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Only a day is left before community pharmacy contractors are required to complete Health Education England's Community Pharmacy Workforce Survey for 2022. The survey closes on Wednesday (November 30). The completion requirements are mandatory and particularly pertinent at a time when workforce challenges have become a major issue within the sector. These pressures are being acutely felt within community pharmacy, with serious consequences for pharmacy contractors. PSNC and the other national pharmacy bodies have called for improved workforce planning to be undertaken by the government and NHS, but for this to happen, high quality workforce data for community pharmacy needs to be available, which will then provide a full picture of the sector's workforce, including identifying the number of vacancies and regions where these are particularly hard to fill.

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).

Tough times for community pharmacies in England are far from over as the industry continues to grapple with major gaps in the workforce. Even though the latest figures released by the Health Education England (HEE) Community Pharmacy Workforce Survey 2021 showed doubling of pharmacist vacancy rate in England to 8 per cent between 2017 and 2021, it flagged the contractors' difficulty level in filling up these positions. The survey report showcased changes in the size and make-up of the community pharmacy workforce since the last survey conducted in 2017. It revealed that 56 per cent of pharmacy contractors reported high difficulty level in recruiting pharmacists, up from 21 per cent in the earlier survey. Moreover, a greater proportion - 60 per cent of contractors found filling up the pharmacy technician role 'fairly' or 'very' difficult. Other roles in the sector considered difficult to fill included accuracy checkers and trained dispensing assistants, both at 58 per cent.

Laura Wilson, Director of the Royal Pharmaceutical Society (RPS) in Scotland discussed the future of the pharmacy workforce with Michael Matheson, Cabinet Secretary for Health and Social Care at the SNP conference. The event, which took place on 17 October in Aberdeen, Scotland featured other health officials including Colin Poolman, Director of the Royal College of Nursing; Kenryck Lloyd-Jones, Public Affairs and Policy Manager for Scotland, Chartered Society of Physiotherapy; and Chris Marshall, Deputy Editor at Holyrood Communications. The Scottish government has recently unveiled its national workforce strategy for health and social care, laying out its plans for achieving recovery, growth, and transformation. Wilson highlighted the challenges and opportunities for the pharmacy workforce in Scotland to attract potential pharmacists into the profession and encourage them to stay within the profession. "This was a great opportunity to discuss with the Cabinet Secretary the challenges which exist for the pharmacy workforce in Scotland and to highlight some of the solutions which need to be implemented to ensure a pharmacy workforce in Scotland which is fit for the future," she said.

In its effort to address workforce challenges, Health Education and Improvement Wales has outlined initiatives aimed at facilitating the return of pharmacy professionals with refugee status to active practice within Wales. This possibility has been stated in HEIW's Strategic Pharmacy Workforce Plan, which commits to investigating the practicality and significance of establishing a registration pathway for pharmacy professionals displaced due to refugee status. According to HEIW, it is currently investigating the viability and importance of revitalising 'return to practice' packages, formulating pharmacy apprenticeships, initiating international recruitment initiatives, and establishing a registration pathway in Wales for displaced pharmacists and pharmacy technicians holding refugee status. "In the past two years, we have arrived at a point where maintaining the desired access to the volume and quality of pharmacy services for our population has proven unattainable," said HEIW. "In Wales, instances of diminished pharmacy services are evident in both hospital and community settings. The trend of abrupt, temporary closures in community pharmacies continues."

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.

The Pharmaceutical Services Negotiating Committee (PSNC) has called for improved workforce planning to be undertaken by the government and NHS. However, for this to happen, it added, "high quality workforce data for community pharmacy needs to be available." For this reason, the Department of Health and Social Care (DHSC), NHS England and PSNC have agreed that it will be a Terms of Service requirement for contractors to complete the annual Health Education England (HEE) community pharmacy workforce survey, which will then provide a full picture of the community pharmacy workforce, including identifying the number of vacancies and regions where these are particularly hard to fill. PSNC said: "It is acutely aware of the challenges that contractors and their teams are currently facing, so in recognition of the workload associated with completing the annual workforce survey, we have negotiated with DHSC and NHS England that the requirement to undertake an annual patient satisfaction survey will be removed from the Terms of Service from 1st October 2022." This means that contractual requirement will no longer apply to contractors in 2022/23 and going forward.

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."

The National Pharmacy Association (NPA) has partnered with training provider Skills 4 Pharmacy to provide Level 2 and Level 3 pharmacy apprenticeships to its members in England. Skills 4 Pharmacy is an experienced pharmacy apprenticeship training provider dedicated to initiating and developing the careers of pharmacy support staff and technicians. They manage the recruitment of apprentices, as well as their enrolment and training. The apprenticeship package offers a Level 2 Apprenticeship - Pharmacy support worker and Level 3 Apprenticeship - Pharmacy technician. Amerjit Singh, Managing Director at Skills 4 Pharmacy said: "As a member for the last 23 years it is a great honour to be able to work alongside the NPA and promote apprenticeships. "As contractors we are facing challenging times, however I firmly believe that apprenticeship programmes which upskill and empower our workforce are essential for our future survival. Apprenticeships are a great way to build a strong talent pipeline and bring new skills to pharmacies.

The pharmacy inquiry will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy services. It will also consider current challenges around funding, workforce and the digital infrastructure. Planned developments within the profession will enable future pharmacists to be independent prescribers from day one of registration, giving them a greater role within primary care teams. Health and Social Care Committee Chair Steve Brine MP said: "It is clear that pharmacy has a central role to play in the future of the NHS. With a greater focus on personalised and patient-centred healthcare, we will be asking what more must be done to make sure that the profession is in the best shape to meet demand. "Better use of the pharmacy workforce would reduce pressures on general practice and hospitals. However, this will not happen without a planned workforce with the funding, supervision and training to support it. "At the end of the inquiry, the committee will be making recommendations to the government on what action needs to be taken to ensure the potential of pharmacy is realised.

Pharmacy bodies and MPs discussed on support needed to unlock the "full potential" of community pharmacy at the All Pharmacy Party Group (APPG)'s general meeting held in Westminster on Tuesday (01 November). The attendees of the meeting were Janet Morrison OBE, Chief Executive of Pharmaceutical Services Negotiating Committee; Malcolm Harrison, Chief Executive of The Company Chemists' Association; Thorrun Govind, Chair of the Royal Pharmaceutical Society; Sanjeev Panesar, National Pharmacy Association Board Member, and Pharmacist Superintendent and Owner of the Pan Pharmacy Group; and Sandeep Dhami, Association of Independent Multiple Pharmacies member and superintendent at MW Phillips Chemist At the session, 18 parliamentarians were briefed on the myriad of ways pharmacies contribute to the health of the nation. The panel of experts also highlighted that pharmacists are 'running out of fuel' with the growing challenges such as flat funding, workforce shortages and the cost-of-living crisis impacting pharmacies' ability to deliver vital services.

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.

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.

The All-Party Parliamentary Group (APPG) on Pharmacy published a new report on Monday (January 23) that calls for "urgent action" to relieve funding pressure so there are "opportunities" for community pharmacy teams to deliver even more for their patients. The report highlights the need for a new "strategic vision" for pharmacy and highlights opportunities for the network to be empowered to deliver even more for patients. However, the manifesto also underlines that there are the very real risks that this opportunity may be lost if significant and ongoing pressures are not addressed. The recommendations are based on written and oral evidence gathered from frontline pharmacists, GPs, professional bodies and healthcare experts. To harness the potential of pharmacy, the report recommends the Government must take urgent action to relieve the funding pressures on the community pharmacy sector in the short term and review the long-term funding model for pharmacy. It also suggested the Government must harness the power of pharmacy to help the NHS deal with the COVID-19 backlog and the UK's growing healthcare challenges. It further recommended that future commissioning and funding must recognise that community pharmacy is the front door to the NHS for many patients.

Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health and Social Care Committee Steve Brine has said. Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a parliamentary debate focused on the future of community pharmacies on September 14. From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible solutions for a sustainable future in the sector. Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs Taiwo Owatemi and George Howarth among others.

Community Pharmacy England (CPE) has launched its third annual Pressures Survey to uncover the various challenges encountered by individuals owning or working in a community pharmacy. The Committee expressed concern that community pharmacies in England are now in a critical situation, significantly affecting workload, stress levels, patients, and businesses. The 2024 Pharmacy Pressures Survey is aimed at finding out more about these issues and other areas such as medicines supply problems and workforce challenges as well as the recently launched Pharmacy First service, it said. CPE chief executive Janet Morrison said that they were able to receive a huge number of responses in previous surveys and they are expecting to achieve a similar level of engagement this year too.

An executive director of Day Lewis and also board director and member of Association of Independent Multiple pharmacies (AIMp) Jay Patel highlighted the key issues and on ground challenges faced by the community pharmacies in a meeting hosted by Prime Minister Rishi Sunak and health secretary Steve Barclay in Downing Street on Saturday (January 7) to tackle the NHS pressure. In his interview with BBC, he said: "He (prime minister) was very engaging and trying to understand the key issues and practical challenges on the ground." Patel described the meeting atmosphere as 'collaborative and proactive', and said, "people were genuinely asked their options and there were listeners too." On BBC, answering to a question on 'how community pharmacies can alleviate the NHS pressure?', Patel said: "Pharmacies is the workplace for this. We have trust of our patients; we have high skilled workforce both clinically and professionally. One of the opportunities we have is working around the acute treat

The Association of Independent Multiple Pharmacies (AIMp) has called upon all pharmacy organisations to unite and collectively represent the sector. While underlining the need for the sector to adopt a straightforward manifesto that can be presented to the public, politicians, and decision-makers, the association also advocated for a revitalisation of the 'Save Our Pharmacies' campaign, injecting it with renewed energy and a stronger sense of purpose. AIMp pointed out that a lack of cohesion is one of the factors contributing to the sector's struggle in gaining attention. "The current trajectory of community pharmacy is unsustainable," said Dr. Leyla Hannbeck, Chief Executive of AIMp. "To tackle the significant challenges ahead, we must work together cohesively. The most effective approach is to actively engage with Parliament, leveraging politicians from across the political spectrum to advocate for our cause." Meanwhile, the association urged various pharmacy bodies to unite in support of the Pharmacy All Party Parliamentary Group (APPG) to enhance its effectiveness and broaden its influence, rather than working independently.

Since the introduction of the 2019 NHS Long-Term Plan, several policy commitments have surfaced, presenting a definitive 'blueprint' for community pharmacy in England. The Company Chemists Association has identified four crucial commitments that, when integrated, hold the potential to revolutionise patient care through community pharmacies. "Each commitment is like a crucial piece of a puzzle," CCA said. "For the transformation of patient access through community pharmacy to be successful, all these pieces must come together harmoniously. Otherwise, the picture will remain incomplete." The four major pieces of the puzzle coined by CCA include: * Building on education and training reforms to increase the size and capability of the workforce. * Expanding the number of clinical services commissioned and delivered in community pharmacy. * Introducing digital enablers which underpin service delivery. * Introducing legislative changes to increase capacity and allow the delivery of more patient-facing clinical care.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."