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In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.

General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS) contract put forth by the Department of Health and Social Care (DHSC) and NHS England. This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement and reforms in the pay recommendation process. The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the existing contract. The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%, notably falling short of recent inflation rates. This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.

NHS England has confirmed the initial sites that will test and implement Martha's Rule in the first phase of the programme. This follows the announcement in February regarding NHSE funding for the major patient safety initiative for this financial year. The scheme is named after Martha Mills, who died from sepsis at the age of 13 in 2021. She had been treated at King's College Hospital, London, where a failure to escalate her to intensive care and a lack of response to her family's concerns about her deteriorating condition contributed to her death. Martha's Rule aims to provide a consistent and understandable way for patients and families to seek an urgent review if their or their loved one's condition deteriorates and they are concerned this is not being responded to. NHS England on Monday (27 May) announced that the scheme will be implemented at 143 hospital sites across the country by March 2025.

The National Pharmacy Association (NPA) is calling on NHS England and its member to pause and reflect before further implementing the pharmacy contraception service. NPA board met on Tuesday (25 April) to discuss the Pharmacy Contraception Service and the board decided that - with the community pharmacy sector at breaking point - it cannot support the immediate roll out of this service. The association believes that with no new funding for the service, and all existing funds in effect already allocated to other pharmacy activity, any payments to the sector for delivery of the oral contraception service will ultimately be clawed back by NHS England. Tweeting after the meeting yesterday, the NPA said: "We can't tell pharmacy owners what they can and can't do. But we can tell them the facts; fact number one is that with no new funding currently available everyone will be a loser from the implementation of this service on the current terms." NPA Vice-Chair Jay Badenhorst added: "We cannot be expected to take on more and more services without the increase in funding necessary to deliver them effectively. Meanwhile, taking on additional work when current workload already exceeds capacity risks impacting negatively on the overall quality of care people experience in pharmacies. We still believe this could, in future, be a great new pharmacy service, but not without the extra funding necessary to deliver it safely and effectively. We want to offer women this extra support, but if it's worth doing it's worth doing properly."

The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists are able to reap the benefits from it. Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies. Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just delighted to have easier access to care," he said. In its first month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an average of 200 interventions per week. "That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a week - that's a huge capability and capacity bump for the NHS," he added. Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.

NHS England and NHS Improvement published on May 26 the findings of the Fuller 'stocktake' - setting out how primary care can work with partners across health and care to best meet the needs of their local communities. Dr Claire Fuller's report lays emphasis on the essential role of primary care and the potential of integrated neighbourhood teams in reducing the burden of ill health and tackling health inequities. It commends community pharmacy for keeping "its doors open to the public throughout" the pandemic whilst being "among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country". The report highlights "recruitment and retention challenges across the wider primary care workforce" including in community pharmacy. Stressing the importance of community pharmacy teams in urgent care and prevention, including early diagnosis of cancers, the report points out that pharmacists could play "a more active role in signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme".

David Webb, the Chief Pharmaceutical Officer for England, acknowledged that the "pressure in the system is high", but urged everyone to "keep our eye on the design" of the NHS plan, adding that the "the objective is to bring the different parts of primary care together" in the patient interest. Speaking during the opening keynote session at the the National Pharmacy Association (NPA) conference held on Thursday (13 October), he added that the NHS plan intends to bring different parts of primary care together to help patients. He said the new integrated care boards (ICBs) are a key strategic framework as they provide the "potential to form partnerships to deliver integrated services across larger populations". "ICBs will want to work with Local Pharmaceutical Committees to plan for the local population and the new community pharmacy clinical leads in ICBs, who have been funded by NHS England, are there to advise." He explained that once an ICB takes over the commissioning of pharmaceutical services (which they are all due to do by April 2023), it could use its funds to commission a local enhanced service as an add on to an advanced service. For instance, a CVD risk assessment could be added to the blood pressure check service.

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.

The Conservative Party Prime Ministerial candidate Rishi Sunak visited Bassett Pharmacy in Southampton on Wednesday (Aug 24) - the pharmacy that used to be run by his family. During the visit, Sunak is reported to have said that he intends to reform the NHS and achieve value for money from health spending, should he become prime minister. Giving his reaction to the visit, National Pharmacy Association (NPA) chief executive Mark Lyonette said: "If Rishi Sunak is serious about NHS reform, he would do well to start with a 'pharmacy first' approach to prevention and treatment which has the potential to transform the way people access NHS care. "That can only happen with a sustained increase in funding for our sector, which is facing much harder times now than it ever did when Mr Sunak's parents owned a pharmacy years ago." Earlier in the week, NPA board member Hiten Patel met the former chancellor when he visited West Harrow for a campaign event on August 23. Patel took the opportunity to explain that pharmacies in England are not being properly supported to fulfil their potential within the NHS.

The National Institute for Health and Care Excellence (NICE) has recommended elosulfase alfa for routine use in the NHS for the treatment of mucopolysaccharidosis type 4A (also known as MPS 4A and Morquio A syndrome). Elosulfase alfa, also called Vimizin and made by BioMarin, becomes the first disease modifying treatment recommended by NICE for routine NHS use for people with this rare, severely life-limiting condition. NICE's final draft guidance follows the collection of 'real-world' data from 69 people who received NHS-funded treatment since 2015 as part of a managed access agreement. Clinical trial evidence and data collected as part of the managed access agreement, along with expert clinical opinion, shows some long-term benefits with elosulfase alfa treatment which suggest it slows progression of MPS 4A.

A new Attention-Deficit-Hyperactive disorder (ADHD) taskforce has been launched by National Health Services England (NHSE) to counter the challenges faced by many suffering from the neurodevelopmental condition. The ADHD taskforce aligns with the NHS Long Term Plan's vision to revolutionise mental health services, with a specific emphasis on bolstering community-based care and reducing reliance on inpatient services. The NHS has partnered with the government to tackle the escalating demands including increasing funding, improving system efficiency, altering the service provision model, and clinical prioritisation by bringing together expertise from across a broad range of sectors, including the NHS, education and justice, to help provide a joined-up approach in response to concerns around rising demand. Over the past two decades, there has been a significant expansion in the acknowledgement and successful medical interventions for ADHD, leading to a steady rise in clinical requests throughout the UK.

The Royal Pharmaceutical Society (RPS) has published its general election manifesto highlighting some of the key challenges the next Government will face to support patients and the NHS. The manifesto calls on general election candidates to show their support to securing patient access to medicines, a better-connected NHS, enhancing accessible prescribing in local communities, and maximising health improvement through locally accessible pharmacy teams. Candidates are urged to called on the next Government, if elected, to support the pharmacy workforce to deliver patient care, unlock the potential of new advances in medicines, and continue to support funding for the UK science and research community. The manifesto highlights the need for investment in IT infrastructure to support a better-connected NHS to enable all health professionals to access and update a patient's record.

The Company Chemists Association (CCA)'s workforce finding showed that by 2024 eight years' worth of growth of the pharmacist workforce will have been funnelled away from community pharmacies. "In 2019, when NHS leaders realised they were unable to find enough GPs to meet the public's needs, they hastily decided to recruit pharmacists and other healthcare professionals to fill the gaps. This was implemented without any corresponding efforts to increase the supply of pharmacists, creating huge shortages," said CCA. "The bulk of the NHS's recruitment drive was paid for using additional money ringfenced by the NHS - the £2.4bn Additional Roles Reimbursement Scheme (ARRS). We estimate over the life course of ARRS funding (2019-2024), the equivalent of eight years of growth in the number of pharmacists in England will have been funnelled directly into primary care at the expense of other sectors. At the current rate, CCA estimate that community pharmacy will have experienced the equivalent of three fallow years by 2024. To ensure the pharmacy network is protected and able to take pressure off other parts of the NHS, there are several urgent measures which must be implemented. Countering the impact of primary care recruitment: Community pharmacists should be commissioned to provide 'packages of care' on behalf of GPs, rather than taking pharmacists away from accessible high street settings.

The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

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.

The regulators have reduced the notice periods for change to supplementary opening hours for community pharmacy contractors from 1 October 2022. Following the Pharmaceutical Services Negotiating Committee (PSNC)'s discussions with the Department of Health and Social Care (DHSC) and NHS England as part of Year 4 negotiations, it has been agreed that the required notice periods for changes to supplementary opening hours will reduce to five weeks. Community pharmacy contractors who want to change their supplementary opening hours are required by their terms of service to notify NHS England. "If a contractor wants to increase supplementary opening hours at the pharmacy, this can be done with no notice - but notification of the change must still be given to NHS England," said PSNC. "To decrease supplementary opening hours at the pharmacy, at least five weeks' notice must be given to NHS England prior to implementing the change."

Steve McCabe, the Labour MP for Birmingham, Selly Oak says a "vicious" NHS contract has been forcing community pharmacies into bankruptcy. Asking his question in parliament during Prime Minister's Questions on Wednesday (March 8), McCabe said he has heard Rishi Sunak speak fondly about working in his mother's community pharmacy. The MP asked how would the prime minister feel "if 600 pharmacies close this year because of a vicious NHS contract which takes no account of rising costs and is forcing many into bankruptcy?" The prime minister responded by saying that community pharmacies do fantastic work and that his government was looking at ways in which it could support the sector to do even more. Sunak said: "I praise the work that our community pharmacies do. They are fantastic at being on the frontline of delivering primary care. And as I've said previously the government is exploring ways in which we can support them to do even more.

Community Pharmacy England (CPE), the Company Chemists' Association (CCA), the Royal Pharmaceutical Society (RPS) and the National Pharmacy Association (NPA) on Tuesday (5 March) released a joint manifesto for community pharmacy in anticipation of the upcoming general election expected later this year. The manifesto has been designed for widespread use within the community pharmacy sector to facilitate engagement with political parties and parliamentary candidates. In their #VotePharmacy manifesto, the pharmacy bodies have highlighted a robust six-point plan to unleash the potential of pharmacy. Election candidates are urged to express their support in six key areas, which include: Filling the funding gap and committing to long-term sustainable funding to empower pharmacies to deliver more NHS care. Enhancing the community pharmacy workforce to ensure they can meet the evolving needs of patients.

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."

Shadow Health Secretary Wes Streeting outlined his plans for NHS reform on Friday (21 April), where he also mentioned a desire to see pharmacies take on more workload and pharmacists' clinical skills to be better utilised. In his speech, he also expressed concern at warnings from the pharmacy sector and pharmacy closures. The Company Chemists' Association (CCA) appreciated Shadow Health Secretary's desire to enhance pharmacies' role in primary care reform but also stated that the sector is in urgently needs a funding injection. Dr. Nick Thayer, Head of Policy at the Company Chemists' Association (CCA) comment: "We are pleased to see the Shadow Health Secretary recognise the enhanced role that pharmacies should play in primary care reform. Mr Streeting wants to see care brought closer to people's homes and more front doors into the NHS. With 89.2% of the population located within a 20-minute walk of a pharmacy, pharmacies do just that. They are essential to realising his vision of a 'neighbourhood health service'. Pharmacies could free up over 42m GP appointments annually, including 10m vaccination appointments. Urgent same-day appointments for minor conditions in pharmacies will immediately benefit patients by increasing GP access. The first step is for the Government to immediately commission a fully-funded Pharmacy First service in England.