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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.

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information. Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of Services (DoS) profile information is kept up-to-date. The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been introduced to make the process as quick as possible and it can be done on either a smartphone or computer. PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."

The new data from NHS England has revealed that more than 100,000 patients were treated for minor illness by their high street pharmacist in just one month. According to new NHS figures, in June, 118,123 people with minor illnesses such as a sore throat or constipation, or those in need of medicine urgently, received a same-day consultation with their local pharmacist after calling NHS 111 or their GP practice - an increase of more than four-fifths (83%) on the number in the same month last year (64,512). The data comes alongside expanded roles for community pharmacies ahead of winter, announced at the NHS England board meeting today. "From this week, NHS 111 online can directly refer people to their high street pharmacist for a same-day consultation, rather than patients needing to call the phone line," said NHS England. Amanda Pritchard, NHS chief executive, said: "Our local pharmacies ensure hundreds of thousands of people every week get the support and medication they need and today's figures show that in just one month, over 100,000 patients have also had consultations with their local pharmacist for minor illnesses - this means patients are getting the care they need quickly but also in a convenient way that can fit in with their busy lives.

The Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first' approach in England as mentioned by his predecessor on numerous occasions. "Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy First' to support patient access to care. I would urge the new Health Secretary to see this through to completion," said chair of RPS in England Thorrun Govind. Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery, including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers. Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures and organisations, and the need for long-term investment in the workforce. "With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.

The Pharmaceutical Services Negotiating Committee on Tuesday (June 30) renamed itself as Community Pharmacy England, promising a "strengthened commitment" to champion and engage with the sector. "The name Community Pharmacy England better reflects the breadth of work that we do to both represent and support community pharmacies in England. We are their champion," the pharmacy negotiator said. Explaining that the rebranding exercise was in line with proposals put forward by the Review Steering Group (RSG), it said the rebrand was part of its Transforming Pharmacy Representation (TAPR) work and that it would signal the beginning of a "new engagement strategy" to build stronger relationships with pharmacy owners. "Becoming Community Pharmacy England is much more than a name change or a new logo, it is a driver for cultural change across our organisation. "Our members want us to be more authoritative, representative, and influential, and rebranding gives us a clearer and stronger voice, helping us to better speak out for community pharmacy."

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.

The Pharmacists' Defence Association (PDA) has created a form to help locum and other pharmacists to report about breach of NHS contract by community pharmacy. According to the association, they have been told by increasing number of pharmacists about contractors closing pharmacies, despite a locum readily available to cover the shift. The PDA said this is an issue of NHS contractual breach and creates difficulties for patients, and so they have created the form to assist members to report unnecessary closures to the relevant NHS England & Improvement pharmacy contract team. A locum pharmacist, who does not wish to be named, has alleged that a community pharmacy declined their offer to cover an extra shift for £5 more per hour, and decided to close the store, denying the public access to services. The pharmacist recalled the occasion while writing in the PDA's latest member voice article.

The regulators have reduced the notice periods for change to supplementary opening hours for community pharmacy contractors from 1 October 2022. Following the Pharmaceutical Services Negotiating Committee (PSNC)'s discussions with the Department of Health and Social Care (DHSC) and NHS England as part of Year 4 negotiations, it has been agreed that the required notice periods for changes to supplementary opening hours will reduce to five weeks. Community pharmacy contractors who want to change their supplementary opening hours are required by their terms of service to notify NHS England. "If a contractor wants to increase supplementary opening hours at the pharmacy, this can be done with no notice - but notification of the change must still be given to NHS England," said PSNC. "To decrease supplementary opening hours at the pharmacy, at least five weeks' notice must be given to NHS England prior to implementing the change."

In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England, Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period. The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies, while the total number of independent operators remained consistent with 2022. According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies. Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators acquiring additional pharmacies through corporate disposal opportunities throughout the year.

NHS England has agreed to offer an additional payment of £2.50 per jab if pharmacies would be willing to extend the duration of their COVID-19 vaccination contract until 31st August 2024. Pharmacies currently providing the autumn vaccination are asked to let their local commissioner know, by 22nd February 2024, if they can provide cover for a potential Spring booster programme, if the Joint Committee on Vaccination and Immunisation (JCVI) advises in their guidance expected to be published soon. NHS figures showed that more than 3,500 community pharmacies signed the contract to deliver COVID-19 vaccinations between 1 September 2023 and 31 March 2024, as part of the autumn booster programme. The health service is hoping that most of these pharmacies will be able to continue to support the Spring campaign, which will run from 1 April 2024 to 31st August 2024, to help protect the nation's most vulnerable populations. For the Spring campaign only, pharmacies would be offered an extra £2.50 per jab in addition to the existing item of service fee of £7.54, NHS England said.

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 Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

The NHS England and Improvement has announced the emergency provisions introduced during pandemic to provide flexible opening hours for pharmacy contractors end today. The flexibilities were enacted in March 2020 when changes to the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 were made following a declaration of emergency at the height of the Covid-19 pandemic. Since March 2020, the flexibilities have permitted temporary opening hours and closures during a specified period due to a genuine Covid-19 related emergency. NHS England and Improvement has advised pharmacy contractors that the emergency declaration will not be extended further and will expire on 31 March 2022. Pharmacy contractors will therefore no longer have the option to close pharmacies within their agreed contracted hours with the NHS.

The Department of Health and Social Care has updated the list of community pharmacies eligible for the Pharmacy Access Scheme (PhAS) and approved 43 cases out of 63 applications, bringing the the total number of eligible pharmacies in England to 1,445. Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I regional pharmacy contract team, and determined by the relevant pharmaceutical services regulations committees (PSRC). Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the scheme.

Starting from January 2024, it will be compulsory for medicine suppliers in the NHS supply chain in England to submit an Evergreen Sustainable Supplier Assessment each year. Suppliers who fail to submit the sustainability assessment will not be placed on medicines contracts, said NHS England. The NHS has taken this move as part of its ambition to reach carbon net zero by 2045. The Evergreen Sustainable Supplier Assessment is a self-assessment and reporting tool for suppliers to share sustainability information with the NHS. Chris McAleer, medicines net zero project delivery manager at NHS England, announced this new rule at the Guild of Healthcare Pharmacists' Procurement and Distribution Interest Group Autumn Symposium held in Birmingham on 2 November 2023.

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.

More than 300 fully-funded training places will be open to pharmacists and pharmacy technicians working in adult critical care units in England this year. NHS England has awarded a contract to the UK Clinical Pharmacy Association (UKCPA) to deliver 200 funded continuing professional development places for pharmacists and pharmacy technicians from April 2024. Another school of pharmacy, the name of which has not been announced yet, will deliver 100 funded places on a pharmacist adult critical care pathway. There are already 15 funded places on an adult critical care training pathway for pharmacy technicians provided by the University of Bradford. Reacting to evidence indicating workforce concerns in critical care, NHS England invited bids from training providers for delivering the training in November 2023.

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.

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.

General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS) contract put forth by the Department of Health and Social Care (DHSC) and NHS England. This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement and reforms in the pay recommendation process. The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the existing contract. The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%, notably falling short of recent inflation rates. This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.