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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.

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.

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.

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.

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).

Pharmacy bodies have urged the Health Select Committee to hold the government to account on pharmacy funding and workforce challenges. In a show of unity, leaders from the sector came together to write a joint letter to the chair of the committee and former health secretary Jeremy Hunt and bring to his attention how financial pressures worsened by nearly a decade of a real-term decrease in funding have made the sector virtually untenable. The Pharmaceutical Services Negotiating Committee (PSNC)'s recently published 'Pharmacy Pressures Survey' confirms how this has had an impact on pharmacy contractors, their teams as well as patients. The survey found that 91 per cent of pharmacies are experiencing staff shortages. At the same time, demand for community pharmacists has risen - nine in ten pharmacy teams reported a significant increase in phone calls from patients about prescriptions, and 86 per cent reported a rise in requests for healthcare advice. The letter to Jeremy Hunt is signed on behalf of the four chief executives of the PSNC, the Association of Independent Multiple Pharmacies (AIMp), the Company Chemists' Association (CCA) and the National Pharmacy Association (NPA).

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.

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.

Professional leadership bodies from around the world discussed workforce shortages in community pharmacy and other challenges affecting the sector at a global meeting held in Paris last month. Delegated from Denmark, Australia, Ireland, New Zealand, Portugal, Spain, US and the UK updated the conference on how the profession was progressing in practice, technology and workforce development in their respective countries. The UK was represented at World Pharmacy Council meeting by National Pharmacy Association chair Andrew Lane and chief executive at the Pharmaceutical Services Negotiating Committee Janet Morrison. Lane said: "It's very useful to be part of a global network of pharmacy bodies who are all going through similar challenges as we are in the UK. Sharing intelligence on other pharmacy systems around the world helps us to prepare the right strategy for engaging with the NHS at home. "Hearing some of the strides in services and digital technology in the profession gives us hope for the future of the sector. It's clear however that key challenges such as workforce shortages are starting to have an effect in other parts of the world too."

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.

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.

At last Friday's Clinical Congress Conference, the NHSE Chief Pharmaceutical Officer for England at NHS England, David Webb, announced the upcoming launch of the Pharmacy Stakeholder Forum- an initiative led by NHS England aimed to improve pharmacy professional leadership and foster collaboration within the sector. Webb highlighted the forum's significance as a platform for driving transformative change in pharmacy leadership. "The aim is to deliver collaboration to develop a stronger and more united voice for pharmacy professionals," Webb emphasised. Highlighting the need to drive transformative change in pharmacy leadership, he underscored that "the overarching goal is to address key challenges facing the pharmacy profession and chart a course for future development and innovation." Scheduled to commence in June, the Pharmacy Stakeholder Forum will provide a space for diverse organisations and networks with a vested interest in pharmacy professional leadership to converge.

We have been specialising in community pharmacy sector for over 30 years and have helped many pharmacists acquire their first pharmacy. We have seen several of those first-time buyers transition into multiple pharmacy owners under our specialist guidance and support through the years. Acquiring the first pharmacy can be a challenge to most pharmacists especially when they do not have the necessary skill in reading the numbers presented in terms of the target pharmacy's performance and how to interpret these in order to arrive at a valuation for the purpose of submitting an offer. Without the guidance of a specialist accountant in community pharmacy, one of the major risks is that one could end up paying more than what the pharmacy is worth. Once the offer is accepted, there are other challenges to overcome to get the deal over the line. 1) Assessing the risk 2) Valuation of the business 3) The negotiation process 4) Asset or company purchase 5) Financial due diligence 6) Asset/share purchase agreement 7) Finance the purchase

In a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE), Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges. Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival. "There have been no years of financial and operational squeezes applied by the NHS and government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival," he said. Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative initiatives like the Discharge Medicine Service and Contraception Service.

Data crunched by an online pharmacy delivery company paints a concerning picture for the pharmacy sector in England. Gophr's 'Prescription For Pressure' initiative reveals a challenging time for the sector and is supported by separate analysis by the BBC showing that the number of pharmacies in England is at its lowest since 2010. In addition, new powers being introduced for pharmacists to prescribe common prescription drugs and perform routine tests create an even greater workload for already overstretched pharmacists. Gophr's data reveals that: * Each pharmacy in England serves an average of 6,078 people. * In 2022, pharmacists dispensed 1.043 billion prescriptions, 26.3 million more than 2021. * A single pharmacy in England dispensed 248 prescriptions a day on average in 2022. Based on the most up-to-date statistics from the Office for National Statistics, NHS England and Statista, Gophr's calculations show that pharmacists have around 116 seconds to dispense a prescription, which is less time than the 180 seconds it takes to make a Quarter Pounder at McDonald's.

A recent survey conducted by YouGov for the National Pharmacy Association (NPA) has highlighted concerning trends in the community pharmacy sector. The survey published on July 18 and conducted over two days in June this year reveals the subsequent challenges patients face due to the increasing pharmacy closure rates. The survey findings, conducted among 2,183 UK adults, indicates that 18 per cent of the respondents reported at least one pharmacy closure in their local area within the past year. Specifically, 12 per cent respondents noted closure of one pharmacy, while 6 per cent observed the shutdown of more than one. These closures are distributed across various regions, underscoring a nationwide issue rather than an isolated one.

Pharmacy bodies have welcomed the new minister in charge of the profession amid warnings that he will find the sector in a state that is "more fragile that ever" due to "untenable funding and workforce pressures". Neil O'Brien was re-appointed as parliamentary under secretary of state in the Department of Health and Social Care (DHSC) on October 25 and was later assigned the pharmacy brief. The Conservative MP for Harborough - who will have a wide-ranging portfolio of responsibilities, including primary care and pharmacy - has taken over the position from Will Quince MP, who had a brief stint as pharmacy minister but remains at the department on a different role. O'Brien was was handed a junior minister's job at DHSC on 7 September 2022 in the government led by Liz Truss but fellow Conservative Quince was assigned primary care duties including pharmacy. Welcoming him to his new role, The Company Chemists' Association said that the minister would find that the community pharmacy sector was "more fragile than ever" with untenable pressures over funding and workforce.

The Department of Health in Northern Ireland has advised pharmacies to continue providing rota services on Easter after learning that many pharmacies are unwilling to provide the services on Easter holidays. "It is extremely regrettable that community pharmacy representatives have advised that access to rota pharmacies in some parts of Northern Ireland will be reduced over the Easter holidays," department said. They have also stated that despite a commitment of recurrent investment, support for new patients assessed by Trusts as requiring blister packs may be restricted. These actions have the potential to impact on patients and other parts of the Health and Social Care system. The department has also called the CPNI's demand to increase the funding up to 50 per cent in the sector "unrealistic" in the current financial climate. It said: "Financial pressures across the entire NI public sector are severe with an extremely challenging health budget anticipated for 2023/24." "The Department is therefore facing a significant funding gap just to maintain existing services and the whole Health and Social Care system is an extremely unpredictable and fragile position. The core funding envelope available to community pharmacies in NI has increased by 16% over the past three years."

The Pharmacy Schools Council (PhSC) has issued a statement urging a cautious approach to the significant expansion of additional UK universities seeking accreditation for new Master of Pharmacy (MPharm) programmes. At least seven more UK universities are seeking accreditation for new Master of Pharmacy (MPharm) programmes, but existing pharmacy school heads are warning that severe staffing shortages could threaten the quality of education. While the council welcomes the increasing interest in the pharmacy profession, it has warned that the "growth is managed not only in the workplace but within the education sector." In a meeting held in April 2024, the council members expressed that while this expansion would increase the number of undergraduate places available for pharmacy students, heads of existing pharmacy schools raised serious concerns about the challenges in recruiting suitably qualified staff to run these programmes. The PhSC highlighted the difficulties in attracting candidates for academic positions, particularly those requiring clinical expertise.

The Pharmacy Supervision Practice Group consisting of members from AIMp, APTUK, CCA, NPA, PDA, PFNI and RPS held its fourth workshop to continue discussions on the future modelling of pharmacy practice. The ideas around 'supervision' shared by the organisation earlier formed the basis of the discussion during the workshop and helped to expand understanding of where there was consensus and disagreement. Examples of ideas explored during the workshop include: the extent to which a pharmacist should supervise the medicines assembly process, the purpose and extent to which a pharmacist might be absent from the pharmacy and how this might affect patient safety as well as the nature of whether fixed rules versus a broad framework were preferable for future practice. Chair of the group, Dr Michael Twigg, Associate Professor of Primary Care Pharmacy, University of East Anglia, said "Once again the sector bodies have come together in a collaborative and positive manner to explore the concept of 'supervision' in the context of current and future community pharmacy practice. This session provided an opportunity to constructively challenge assumptions and viewpoints within the group with the aim of moving the discussion forward." As part of the session, the DHSC, GPhC and PSNI gave an overview of the difference between legislation, regulation and guidance which was helpful to inform the group's thinking. Each of the organisations have been asked to use the conversation to refine the ideas presented in advance of the next workshop.