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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.

Community pharmacists across the UK are looking for ways to reduce operational costs and find new sources of revenue. This is a pressing issue for the sector: reversing a decade of cuts to pharmacy funding will be a mammoth task, while pharmacists have taken on new primary care responsibilities under Pharmacy First. This means that fresh sources of revenue and lower costs will overwhelmingly come from new technology and the efficiencies they can bring. As Britain's 11,500 community pharmacies assume a larger role on the frontlines of primary care, pharmacists should rapidly implement cost-effective tech solutions that provide pharmacies with a one-stop-shop to drive down costs and increase revenue. Opportunity in PGD reform New technology will be key for community pharmacists to benefit fully from reforms to PGDs. The scope of PGDs is now significantly expanding: as of June 26, pharmacy technicians are now on the list of registered healthcare professionals who can make use of PGDs. These reforms can benefit community pharmacies in several ways. For one, they will allow more pharmacy staff to administer 'frontline services' such as vaccinations - reducing costs and generating revenue. Further, the wider range of services that pharmacies can offer under Pharmacy First will make these procedures, as well as other kinds of preventative care, more accessible and convenient - increasing footfall. With international travel and tourism now growing apace, increased demand for travel vaccinations means that, according to research from Charac, the average UK community pharmacy can expect to generate £46,800 a year through travel health services.

A harsh funding regime that hasn't adapted to changing macroeconomic realities means the viability of large parts of the pharmacy sector is at risk unless the model changes. Very simply, across the sector, revenue has remained largely fixed while costs have increased significantly, making it impossible for many pharmacies to sustain their business models. The sector has seen the closure of more than 1,500 community pharmacies since 2015, with 700 of these closures occurring since 2021. Larger pharmacy operators such as Lloyds, Boots, and Rowlands have seen the biggest decline in numbers, with smaller businesses operating between one and five pharmacies now accounting for almost 50% of the sector. Despite rising inflation and business costs, the NHS pharmacy funding model has remained fixed. Over the period of the current Community Pharmacy Contractual Framework (CPCF) - 2019-2024 - pharmacies have experienced a 30% real terms cut in core funding leading to an annual shortfall of over £750 million, equivalent to £67,000 per pharmacy in England. The current CPCF is due to end in 2024, and there is still no arrangement in place for future funding, leading to delayed and inefficient spending decisions and hampering the ability of the sector to plan and attract much-needed investment.

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.

Increased cooperation between countries is needed to ensure better regulation of online pharmacies, said authors of a new report - 'Online pharmacy operations and distribution of medicines', published by the International Pharmaceutical Federation's (FIP) Community Pharmacy Section. The report presents findings of a global survey of pharmacy organisations covering various aspects, such as type of medicines supplied by these pharmacies in different countries, how the authenticity of online pharmacies can be verified, and the usage of e-prescriptions and shared patient health records. Of the 79 countries responding to the survey, 51 per cent acknowledged that no regulation of online pharmacies exists. A quarter of the respondents reported cases of irresponsible self-medication by consumers who had purchased medicines through online pharmacies. A lack of regulation creates "an avenue for illegal pharmacies and may impact the overall quality of medicines and services offered to consumers," authors of the report said. Lars-Åke Söderlund, immediate past president of FIP's Community Pharmacy Section and co-editor of the report, said that the pandemic has increased preference for online services, including in the pharmacy sector.

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.

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 has submitted a full and detailed written response to the Health and Social Care Select Committee's pharmacy inquiry. The Committee is expected to hold oral evidence sessions when Parliament returns in the Autumn. The commencement of this inquiry follows on from those held on other primary care sectors, including Dentistry and General Practice. According to the Committee website this inquiry 'will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy services'. Key themes of CPE's submission include- Suggestions on future service provision; Challenges with the pharmacy workforce; Longstanding underfunding of the sector; and Current pressures. Janet Morrison OBE, Chief Executive of Community Pharmacy England, said: "This is an extremely important opportunity for all who work with and in the Pharmacy sector, to highlight not only the extreme challenges we face, but also ideas and suggestions for what more we can do to help patients and the public in the future.

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."

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."

A survey of over six thousands pharmacies has revealed that the community pharmacy sector is buckling under growing cost and capacity pressures. The survey conducted by the Pharmaceutical Services Negotiating Committee, which also involved two thousand community pharmacy confirms, rising costs, patient demand and medicine supply issues continue to grip the sector. PSNC's 2023 Pharmacy Pressures Survey, run as a follow up to the 2022 pressures survey, provides clear comparative data showing the worsening situation across the sector. Govt must act now The result of the survey indeed paints a bleak picture for community pharmacies and it is clear that without urgent action from government and the NHS this will only get worse: more community pharmacies will either be forced to reduce the number of services they provide or, in the worst-case scenario, will be left with no option but to close their doors for good. The PSNC has urged the government to act now "to save our pharmacies, before it is too late for patients, the public, and the rest of the NHS". "This year's survey clearly shows that community pharmacies are buckling under growing cost and capacity pressures," said PSNC Chief Executive Janet Morrison.

We're approaching that time of year where the sun is supposed to be shinning and things are supposed to quieten down over the summer holidays (note I said supposed to. . . well we have the sun at least). The elections are over, and a new party is in power. Wes Streeting is the Secretary of State for Health and Social Care. He's met with GPs and Dentists and has great ambitions for Primary Care but when will he meet with community pharmacists? To be fair to Wes, he did visit a local pharmacy in his constituency, with CPNEL last year as Shadow Health Secretary (and was a guest speaker at the Pharmacy Business Awards 2023). He has also had meetings with NPA and CPE, so we know he understands the value of Community Pharmacy. The question is, do we as a sector and profession need to shout louder so that we aren't forgotten about, as healthcare plans are being drawn up? Community Pharmacy is a humble sector, not unlike most other HC sectors. The difference is that we often get forgotten. I have lost count of the times I've heard in meetings or conversations "Primary care and community pharmacy. . ." totally disregarding the fact that we are part of primary care.

The Company Chemists Association (CCA)'s 'Prospectus for community pharmacy' has revealed that community pharmacies can release over 42 million appointments from general practice every year. In its prospect, the association calculated that community pharmacies could reduce hospital readmissions by 65,000 and administer an additional 10m routine vaccines annually. The prospectus sets out bold ideas and proposals regarding the future of community pharmacy. The association said: "Community pharmacies already work collaboratively with the NHS to ensure that patients can access care easily and safely. Whilst the sector has evolved considerably in recent years, the CCA proposes that pharmacies could do even more to directly tackle key problems for patients." CCA is concerned that without immediate action pharmacy closures will become increasingly common. "Fewer pharmacies will considerably diminish access to vital medicines and services, with the greatest impact on those in deprived communities."

The National Pharmacy Association (NPA) will deliver the national #saveourpharmacies petition to Prime Minister Keir Starmer and Health Secretary Wes Streeting on September 19. Over 300,000 people have signed the cross-sector petition in support of hard-pressed community pharmacies across the UK, which have been ravaged by funding cuts over the past decade. The NPA is inviting pharmacy bodies in England to join them on the second national pharmacy day of action to demonstrate unity in calling for a new deal to support the pharmacy sector. Earlier this year, the NPA distributed petition sheets to pharmacies across the country to maximise the number of signatories to increase pressure on the government to act in support of the pharmacy network. In preparation for the September 19 day of action, the NPA is sending out thousands of campaign packs including medicine bag stickers, posters, and postcards, to pharmacies across the UK. Through these materials, the NPA is urging pharmacies and their patients to highlight the issues of funding cuts and closures.

After the government announced to award pay rise to pubic sector workers, pharmacy trade bodies have expressed their disappointment at the neglect shown towards funding crisis in community pharmacy. The National Pharmacy Association (NPA) chair, Andrew Lane, said: "Our sector can't help but feel utterly neglected after seven years of crushing real terms cuts to pharmacy funding, amounting to half a billion pounds, and no hint of any relief to come. "This week's public sector pay awards, which include a large number of our health service colleagues, highlight that there's an unresolved funding crisis in community pharmacy which needs urgent attention." "Four months into this financial year, there is as yet no clarity even on current arrangements." "After stepping up to tackle Covid and keep the wheels on the NHS, the sector deserves better than to be neglected in this way," Andrew opines.

This year has been another turbulent year for the UK pharmacy sector. The sector continues to undergo significant transformations, driven by evolving healthcare needs, regulatory shifts, and economic pressures. For pharmacy owners, staying abreast of these trends is crucial to navigating the challenges and seizing opportunities. IQVIA, a leading global provider of clinical research services, commercial insights and healthcare intelligence, delves into the key issues, challenges, and developments shaping the sector, drawing insights from the latest industry data and reports, supported with data released by NHS England (NHSE). The community pharmacy landscape remains unsettled, with disruptive market dynamics at play. The decline in the number of pharmacies, particularly within the Managed Chains channel, underscores the volatility of the market. The number of active pharmacy contractors in England has dropped significantly, with more closures than openings each month, exacerbated by the exit of Lloyds Pharmacy from the UK market which completed at the end of 2023. In the year ending June 2024, there was a net closure of 440 sites within NHSE which equates to a 4% decline in available pharmacies1. The increase in closures from June 2023 was driven by the closures of Lloyds in Sainsburys and the ongoing divestment of the Boots estate.

With the UK General Election set for 4 July, pharmacy bodies are actively engaging with all political parties to secure support for the community pharmacy sector. They are pressing parties to address urgent issues such as pharmacy closures and medicine shortages. "The upcoming general election is a critical opportunity for us to strengthen supporters of community pharmacy in readiness for the new Parliament," said Janet Morrison, chief executive of Community Pharmacy England (CPE). She stressed the need for unity within the sector in advocating for community pharmacy and raising awareness of the issues with election candidates from all parties. As the general election approaches, CPE has called upon all political parties to support pharmacies by "introducing a long-term sustainable funding model and reviewing the medicines supply chain, including much-needed short-term relief measures."

Stephen Kinnock, Minister of State at the Department of Health and Social Care (DHSC), discussed all primary care contracts, including those related to community pharmacy, during his meeting with Community Pharmacy England (CPE) Chief Executive and two members from the Negotiating Team. The pharmacy minister reiterated that community pharmacies will be central to the new government's health and wider missions. CPE Chief Executive Janet Morrison and her team updated Kinnock on the community pharmacy sector, highlighting the pressures throughout the summer. They underscored the critical challenges facing the sector and the urgent need for a funding lift. They also discussed Pharmacy First and emphasised the broader potential for pharmacies to further support the health of their local communities.

Pharmacy minister Stephen Kinnock has pledged to enhance the role of community pharmacies, particularly in deprived areas, by making better use of the skills of pharmacy teams. In a video message at the SIGMA UK Community Pharmacy Conference 2024 on Sunday, Kinnock also announced plans to expand the Pharmacy First initiative and introduce an independent prescribing service, making prescribing an integral part of the service delivered by community pharmacies. He said: "Since taking on the role of minister of state for care in government, my message has been very clear: we must get our fantastic primary care sector back on its feet to be able to deliver for our patients. "This government is committed to shifting care from hospital to community, from analogue to digital, and from sickness to prevention, and pharmacies will play a vital role in that." Kinnock acknowledged the pressures faced by the sector and expressed concerns that so many community pharmacies have exited the market over the past decade.

The Community Pharmacy England Committee has adopted a new approach to engagement with sector by inviting all pharmacy owners to share their views on pharmacy's finances, pressures and capacity ahead of its meeting in July. It has sought views of pharmacists via short poll by Sunday (2 July) and will have a discussion on the poll results at the meeting before reporting back to the sector afterwards. The key focus for July Committee Meeting will be to make most of £645m for the community pharmacy sector, and also on the ongoing work to make the wider case for more investment in the sector. This new way of working follows association's rebrand on 30th May which signalled the start of its new approach to engagement to help them to build stronger relationships with pharmacy owners. The association hopes this new approach will help them better engage with members and listen to pharmacy's views better.