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Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

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.

Community Pharmacy England (CPE) is gearing up to conduct a vital Pharmacy Advice Audit, calling on pharmacy owners and their teams to help measure the increasing reliance on pharmacies within communities. With years of financial strains impacting the sector, despite the much-needed £645 million recovery plan funding, the sector finds itself on the edge. The launch of Pharmacy First sparked a notable surge in people seeking advice from community pharmacies, both within and beyond the funded service, as revealed by recent sector polling. To accurately assess this trend and advocate for sustainable funding, CPE is initiating an audit to gather data crucial for showcasing the extent of unfunded care provided by community pharmacies. Scheduled to commence this week, the Pharmacy Advice Audit will entail pharmacy teams documenting informal healthcare advice dispensed over a single day.

Analysis by IQVIA revealed that over the past four years, from May 2020 to May 2024, the average number of prescriptions processed by pharmacies has risen by 8 million per month. However, this is happening against the backdrop of a declining number of pharmacies. During these four years, nearly 900 pharmacies have closed in England, with almost 500 of those closures occurring in the last 12 months. Carol Alexandre, vice president at IQVIA, presented the data at the recent SIGMA UK Community Pharmacy Conference 2024, where she shared insights into the dynamics of the UK market, the pharmacy sector, and the Pharmacy First initiative. As of August 2024, there were just 10,059 community pharmacies (excluding distance-selling pharmacies) in England, 1,589 less than in March 2015, when the number stood at 11,647 (source: NHS BSA). There has been a significant shift in the distribution of pharmacy ownership, with independents (single pharmacies and chains with 1-5 stores) and regional chains (pharmacy chains with 6-200 stores) growing at the expense of managed chains.

Community Pharmacy England (CPE) is inviting community pharmacy owners to share their insights and views about increasing Pharmacy First thresholds and the effects of GP collective action on their pharmacies. This feedback will be discussed at the upcoming Community Pharmacy England Committee meeting in September. During the meeting, the Committee members will also discuss urgent matters including the 2024/25 negotiations, collaboration with the new government, and their ongoing strategies. A key point of discussion will also be the effects of GP work-to-rule action on community pharmacies. CPE has raised concerns that many pharmacies might face challenges meeting the scheduled increases in the monthly Pharmacy First payment threshold, noting that pharmacy owners are already considering their options if they start failing to meet the threshold. In response to concerns from Community Pharmacy England, Ministers have recently agreed to lower the August threshold from 20 to 15.

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.

Stone Pharmacy in Barnsley, South Yorkshire has been sold to existing operator, Livesey Healthcare, which owns another pharmacy in East Lancashire for an undisclosed price. Stone Pharmacy is a well-established, 100-hour community pharmacy that is run under full management with a locum Pharmacist, and dispenses an average of 22,000 items per month. The business adjoins Garland House surgery in the South Yorkshire village of Darfield, which is circa six miles east of Barnsley and circa 14 miles north of Sheffield. The pharmacy has been owned by experienced operators, Khuram Akhtar and Mohammed Ali, trading as MEDS2U Ltd, for the last seven years, and was recently brought to market to allow the pair to pursue new ventures both in and out of community pharmacy. Khuram Akhtar, former owner of Stone Pharmacy, commented: "The business at Stone Pharmacy has been a fantastic enterprise for many years for us, with limited competition and a position central to the local community we have always enjoyed the support of the nearby population and are pleased that it is now in the hands of experienced operators who can build on that foundation with the expansion of new services.

A new report from Community Pharmacy England (CPE) has raised alarms about the severe financial challenges plaguing pharmacies across the sector, threatening their ability to provide even the core services for their patients. The findings are based on responses from over 6,100 pharmacy owners and 2,000 pharmacy staff who participated in the recent Pharmacy Pressures Survey 2024. The report reveals that spiralling costs and increased workloads, coupled with a 30 per cent funding cut in real terms since 2015, are putting countless pharmacies at risk of closure. "Nearly 1 in 6 may close within the next year," the report revealed. A vast majority (94 per cent) of pharmacy owners reported that they have seen significant increases in costs, with almost two-thirds (64 per cent) saying they are operating at a loss. Concerningly, these financial pressures are now affecting patient care, as 18 per cent of pharmacy staff reported severe impacts. The survey revealed that most pharmacies are experiencing longer prescription dispensing times (86 per cent), delays in responding to patient inquiries (80 per cent), and less time to spend with patients (79 per cent).

Two dozen parliamentarians from across the political spectrum have called on the prime minister to act as a wave of pharmacy closures in recent years has threatened to spiral out of control. A letter to the prime minister signed by 24 MPs and peers has warned that worse could be yet to come after "spiralling business costs" and "year after year of real terms funding cuts" have led to hundreds of pharmacy closures. New data from the PSNC shows that over 639 local pharmacies have been lost in England since 2016. "This is the equivalent to just short of one pharmacy closure per constituency", the cross-party group warned. The letter comes as MPs came together at a parliamentary summit to call for pharmacies to be embraced as a "game-changer" for tackling healthcare backlogs and taking pressure off other areas of the NHS. A 'Future of Pharmacy' event was attended by 53 parliamentarians on July 5 in the Palace of Westminster. At the event parliamentarians heard directly from frontline pharmacists and representatives of pharmacy bodies where a map of constituency-specific pharmacy numbers was also unveiled, with details of the number of pharmacy closures in MPs' local area.

Achieving the community pharmacy vision necessitates legal adjustments and additional funding beyond recent boosts, the pharmacy vision document published by Nuffield Trust and The King's Fund has revealed. It says community pharmacies in England must adapt to changing population needs amidst unprecedented health and care challenges. Commissioned by Community Pharmacy England, the report titled 'A Vision for Community Pharmacy', published on Sept. 19, is a result of almost a year of research and extensive consultation with the sector and wider stakeholders, advocating for community pharmacy. The think tanks detail a shift in the community pharmacy sector, highlighting how pharmacies can contribute to crucial policy objectives regarding population health, prevention, and the increasing demand in primary care. "The health and care needs of the population are evolving, and pharmacies in England, like all components of the health and care system, must adjust to address these changes," said Helen Buckingham, Director of Strategy at Nuffield Trust.

Balmedie Pharmacy based in Aberdeenshire, Scotland has been purchased by local expanding multiple operator JMF Healthcare. Balmedie Pharmacy is a well-performing community pharmacy that dispenses an average of 5,255 items per month. It lies completely unopposed in the large Aberdeenshire village of Balmedie, which is circa eight miles north of Aberdeen City Centre. The pharmacy has been owned by Brian Arris since 2004 and was recently brought to market to allow him to pursue other pharmacy business opportunities. Following a confidential sales process with Christie & Co, JMF Healthcare to benefit from new housing developments in this area of Aberdeenshire such as 300 new homes planned in Balmedie, approved plans for up to 500 new homes in Trump Menie Estate, and 284 new homes planned in Blackdog Village. Brian Arris, previous owner of Balmedie Pharmacy, comments, "I'm sad to see the business go as the excellent staff have helped grow the pharmacy from scratch since 2004 and we've all put our hearts and souls into providing good pharmaceutical care for the village and surrounding area. I'm confident everyone is left in safe hands with John at the helm now."

Kent based N.B. Pharmacy has been sold to first-time buyers, Venkat and Preeti Adama, from Essex for an undisclosed price. N.B. Pharmacy is a standard hours community pharmacy that dispenses an average of 6,393 items per month. The business has been owned by Nirmal Bajaria for 39 years and was recently brought to market to allow him to pursue a well-earned retirement. Following a confidential sales process with Christie & Co, it has been purchased by first-time buyers, Venkat and Preeti Adama, from Essex. Nirmal Bajaria, former owner of N.B. Pharmacy, comments, "Having run the pharmacy for around 39 years, it was a difficult decision to put the business up for sale. I was very pleased with the high number of viewers and feel delighted that a young family bought my pharmacy."

All pharmacy businesses are reporting that they are struggling to find the registered professionals needed to open their pharmacies, clarified the Company Chemists' Association (CCA) in response to an attack by the Pharmacists' Defence Association. Last week, PDA allegedly accused some large pharmacy chains of 'orchestrating' full or part-time closures of some of their shops due to the staff shortage. In its Open Letter published on Tuesday (July 19), PDA demanded urgent action "to protect patients by ensuring that essential community pharmacy services are provided safely and consistently". "All parts of the healthcare system are struggling to recruit staff and to assume that pharmacies would be immune to such pressures, seems fanciful," said CCA. "CCA members are working extraordinarily hard to prevent temporary closures, but recruitment and retention of pharmacists is becoming increasingly tough. The recent rise in Covid cases and the beginning of the summer holiday season in parts of the UK have only worsened the situation." The Association also showed data from the PSNC Pharmacy Pressures Survey (April 2022) which found that 91 per cent of pharmacies are experiencing staff shortages, clearly demonstrating that these shortages are affecting the entire sector.

The Royal Pharmaceutical Society (RPS) has urged people across Scotland to be kind to their pharmacy teams this winter through its campaign called 'Be Kind'. The pharmacies are facing lot of pressure and challenges during winter, RPS has heard from its members that abuse towards pharmacy teams, particularly those in community pharmacy, has 'unfortunately' risen. The campaign has been running throughout December, to promote 'be kind' message to the public at a time when pharmacy services are particularly stretched by winter pressures and other factors, including the recent shortages of antibiotics. "Throughout December, leading figures have provided a series of powerful videos, which all encourage the public to be kind to their pharmacy teams. The campaign has highlighted personal video messages from many figures including Jason Leitch, Scotland's National Clinical Director, Maree Todd, Minister for Public Health, Women's Health and Sport, and Andrew Carruthers, RPS Scottish Pharmacy Board Chair," said RPS.

Responding to an MP's question in the House of Commons, prime minister Rishi Sunak reiterated his deep concern for the future of UK community pharmacies, stressing their commitment to enhancing the sector with an additional £645 million in funding through the Pharmacy First initiative. At the recent Prime Minister's Questions last Wednesday, Angela Richardson, the Conservative MP for Guildford, raised the issue of rising pharmacy closures, revealing that Guildford recently lost two neighbouring pharmacies. Highlighting that empowering local pharmacies is a key part of this government's plan to cut waiting lists, she asked Sunak whether he would agree that it is vital for residents to have access to "a good, efficient, and above all, local pharmacy." In response, Sunak said: "I care deeply about the future of our community pharmacies."

"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 General Pharmaceutical Council (GPHC), Royal Pharmaceutical Society (RPS), Company Chemists Association (CCA), Association of Pharmacy Technicians UK (APTUK), National Pharmacy Association (NPA), Guild of Healthcare Pharmacists, Pharmacists' Defence Association (PDA), and Independent Pharmacies Association (IPA) have released a joint statement in response to the far-right riots across the UK. They emphasised their united stance, declaring zero tolerance for racism towards colleagues or the public in any form. The joint statement reads: "We are shocked and saddened by the violent public disorder events in recent days. "We acknowledge how all sectors of the pharmacy profession may be impacted and recognise the challenges that this level of overt aggression can have on people's ability or willingness to live their daily lives. "The pharmacy workforce deserves peace and safety, not fear and harm. We stand united in having a zero tolerance of racism towards our colleagues or the public in whatever form it takes." Meanwhile, Community Pharmacy England (CPE) has expressed concerns that protests and violent disorder in various towns and cities across England may impact the ability of community pharmacies to operate.

A recent report published by the General Pharmaceutical Council (GPhC) has highlighted a significant increase in the number of registered pharmacists and pharmacy technicians, indicating the expanding role of these professionals in the UK healthcare system. As of May 31, 2024, the GPhC register recorded a total of 90,739 pharmacy professionals, up from 90,604 at the end of April 2024. This includes 64,415 pharmacists and 26,324 pharmacy technicians, maintaining a steady split of 71 per cent pharmacists and 29 per cent pharmacy technicians. This reflects an overall increase of four pharmacists and 131 pharmacy technicians from the previous month. The report underscores the critical role of pharmacy professionals in ensuring high-quality patient care and supporting the operational efficiency of pharmacies.

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.

Blackthorn Pharmacy in Southampton, Hampshire has been sold to expanding operator, Rosechem Limited, which has multiple other pharmacies in Hampshire and Surrey for an undisclosed amount. This health centre pharmacy dispenses an impressive average of 25,000 items per month. It has been owned by Patrick Stephens for over 25 years and was recently brought to market to allow him to retire. Patrick Stephens, previous owner of Blackthorn Pharmacy, commented: "Over the years, with a lot of hard work and support of my pharmacy team, the business had grown significantly and, after 25 years, I was keen to retire and for someone to take over my business. I am sure the buyer will be successful and will continue to grow the business and build on the great relationships we have created. I would like to thank Jonathan at Christie & Co for all his hard work and am delighted that the sale has now completed."