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The new board of the National Pharmacy Association (NPA) has adopted 10 principles for transforming the contractual framework in England. The board met for the first time in April, believes that the current Community Pharmacy Contractual Framework is failing NPA members, the wider sector, the NHS, Government and patients. The association's new vice chair, Jay Badenhorst, said: "We can't wait until the current framework limps to its finish line in 2024 before giving serious thought to the new race we must all run in the future." "Before negotiations for a new contract begin in earnest, we want to make our position clear to all of those who will be involved in its development. Years more of the same would be totally unacceptable. Tinkering at the edges of the current arrangements as the basis for a new deal could not achieve the transformation that is needed." Former chair of the NPA, Andrew Lane, listed some of the principles in a speech to industry leaders in January, but this is the first time the approach has been agreed in its entirety, following months of testing with NPA members.

Nuffield Trust and The King's Fund are seeking feedback from community pharmacy on their proposals for the future of community pharmacy and they are seeking feedback from community pharmacy stakeholders. The online survey is the latest opportunity for pharmacy owners, LPCs and others in the sector to engage with the project to develop a Vision for Community Pharmacy. Nuffield Trust and The King's Fund want to hear their views on their proposals, ahead of the publication of the final report later this year. The vision is critically important, as it will be used to develop the future strategy for the sector and lay the groundwork for the next Community Pharmacy Contractual Framework (CPCF) negotiations. The survey is asking for thoughts on key aspects of the vision and its recommendations. The vision has been developed by Nuffield Trust and The King's Fund following an extensive programme of research, interviews and meetings of the vision Steering Group, Advisory Panel, and Working Groups, all of which have contractors, LPCs and other representatives of the sector at their heart. The vision project team are looking forward to hearing views from across the sector on their proposals and what will need to happen to make them a reality.

Community pharmacy representatives and MPs from across all political parties discussed the impact of winter pressures on pharmacies in England during a parliamentary drop-in event held on Tuesday (5 December). As many as 34 MPs attended the event, including Bradford South MP Judith Cummins, who hosted the event. Members of the Community Pharmacy England (CPE) Policy Team and LPC leaders briefed the politicians about the current winter pressures that all NHS community pharmacies are grappling with, and asked them to help get more support. CPE Chief Executive Janet Morrison said: "Community pharmacies play an active role to support their patients throughout the winter period, but the sector needs fair and proper funding to enable its vital services to be delivered in the long term. This event came at a key moment for the sector as we work towards implementing the Pharmacy First service and negotiations begin for the 2024/25 Community Pharmacy Contractual Framework (CPCF).

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."

The Health Select Committee Expert Panel has concluded in its report published on Tuesday (25 July) that the funding aspect in the community pharmacy sector 'requires improvement' based on the evidence received. The Expert Panel reviewed nine Government commitments, seven of which were from the Community Pharmacy Contractual Framework. It was found that available funding was not sufficient to keep pharmacies open, struggling financially with increased demand for dispensing, workforce pressures and rising costs due to inflation. One of the other commitments requiring improvement covered a scheme intended to protect access to local physical NHS pharmaceutical services in areas where there were fewer pharmacies. Professor Dame Jane Dacre, Chair of the Expert Panel, said: "Pharmacy plays a key role in the delivery of care so it's disappointing that progress overall to deliver on the Government's commitments was rated as 'requires improvement'.

The proposed increase in the national living wage (NLW) is expected to impose an implementation cost of £150 million to £195 million on the community pharmacy sector, Community Pharmacy England (CPE) has warned. Chancellor Jeremy Hunt recently announced a 9.8 per cent increase in the national living wage, raising it from £10.42 to £11.44. "The Autumn Statement overlooks the knock-on effects these measures will have on small businesses like community pharmacies," CPE Chief Executive Janet Morrison said in a statement. "The majority of pharmacies employ staff on or around the NLW, which has increased nearly 40 per cent since the start of the current contractual framework." "This is at a time when pharmacies have faced a 30 per cent real terms reduction in funding since 2015," Morrison added. "No viable business can absorb these cost increases without significant support. This is just another cost pressure that pharmacies cannot control and must be addressed through a sustainable, long-term funding arrangement."

The National Pharmacy Association (NPA) has commissioned Professor David Taylor of University College London to investigate the implications of all-time high inflation rates on community pharmacies in the UK. Professor Taylor's will assess rates of inflation affecting community pharmacy across the UK, using public data sources whilst examining inflated costs in the context of the current five year contractual framework in England (2019-2024). He would review the EY (Ernst & Young) report into pharmacy funding, to identify whether current inflationary pressures could change any of the findings and consider the policy implications and impacts of inflationary pressures, including pharmacy's ability to prepare for a more clinically focused future and maintain current core services. NPA chief executive Mark Lyonette said: "Inflationary pressures are eating into the limited funds provided by the NHS for pharmacy services. We believe the real level of inflation for pharmacy businesses could be higher than the CPI inflation rate, which itself is at a 40 year high. Staff and locum costs in the sector as well as medicines costs have risen dramatically.

Wales has begun the rolled-out of a community pharmacy prescribing service as part of reforms agreed by the Welsh health minister last December. Eluned Morgan approved wide-ranging changes following re-negotiation of the Community Pharmacy Contractual Framework with Community Pharmacy Wales, the representative body for community pharmacies in Wales. The roll out will allow appropriately trained community pharmacists to treat an extended range of conditions that currently require people to visit their GP. Initially pharmacist prescribers will be able to prescribe medicines, including antibiotics for acute illnesses like urinary tract and upper respiratory tract infections, and also prescribe routine contraception. The first of its kind in the UK, the service is being rolled out progressively across Wales, building on local schemes which are already in place.

The Community Pharmacist Consultation Service (CPCS) will be expanded to enable urgent and emergency care settings to refer patients to a community pharmacist for a consultation for minor illness or urgent medicine supply from Monday (15 May), the DHSC and NHSE said. The service builds on the progress made in GP referrals via the CPCS and hospital referrals under the Discharge Medicine Service. It was originally planned to launch in March, and fee for this service will be the existing CPCS fee of £14, as per the agreement for both year 4 and year 5 of the Community Pharmacy Contractual Framework (CPCF) 2019 to 2024 5-year deal. In an update on the CPCF, published today (12 May), the Department of Health and Social Care (DHSC) and NHS England (NHSE) has also committed to the 4 October 2023 launch date for the Tier 2 of the Pharmacy Contraception Service, subject to a positive evaluation of the pilot. The Tier 1 of the service was launched on 24 April, delayed by over three months. This new service enables community pharmacists to provide ongoing management, via a patient group direction (PGD), of routine oral contraception that was initiated in general practice or by a sexual health clinic. The fees for this service are as follows: a fee for each consultation of £18; and a set-up fee of £900, paid in instalments. The Tier 2 will "enable community pharmacists to also initiate oral contraception, via a PGD, and provide ongoing clinical checks and annual reviews," Alette Addison, deputy director for pharmacy, dental and optical at the DHSC and Ali Sparke, director for dentistry, community pharmacy and optometry at the NHSE, said in a letter.

The Pharmaceutical Services Negotiating Committee (PSNC) has commissioned Nuffield Trust and The King's Fund to develop a new vision and strategic options for community pharmacy. The report is expected to be published in early summer next year, to underpin the future strategy for the sector. It will also support negotiations between PSNC and policymakers as the current five-year Community Pharmacy Contractual Framework (CPCF) comes to an end. Those negotiations will decide what happens after April 2024, and they will be critical to the future of the sector. The development of a compelling vision and an effective strategy for community pharmacy was a key recommendation from the Pharmacy Representation Review Steering Group (RSG). It forms one of the workstreams of the Transforming Pharmacy Representation Programme (TAPR) currently being undertaken by PSNC. But it is also a project that PSNC wants to undertake anyway to help lay the foundations for those crucial upcoming negotiations.

The Challenges There cannot be anyone working in or with community pharmacy that either feels or sees the pain that emanates from the current operating climate. Pharmacy closures; increased workload and operating costs; increased patient and commissioner expectations; and, more fundamentally, an inadequate, undervalued and poorly structured remuneration and reimbursement contractual framework. As important as they are, we will not focus on these points here as they are not in the control of pharmacy owners and managers. They are the responsibility of those organisations that represent them at a national and local level who must deliver a better outcome as difficult as that may be. However, there are matters which are in the control of pharmacy owners and managers. These include their premises, their team, their systems and processes, their relationships with other healthcare providers and the broader community, their NHS and private service offer, and how they promote and deliver them to give the best patient experience. In order to create the head space to develop and implement a business plan, pharmacy owners and managers must make time to work on their business as well as in it. Then it requires the capacity and capability within their team to deliver the services and that excellent patient experience.

The tripartite negotiations to set the arrangements for the Community Pharmacy Contractual Framework (CPCF) in 2022/23 - Year 4 of the five-year CPCF deal - have now begun, the Pharmaceutical Services Negotiating Committee (PSNC) said. The discussions, beginning ahead of the start of the financial year, are taking place between the PSNC and the Department of Health and Social Care (DHSC) and the NHS England and NHS Improvement (NHSE&I). It will cover issues related to service, funding and other arrangements for pharmacies in 2022/23, in line with the five-year CPCF deal. The three entities will also discuss the progress made to date, which has been partly impacted by the Covid-19 pandemic, and the recent joint Annual Review process, where PSNC raised serious concerns around the available capacity within community pharmacy.

A full CPE Committee Meeting was organised in London on April 17 and 18, 2024, to discuss crucial sectoral issues. Key topics discussed during the two-day meeting included intolerable pressures on pharmacy owners, the ongoing Community Pharmacy Contractual Framework (CPCF) negotiations, implementation of the Pharmacy First service, and governance changes. Committee Members reviewed the progress of CPCF negotiations with the Department of Health and Social Care (DHSC) and NHS England. These critical negotiations are being led by the Negotiating Team (NT), which includes independent pharmacy owners and representatives of CCA and non-CCA multiples. The CPE has been advocating for an uplift to the core global sum, margin write-offs, an agreed mechanism for regular funding increases linked to activity and inflation, annual uplifts to service fees, more fundamental reform of the margin delivery framework and an economic review of the medicines supply chain. The Committee also discussed the results of the 2024 Pharmacy Pressures Survey, which was conducted during March and April.

It's no secret that as pharmacists we are navigating a new and more demanding healthcare landscape. Our role has changed significantly since the start of the 21st century due to increased expectations from the public, advances in science and technology and changing workforce pressures. The Community Pharmacy Contractual Framework for England has placed a higher focus on clinical service. In addition, the Covid-19 pandemic resulted in significant acceleration in changing how we work day-to-day and the public perception of our role. Community pharmacy owners and staff have been under relentless pressure for the last two years. Dispensing volumes are continually increasing but dispensing revenues are being replaced by launching new services. We must find solutions to reduce the time it takes to dispense medication so we can focus on these new revenue generating services. To not just succeed, but to thrive, it is becoming increasingly important to understand and embrace the technology available.

The Pharmaceutical Services Negotiating Committee (PSNC)'s members are seeking immediate rescue packages for the sector to help with energy bills and to ease capacity constraints. In a meeting held on 14th and 15th September, the committee members expressed their anger and frustration on the reluctance of NHS England and government to fund pharmacy sustainably. The meeting was held to consider practical steps to ease the pressures on the community pharmacy sector, and to oversee the progress of negotiations on the Community Pharmacy Contractual Framework (CPCF) and other work. Committee members, as pharmacy contractors, shared their experiences of the current pressures on all contractors, including the inability to deliver some services and to maintain core service levels; the capacity and workforce crises facing the sector; the critical need for funding support this winter; and the urgent need for Government to adapt the Price Concessions system to meet the needs of contractors. "The Price Concessions system is no longer working for contractors in the current volatile medicine supply environment and PSNC is clear this is not acceptable," said the committee.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels. PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community pharmacy contractual framework to ensure that the services are adequately resourced." Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular and accessible places for people to receive a range of vaccinations. "The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views on the topic. "In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS response to this consultation."

Pharmacy sales specialist, Hutchings Consultants has revealed its market predictions for the next 12 months in a new report. The broker is anticipating that both independent group operators and corporate owners will continue to reassess their existing portfolios in 2024, making strategic disposals of varying sizes. "This is likely to result in transaction volumes remaining high for the foreseeable future," stated the report authored by Paul Steet, Associate Director, Hutchings Consultants. Community Pharmacy Contractual Framework negotiations will be the most notable opportunity for the sector to capitalise upon this year, the broker said, adding that it's "a belated opportunity for the sector to secure a vital uplift to the contract's fixed global sum."

Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling it "the biggest dis-service ever done" to community pharmacy. The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years. This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector. The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework. The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she assured everyone that the committee was well aware of the pressures the sector was facing. "I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce crisis is critical, leading to temporary closures.

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".