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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 National Pharmacy Association (NPA) has raised its concerns over rising cost of rent for its members. The association highlighted that pharmacy spending is shrinking, and therefore, the NHS Property Services must ensure viability of health centre pharmacies. In May, the NPA wrote to NHS Property Services to voice its concerns over the rising cost of rent after some of its members reported demands for a three-fold increase in rent. Many pharmacies operate in premises of which NHS Property Services is the landlord. In a letter last month to chief executive Martin Steele, NPA said: "The past years have seen far fewer patients in health centres and therefore using the on-site pharmacy - whilst the situation will change somewhat as we move out of the pandemic we expect a permanent impact on workload as practices handle more of their interactions virtually. "The NPA encourages NHS Property Services to review lease agreements involving community pharmacies and consider favourable changes to terms that are in line with current financial realities affecting the sector. This could avoid the loss of a pharmacy service to communities and the resulting loss of rental income to NHS Property Services."

The Proprietary Association of Great Britain (PAGB) has called on the new Labour government to prioritise six key actions within its first 100 days to harness the benefits of self-care for the public, the NHS, and the wider economy. Aimed to ease the burden on the NHS, the PAGB hopes that the suggest six key actions would help during the incoming winter illness season. According to PAGB, the NHS deals with approximately 25 million GP appointments and 5 million A&E visits each year for self-treatable conditions. By empowering individuals to manage their own health more effectively, the NHS could potentially save up to £1.7 billion annually. In her letter to Wes Streeting, Secretary of State for Health and Social Care, Michelle Riddalls, CEO of PAGB, urged the government to act promptly.

The Royal Pharmaceutical Society in England (RPS) and Community Pharmacy England (CPE) have raised alarm over the impending increase in NHS prescription charges, slated to take effect from May 1, 2024. The RPS, represented by Chair Tase Oputu, condemned the rise, labeling it a "dark day for patients" who will now face nearly £10 per prescription item. Oputu emphasised the disproportionate impact on individuals with low incomes, citing the "relentless annual increases in prescription charges" as exacerbating the affordability crisis in healthcare. " Every day pharmacists are asked by patients who are unable to afford all the items in their prescription which ones they can 'do without'" she said. She further added that the financial barriers to get vital medicines should not be faced by any one and advocated for "the abolition of prescription charges in England, as has been implemented in other parts of the UK".

Healthcare is one of the most crucial sectors in the UK accounting for over £290 billion, around 10% of the GDP for the entire country. Despite this, however, many businesses operating in the healthcare sector are currently in favour of an urgent cash injection from the government. The figures make for sobering reading with over 65% of pharmacies operating at a loss and a bleak forecast that one in six might shut their doors for good within the next year. Business costs have soared in the last two years and combined with a funding cut of around 30% in real terms over the last decade this has left many pharmacies struggling to make ends meet. In real terms, these issues affect those who we wish to help the most - our patients. As the expenditure rises, income doesn't always follow meaning that pharmacy staff have to work even harder. However, despite their best efforts they report that this has an impact on some of the valuable face time that they can give to their patients. Longer prescription dispensing times have been an issue across the board as this then creates a domino effect on responding to patient enquiries. This then means that when a patient is actually in store there is less time for a pharmacist to spend with a patient discussing their health issues.

Coeliac UK has raised grave concerns about the decision by NHS Leicester, Leicestershire and Rutland Integrated Care Board (ICB) to withdraw gluten free prescriptions for people with a diagnosis of coeliac disease and its potential impact on their health. The charity highlighted the significant additional cost of gluten free staple substitute products, which poses a real challenge to maintaining the gluten free diet, the only treatment for the condition. Coeliac UK noted that 72 per cent of respondents to a recent public consultation disagreed with the ICB's proposal to stop gluten free prescribing, and said it is "deeply concerned" by the potential impact of the decision to proceed with removal of provision. The charity accused the ICB of making no meaningful effort to reduce the impact of this policy change for those on low incomes, despite the additional cost of gluten free food being highlighted by 58 per cent of those who disagreed with the proposal.

The Pharmacists' Defence Association (PDA) has called for a mandatory training for those who wish to sign fit notes. The union said it will be seeking urgent clarification around the rollout of guidance and timescales of when this will be available to PDA members working in primary care and hospitals, who will be at the forefront of the implementation. "As with any activity, regulated health professionals will be expected to ensure they have received adequate training and guidance before taking on new elements of practice and to ensure they are acting within the limits of their professional competency," said the association. It also highlighted that completing a fit note may have an impact on the income received by the patient and therefore the consequences of supplying the document could mean a direct financial consequence for them, such as eligibility for sick pay or insurance claims, as well as a health outcome. The PDA expects the mandatory training to cover any factors which will need to be considered in this regard so that pharmacists understand any limitations on when, how, and for who they might complete the fit notes.

Boots is reportedly closing another branch in Watton, Norfolk from January, after shutting its High Street branch in Gorleston last month. The Boots store would be one of the four pharmacies expected to be closed next year in the county, which saw closures of six pharmacies in recent months, according to a BBC report. However, the retailer hasn't made any announcement regarding the Watton closure or commented on its decision to shut its Gorleston branch. If the Boots' branch in Watton is closed, the town will be left with only one pharmacy to cater to the healthcare needs of a population of about 12,000, and this is the concern people in the area have expressed. Conservative councillor Tina Kiddell told BBC: "I do worry how they are going to cope, they're already incredibly overwhelmed now."