medicines optimisation; and strengthening of professional leadership for community pharmacy.
He also reported that NHS England had recently increased its team of regional pharmacy integration leads from seven to 14, creating seven new senior posts.
Webb told NPA board members: "I want sincerely to thank community pharmacy teams for everything they are doing and to say that you have my wholehearted support. I believe in the importance of community pharmacy and will listen and engage as I've already demonstrated.
The Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first'
approach in England as mentioned by his predecessor on numerous occasions.
"Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy First' to support patient access to care. I would urge the new Health
Secretary to see this through to completion," said chair of RPS in England Thorrun Govind.
Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery,
including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers.
Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures
and organisations, and the need for long-term investment in the workforce.
"With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing
the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.
NHS England has mandated a business continuity plan for pharmacies dealing with temporary closures from the end of this month.
Community Pharmacy England (CPE) has put together a briefing and a template plan to help guide pharmacy owners through the process. It explains what is required
in the plan, describes how and when to implement it, and outlines some additional considerations.
"This could be added as an annex to your pharmacy's existing business continuity plan. A checklist has also been added, which may be used in the event of a
temporary suspension," said CPE.
"NHS England will be publishing the approved particulars shortly. NHS England is also still to publish guidance on the amendments to the Pharmaceutical Regulations
that came into force on 25th May, which will include guidance on these requirements.
Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems.
Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS.
"It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework."
Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector."
"We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."