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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".

As the countdown to the next UK election begins, the King's Fund has identified three priorities to improve public health. The national action would be taken by the future government to fix the "NHS and social care" in the country. The health policy think tank said it would prioritise "improving access to out-of-hospital care", making "careers in health and social care" more attractive and tackling the biggest risk factors affecting people's health. It highlighted that workforce crisis is one of the biggest challenges faced by the National Health Service (NHS) and social care services in England while citing "years of poor planning and fragmented responsibilities" as the reason for widespread staff shortages. As per the King's Fund's data, there were more than 125,000 vacancies across the NHS workforce in England in October 2023, not including primary care vacancies such as GPs, and 152,000 vacant posts in the adult social care workforce.

The National Health Service said that over 425,000 patients have utilised its new national online service to complete GP registration within its inaugural year. The GP surgery registration service, managed by NHS England, has granted NHS patients efficient and user-friendly access to GP registration since its inception in August 2022. According to the NHS, more than 1,400 GP surgeries, a fifth of the national count, have joined the NHS online registration service as part of a new plan to improve access to primary care. "This aligns with a new strategy to enhance primary care access, with a target of enrolling 2,000 practices in the Register with a GP surgery service by December 2023." Many GP surgeries still use paper forms, requiring patients to visit surgeries to collect paperwork. However, the new online service has been shown to save GP surgery staff up to 15 minutes per registration by helping to reduce paperwork and admin time, the NHS said. The NHS said that this service enables patients to register with a local GP online at any time, eliminating the need for in-person visits and simplifying the process for both patients and GP surgeries.

Over the last few years, we've seen the aftermath of Covid-19, with the demand for consumer health products being unprecedented and unpredictable, placing pressure on supply chains and labour market. In turn, the industry has experienced acute shortages across the healthcare sector, placing huge pressure on pharmacists, doctors, nurses, and other healthcare professionals. Europe has an estimated shortage of around 50,000 public-sector doctors[1], which is set to increase in the coming years. While this shortage stems from several complex problems, there is a hidden force that could play a key part in helping to alleviate this burden. That force is the potential of self-care. Encouragingly, last month the UK government recognised the unique role that self-care can play through the introduction of its Delivery plan for recovering access to primary care. Through this, it has pledged to empower patients to manage their own health through several commitments, including improving accessibility to online tools and reclassifying medicines to make formerly prescribed options available over the counter.

The Royal Pharmaceutical Society (RPS) Wales has welcomed proposals from the Welsh government to increase access to PrEP via community pharmacies for people at risk of HIV. The new HIV Action Plan for Wales consultation proposes a shared care model between primary care and specialist sexual health services to improve access to PrEP. Commenting on the proposal, chair of RPS in Wales Cheryl Way said: "Increasing access to the medicines has been a long-standing issue of concern for us at RPS and we're therefore delighted to see the proposals outlined by the Welsh government to develop a model which will enable PrEP to be provided by community pharmacies across Wales. "PrEP are highly effective medicines, that reduce the chances of getting HIV, as proven by the Welsh Government's three year PrEPARED study which found no new diagnoses of HIV among over 1,200 people taking PrEP in Wales. This is clear evidence that PrEP should be made as easily accessible as possible to those who need it.

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 Pharmacy Supervision Practice Group held its second meeting to discuss the future modelling of pharmacy practice. Some of the leading bodies from the community pharmacy sector have joined the group. The members explored themes centred around accountability, delegation and responsibility. The session included a wide-reaching discussion, including what future guidance might look like and the continued patient access to the pharmacist through a comprehensive, accessible and equitable community pharmacy offer. Chair of the group, Dr Michael Twigg, Associate Professor of Primary Care Pharmacy, University of East Anglia, said: "The primary objective of the group is to develop a co-designed and co-produced solution that will not only enhance the patient experience within community pharmacy practice, but that will enable the community pharmacy workforce to maximise role and professional skills. "At its second meeting, the group was unanimous that any changes in the delegation, responsibility and accountability space should be in the patient interest, distil confidence for patients and ensure that community pharmacy remains accessible and equitable."

Will Quince, MP for Colchester and Health Minister visited Rowlands pharmacy on Friday (20 January) in Nayland Road in his constituency. The important role played by pharmacies in providing NHS care, support, and advice helping the local community to live healthier lives and manage long-term conditions were discussed among the pharmacy teams. Mr Quince said: "Community pharmacy is playing an increasingly important role in ensuring people in Colchester have convenient walk-in access to the healthcare support and advice they need. Pharmacies are not simply places to collect prescriptions, they provide a wide range of services and are the third pillar of access to primary care alongside GPs and A&E. I would urge people to think pharmacy first if they have a minor ailment; need advice on taking their medication; want to stop smoking or want to check their blood pressure."

The Company Chemists' Association (CCA)'s analysis on permanent closures of community pharmacies in England showed that there has been a net loss of 670 pharmacies between 2015 and 2022. The analysis highlighted that 37 per cent of permanent closures of pharmacies and GP practices have occurred in the 20 per cent most deprived parts of England. Current trends indicate that primary care 'cold spots' could soon emerge - areas where there is significantly reduced or inadequate access to a pharmacy or a GP. The CCA's analysis shows that some of the most deprived neighbourhoods concentrated in the North West, the West Midlands and Yorkshire have faced the highest losses of local pharmacies and GP practices since 2015. It demonstrates that the trend of permanent closures amongst pharmacies and GP practices is worsening. Moreover, this burden is likely to be felt unevenly with permanent closures occurring disproportionately in areas of high deprivation. Without action, deprived communities, where need is typically greater, may no longer be able to access the GP and pharmacy services they require.

A Company Chemists' Association (CCA) analysis has shown that 'Pharmacy First' service in England could free up 30m+ GP appointments each year. It has urged the Government and NHS to be even 'bolder in their ambition and go further and faster'. The recent 'Delivery plan for recovering access to primary care' announced a 'Pharmacy First' service for England, mirroring similar approaches in Scotland and Wales. The association has estimated that with the added capability to supply non-prescription medicines and prescribe additional prescription-only medicines, an ambitious 'Pharmacy First' service could free up 30m+ GP appointments annually. Harnessing community pharmacies to deliver care for minor health conditions will effectively create 11,000 urgent care centres in England.

As part of a new blueprint for primary care, the government today (May 9) announced an investment of £645 million over two years to expand community pharmacy services in England. In a statement, NHS England said: "For the first time ever, patients who need prescription medication will be able to get it directly from a pharmacy, without a GP appointment, for seven common conditions including earache, sore throat, or urinary tract infections." Prime minister Rishi Sunak hopes that the measures will help end the "all-too stressful wait on the end of the phone for patients" by freeing up 15 million slots at doctors' surgeries over the next two years. "We will end the 8am rush and expand the services offered by pharmacies, meaning patients can get their medication quickly and easily," he said Almost half a million women will no longer need to speak to a practice nurse or GP to access oral contraception and will instead be able to pop into their local pharmacy for it, according to the government announcement. Blood checks for people suffering from moderate risk of heart attack or stroke conducted in community pharmacies will more than double from 900,000 last year to 2.5 million next year. NHS chief executive Amanda Pritchard said the "ambitious package" would help transform how care is provided within the health service "with pharmacies playing a central role in managing the nation's health including providing lifesaving checks and medication for common conditions for the first time.

The National Institute of Health and Care Excellence has recommended that surgeons working in hospitals with limited or no access to a radiopharmacy department could now use Magtrace and Sentimag as an option to locate sentinel lymph nodes in people with breast cancer. The recommendation in draft NICE medical technology guidance could see a change in NHS standard care for the first time in years. The technology could also mitigate the reliance on radioactive isotope tracers shipped in from outside Great Britain. The magnetic liquid tracer - Magtrace - is a non-radioactive dark brown liquid. It is both a magnetic marker and a visual dye. The Magtrace is injected into the tissue around a tumour. The particles are then absorbed into the lymphatic system, following the route that cancer cells are most likely to take when they spread from the primary tumour and become trapped in sentinel lymph nodes. The Sentimag probe moves over the skin emitting sounds of different pitches as it passes over the Magtrace tracer, in a similar way to a metal detector locating metal in the ground. The nodes often appear dark brown or black in colour, which also helps with identification.

People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP). According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in England last year, rising from 12.8 million in 2022 to 17.6 million. Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for their services due to severe staff shortages. Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five years ago. Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and unsustainable workloads" and "we can't keep doing more with less."

The National Pharmacy Association (NPA) has emphasised that the community pharmacy sector must be involved right from the start in all local planning meetings pertaining to the roll-out of vaccine services in potential future pandemics. This includes crucial discussions regarding supply logistics and resource allocation, lawyers representing the NPA told COVID-19 public inquiry hearing. Chaired by Baroness Heather Hallett, the independent public inquiry is examining the UK's response to the Covid-19 pandemic and lessons for the future. The NPA has been designated as a 'core participant' in Module 4 (vaccines) of the inquiry, which considers various issues related to vaccine development and rollout, as well as Module 3 (healthcare). During the hearing on September 13, NPA lawyers outlined three key areas the association says must be improved in future pandemic vaccination programs, including properly utilising existing primary care expertise, better planning and engagement, and improved access to information for community pharmacists.