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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)."

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.

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.

The Pharmacists' Defence Association (PDA) has created a form to help locum and other pharmacists to report about breach of NHS contract by community pharmacy. According to the association, they have been told by increasing number of pharmacists about contractors closing pharmacies, despite a locum readily available to cover the shift. The PDA said this is an issue of NHS contractual breach and creates difficulties for patients, and so they have created the form to assist members to report unnecessary closures to the relevant NHS England & Improvement pharmacy contract team. A locum pharmacist, who does not wish to be named, has alleged that a community pharmacy declined their offer to cover an extra shift for £5 more per hour, and decided to close the store, denying the public access to services. The pharmacist recalled the occasion while writing in the PDA's latest member voice article.

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 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.

Lloyds Pharmacy's closure of all its 1,300 branches will wake-up the ministers and NHS officials to the reality of community pharmacy sector in England has reached crisis point, expressed Nigel Swift Managing Director of Rowlands pharmacy and Deputy Managing Director of PHOENIX UK. On Friday, The SUN reported that the UK's second largest pharmacy provider - is allegedly in the process of selling its entire estate of 1300 branches. Lloyds Pharmacy will no longer be a High Street presence following its decision to put all its pharmacy branches at the risk of closure. In January it has announced to close its 237 Sainsbury-based pharmacies. Nigel highlighted the fact that community pharmacy is struggling due to insufficient government funding and immense pressures on GPs and A&E departments - an ongoing issue which poses a very real threat to the sector. Commenting on the announcement, he said: "It's not just Lloyds - an independent analysis by Ernst & Young estimated that 75% of community pharmacies will be in financial distress in the coming years. £750 million has been taken out of the English contract due to inflation since it began."

There is clear evidence that the majority of distance selling pharmacies are operating in breach of their NHS contracts, and a failure to properly regulate 'pseudo' distance selling pharmacies is leading to local pharmacy closures, the Company Chemists' Association has reported. According to the CCA's recent findings, 72 per cent of DSPs dispense over 50 per cent of their prescriptions to patients within a single postcode area within 10 miles of the pharmacy. "Operating within constrained geographical regions, pseudo-DSPs achieve reduced overheads and operational costs by focusing on localised marketing and medicine delivery. They compete against local brick-and-mortar pharmacies, causing them to lose vital trade," the CCA claimed, based on its recent survey - The Impact of Pseudo Distance Selling Pharmacies. "As per their terms of service, DSPs are obligated to provide prescription delivery nationwide, extending beyond local patients," said the CCA, adding that the financial savings resulting from the lack of patient access are balanced by the necessity to function on a national scale.

The National Pharmacy Association (NPA) has been in dialogue with the senior management of NHS Property Services to bring down the rent for community pharmacies based in NHS health centres. Association said: "Community pharmacies based in NHS health centres are struggling to make ends meet due to expensive rental rates." It is calling for pharmacies to have the ability to renegotiate rental rates part way through a contract. Gareth Jones, Director of Corporate Affairs at the NPA, said landlords need to take into account that pharmacy spending power is shrinking and the previous formula used to set rental rates is no longer fit for purpose. "It no longer makes sense to calculate based on historical assumptions about how many prescriptions the co-located GP will generate for the pharmacy," he said.

In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England, Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period. The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies, while the total number of independent operators remained consistent with 2022. According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies. Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators acquiring additional pharmacies through corporate disposal opportunities throughout the year.

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.

NHS England has agreed to offer an additional payment of £2.50 per jab if pharmacies would be willing to extend the duration of their COVID-19 vaccination contract until 31st August 2024. Pharmacies currently providing the autumn vaccination are asked to let their local commissioner know, by 22nd February 2024, if they can provide cover for a potential Spring booster programme, if the Joint Committee on Vaccination and Immunisation (JCVI) advises in their guidance expected to be published soon. NHS figures showed that more than 3,500 community pharmacies signed the contract to deliver COVID-19 vaccinations between 1 September 2023 and 31 March 2024, as part of the autumn booster programme. The health service is hoping that most of these pharmacies will be able to continue to support the Spring campaign, which will run from 1 April 2024 to 31st August 2024, to help protect the nation's most vulnerable populations. For the Spring campaign only, pharmacies would be offered an extra £2.50 per jab in addition to the existing item of service fee of £7.54, NHS England said.

In many cases, a pharmacy's most valuable asset is its NHS contract. This is what buyers are paying for - the right to provide pharmaceutical services commissioned by the NHS and be reimbursed for the medicines dispensed. However, a pharmacy consists of more than just an NHS contract and when buyers look for a pharmacy to buy, they will also examine these other areas - the pharmacy's customer base, its staff, the property it operates from - to name a few - because these are all also crucial to a successful pharmacy. In this day and age, another important consideration is the pharmacy's intellectual property (IP) i.e. the pharmacy's rights to certain types of information, ideas, and forms of expression. At the most basic level, this includes the trade mark in the name of the pharmacy, because all pharmacies will have a name by which they distinguish themselves from other pharmacies. The more well-known the name, the more valuable this form of IP is - mention 'Boots', for example, and most will have an instant association with the largest pharmaceutical retailer in the UK.

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."

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."

The Department of Health and Social Care has updated the list of community pharmacies eligible for the Pharmacy Access Scheme (PhAS) and approved 43 cases out of 63 applications, bringing the the total number of eligible pharmacies in England to 1,445. Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I regional pharmacy contract team, and determined by the relevant pharmaceutical services regulations committees (PSRC). Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the scheme.

The NHS England and Improvement has announced the emergency provisions introduced during pandemic to provide flexible opening hours for pharmacy contractors end today. The flexibilities were enacted in March 2020 when changes to the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 were made following a declaration of emergency at the height of the Covid-19 pandemic. Since March 2020, the flexibilities have permitted temporary opening hours and closures during a specified period due to a genuine Covid-19 related emergency. NHS England and Improvement has advised pharmacy contractors that the emergency declaration will not be extended further and will expire on 31 March 2022. Pharmacy contractors will therefore no longer have the option to close pharmacies within their agreed contracted hours with the NHS.

"Discussions must involve the government on behalf of NHS Scotland, CPS on behalf of the owners, and the PDA as the pharmacists' representative," it said. The association believes that there is a need for discussion and decision-making that listens to and balances the rights and responsibilities of both employers and workers, to generate benefits for individuals, organisations, and society. It added: "Even though Scotland provides the most generous community pharmacy settlement in the UK, recent reports suggest it is not enough for pharmacy owners with CPS's rejection of the latest funding proposal in May. Though the Scottish government found an extra £20M to ease pressures related to medicines price increases, an overall agreement has still not been reached." "The UK-wide chains may be doing less well in the parts of their networks covered by the Westminster government's contract, but the taxpayers and government of Scotland need to be given reassurance that they are in no way subsidising funding shortfalls in England's pharmacy contract." Recently, when LloydsPharmacy's Scotland branches recently came on the market, they appear to have been sold exclusively to existing contractors, including the UK-wide multiple, Rowlands Pharmacy, who have acquired 30 of them. Other small and medium-sized Scottish pharmacy chains have apparently been able to double in size overnight by acquiring branches.

The Parliamentarians have called the government to urgently consider the short-term funding to stabilise the community pharmacy sector. 39 MPs and Peers from across the political spectrum have signed letters to the Health Secretary, Steve Barclay MP and raised their growing concern about the pressures facing England's community pharmacies and the risks this poses to patient care and safety. "Steve Barclay MP received correspondence from 23 Opposition MPs, with six Peers also signing a letter. Separately, 9 Conservative MPs also wrote to the Health Secretary and up to 10 others have signalled their intention to write to the relevant Minister," said the Pharmaceutical Services Negotiating Committee (PSNC). The Parliamentarians acknowledged that pharmacies have the potential to do more to support the NHS and they called for the government to urgently consider a commitment to working with the sector to create a fair and fit for purpose future funding model that ensures sustainability and properly funds pharmacies for what they do. All signatories also called for the introduction of a fairly-funded Pharmacy First service.