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Health leaders have said that delivering faster and more productive patient care would be difficult unless NHS capital budgets are nearly doubled to at least £14.1 billion from the current spending of £7.7 billion. The NHS Confederation has highlighted the impact that low levels of capital investment have had over the last decade in its report published today (29 November). The report, 'Investing to save: The capital requirement for a more sustainable NHS in England', revealed that the UK has lagged behind other comparable countries in terms of health capital investment for more than five decades, resulting in less productivity. It revealed that the NHS now has the sixth lowest number of CT and MRI scanners per million people of the OECD countries.

The government, NHS England and the Association of the British Pharmaceutical Industry (ABPI) has begun the negotiations for a new voluntary scheme for branded medicines pricing on Thursday (4 May). A new voluntary scheme is expected to take effect from 1 January 2024, replacing the current scheme which came into force in 2019 and ends on 31 December 2023 In their first meeting, the government, NHS England and industry - represented by the ABPI -expected to agree to a shared negotiation aim of working toward a mutually beneficial agreement that supports better patient outcomes and a healthier population, a financially sustainable NHS, and UK economic growth. Health Minister, Will Quince, said: "These negotiations will ensure a new scheme continues to deliver value for money by providing significant savings for our health services, securing access to innovative lifesaving drugs for NHS patients, and helping to reduce waiting times - one of the Prime Minister's 5 priorities. The current voluntary scheme supports investment in NHS services and saves billions of pounds for the NHS, while also promoting innovations and a successful life sciences sector.

Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems. Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS. "It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework." Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector." "We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."

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.

Community Pharmacy England (CPE) CEO, Janet Morrison said that the negotiations for the £645 million investment pledged to community pharmacies in 2023-25 have concluded. The government's primary care recovery plan is to be announced in a "few weeks" and negotiations for the Community Pharmacy Contractual Framework (CPCF) from April 2024 will begin. She said: "We have finished the substantive discussions on the recovery plan but detailed discussions about implementation are ongoing and we are awaiting final clearance from the Government and the NHS. "We hope that we will be in a position to make an announcement in the next few weeks and that negotiations on the CPCF from April 2024 will commence soon after that." Morrison reminded attendees that the Primary Care Recovery Plan is "to improve access to primary care by investing £645 million over the remainder of the year".

A group of 20 MPs from the different political parties, including Dame Priti Patel and Judith Cummins, have written a joint letter to health minister Andrea Leadsom, calling for urgent action to address the pressures faced by community pharmacies. Taking note of rising pharmacy closures, they have highlighted the need for more investment and support from the government. Recent NHS figures showed that around 1,400 pharmacies have closed permanently since October 2016, and many more are withdrawing services or reducing their opening hours, particularly in deprived areas. The MPs have urged the pharmacy minister to commit to making essential changes including a fair and sustainable core funding model, an effective implementation of the Pharmacy First service and an expansion into other clinical service areas.

The English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of community pharmacy as the third pillar of patient access to essential healthcare. Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC announces no new long-term investment to sustain the sector. Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners. Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated. Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances need open heart surgery not a couple of paracetamol tablets.

The community pharmacy bodies, along with England's largest pharmacy chains, have urged the Prime Minister, Rishi Sunak to resolve fund and workforce crisis in the sector. In the joint letter the Chief Executives of Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC), along with Boots, Lloydspharmacy, Well and Rowlands Pharmacy, said they are pleased to see Government now recognising the key role that community pharmacy' could have in alleviating the strain on other NHS services. However, the associations also warn that although the sector is ready to support, 'this will not be possible unless pharmacy is properly funded.' Janet Morrison, PSNC Chief Executive, said: "The Prime Minister should also know that community pharmacies are also facing a crisis. They need sustainable investment, urgently, if we are to avoid devasting consequences for pharmacies and for their patients." The letter calls on Government to help pharmacy to resolve the funding, workforce and capacity issues engulfing the sector. It said: "Community pharmacies are in crisis and after 7 years of 30% funding cuts have reached their limit."