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Over the past two years, the Covid pandemic has resulted in a backlog of elective care within the NHS, with record numbers of patients on waiting lists across the UK. Despite efforts to catch up after the first wave, subsequent waves have put further strain on an already stretched NHS system. This has had a tremendous impact on many patients waiting for routine dermatology appointments and, while every effort has been made to see patients with suspected serious skin cancers within two weeks, this target is not always achieved. With rising waiting times, pharmacists are increasingly the first port of call for patients suffering with a broad range of skin problems. From acne and rosacea, eczema or psoriasis, to changing skin lesions or simple insect bites, pharmacists can give helpful advice, allowing some customers to find quick relief to their skin complaint in mild cases, while directing others to see their GP without delay. Below is some practical advice that pharmacists can give to their customers with commonly encountered skin complaints. Acne Acne is a common skin condition that not only affects teenagers but adults too. It is estimated that up to 40 per cent of women continue to suffer with acne into their adult years. Acne has been linked to an increased incidence of depression, anxiety and even suicidal ideation. Patients have reported feeling overlooked and often dismissed in their concerns by health care professionals. Unfortunately, these issues have been further compounded by delays in being seen and treated due to the ongoing Covid pandemic. Pharmacists are well placed to help acne patients choose the right skincare. This should consist of lightweight products, such as gel or milky cleansers, with moisturisers in serum, lotion or light cream preparations. Some acne suitable products are further labelled as non-comedogenic. Oil-based or occlusive preparations are best avoided. There are many good quality, non-comedogenic sun blocks suited

The Pharmaceutical Defence Association (PDA) has urged health ministers of the UK to take a strict and necessary action against the unnecessary closures of pharmacy. Concerned over the rising number of pharmacy closures, PDA has written an open letter to health secretary Steve Barclay; Robin Swann, health minister for Northern Ireland; Eluned Morgan, minister of health and social services for Wales; and Humza Yousaf, the Scottish health secretary. In its letter, PDA said: "The minister of health must now ensure the regulation of poor business behaviours and be prepared to take over rogue pharmacies, however large their corporate owner may be. If patients' access to NHS services is to be protected from the consequences of avoidable full or part-day pharmacy closures." The association believes it is only a matter of time before serious harm to patients' health will be caused by the decisions of mainly large chains of pharmacies to close some of their branches for all or part of a day, instead of engaging an available pharmacist to cover their agreed opening hours. "While a small number of unforeseen closures have always occurred from time to time in pharmacies for genuine reasons, the indiscriminate scale at which closures have now become commonplace seems to have evolved over the last 20 months."

The General Pharmaceutical Council (GPhC) has raised concerns over the rising risks related to online pharmacy services. It revealed over 30 per cent of its open Fitness to Practise (FtP) cases were related to online pharmacy, which is disproportionate to the sector of the market that online services occupy. The regulator has advised pharmacists and pharmacy owners providing online services that they should "not work with online providers who try to circumvent the regulatory oversight put in place within the UK to ensure patient safety". In the past five months, the Council has imposed seven interim orders on the registration of pharmacists who have worked for or with online prescribing services - after identifying serious concerns with their practice. It said: "These pharmacists were working as pharmacist independent prescribers for online services or were dispensing medicines prescribed online. Some of these pharmacists were the Responsible Pharmacist (RP) or the Superintendent Pharmacist (SP)."

The Pharmaceutical Services Negotiating Committee (PSNC) chief executive Janet Morrison has assured contractors that PSNC will continue to raise with the new prime minister all concerning issues that are bothering pharmacy businesses. She felt the "fixed five-year funding settlement that is declining in real terms" was one of the serious factors that is putting a lots of pressure on contractors. PSNC has provided a compelling portfolio of evidence on the impact that pressures are having on the sector, and requested urgent additional funding, she said. Morrison, in her video message shared yesterday (August 24), urged contractors to keep sharing and sending evidences to act on their behalf. She said she is aware "this one of the toughest periods for the businesses" and "I believe that it demands more action from the government." Morrison assured the sector she was aware that contractors were also facing difficulties in "dealing with global medicines market and the challenges on been able to procure medicines within the drug tariff." "I know how hard it is to see the future sustainability of your businesses. I can see you are facing serious workforce pressure, rising cost, shortage of pharmacists, inflation pressure. I know your using facing increase in demand from the patients who has given up on their GPs and turning to you for support and advice."

The Hormone Replacement Therapy (HRT) Taskforce head Madelaine McTernan has returned to working full time as the director general of the Vaccine Taskforce for autumn booster campaign preparation. She has presented a few key recommendations to help ensure continued HRT supply to meet rising demand. "Improved access to data on prescriptions to more easily see where there are shortfalls between HRT packs prescribed and HRT packs supplied by manufacturers," she suggested. "Taking lessons from the HRT supply chain work to inform broader medicine supply work." Madelaine said: "I am pleased to see the situation with HRT supply is improving across the country. I want to thank suppliers and manufacturers for their engagement and positive action to tackle this serious issue.

Being accepted and appearing attractive has always been among the most coveted goals in the world, which has given rise to the multibillion-dollar cosmetic and beauty industry. Fairy stories have been written about everlasting charm, and battles have been waged over attaining beauty. For the most part throughout history, people have continuously sought ways to improve their features using natural materials, and as technology advanced, they began to use technical methods like light therapy to accomplish the same goal. Chains of cosmetic clinics have sprouted up as a result of advances in technology and cosmetic materials, providing a variety of techniques to slow down the aging process or improve our appearance. So how can you set up your own beauty treatment and plastic surgery clinic to take advantage of this rapidly expanding market? Here are some pieces of advice! FIND QUALITY EQUIPMENT Your success depends on securing the greatest tools available for skin care and plastic surgery. Good quality equipment is a complete solution for distinguishing yourself from the competition. The initial step would be to locate different vendors. Using criteria like the cost of the equipment and replacement parts, the vendor's training, the company's reputation, the after-sales services, yearly maintenance, system performance, warranty, and extended warranties, you may narrow down your list of recommended suppliers. When selecting the appropriate medical supplies and equipment for your clinic, keep your budget in mind.

The Department of Health and Social Care (DHSC) has confirmed on Thursday (15 June) that everyone aged 60 and over will continue to receive free prescriptions. In response to a consultation launched by the DHSC in 2021 looking at whether the age free prescriptions become available should be aligned with the State Pension age, which is currently 66, the government decided to freeze the age at 60. Minister for Health Neil O'Brien said: "This government recognises the pressures with the cost of living caused by Russia's invasion of Ukraine. That's why we are providing cost of living help worth £3,300 on average per household over last year and this, among the most generous help anywhere in Europe. "It's also why we have decided to maintain the prescription exemption age where it is. Nine out of 10 prescriptions are already free at the point of use and on top of that we also provide financial help to others on low incomes who don't automatically get prescriptions for free. "Prescription charge exemptions will also remain in place for those aged under 16 or aged 17 and 18 but in full time education, while those in receipt of certain benefits can also receive free prescriptions," said DHSC. For those who do not qualify for an exemption or the NHS Low Income Scheme, prepayment certificates (PPC) are available to help with frequent prescriptions should they be required. The annual PPC can be paid for through 10 instalments. This means people can have as many prescription items as needed for just over £2 per week.

The British Generic Manufacturers Association (BGMA) has published a positioning paper which sets out the objectives that need to be delivered through the next Voluntary Pricing and Access Scheme (VPAS) on Thursday (15 June). The paper details how a financially sustainable VPAS can support widened medicines access to patients. VPAS is an agreement between the Department of Health and Social Care (DHSC), NHS England and The Association of the British Pharmaceutical Industry (ABPI). The scheme aims to limit increases in spending on branded medicines to no more than 2% per year via a rebate system which is charged on companies' sales revenues. Two years ago, the rate was 5.1% but for 2023 it has soared to 26.5%. Last year, the association had raised concerns over the rise in the VPAS rate for 2023 to 26.5 per cent. "The rocketing rate is in large part due to the growth in spend in on-patent medicines since 2019. Looking at the four completed years of the current VPAS scheme, data shows that the average annual growth rate for on-patent medicine sales value from 2019-22 was 18% compared to just 2% for off-patent products," said the association.

Alphega Pharmacy Oncology Support Programme allows community pharmacists from six European countries to enhance support and guidance they provide to cancer patients. The programme aims to help upskill pharmacists and their teams to provide more expert advice to patients living with cancer, raising their profile in the community as key healthcare providers. Enhancing knowledge amongst community pharmacists about cancer treatment and its side effects is vital as cancer cases are set to increase if current trends continue. The programme covers practical help topics, such as oral care, nutrition advice and skin, hair and nail care among others, helping patients to get more of the support they need because community pharmacists are easily accessible, rather than needing to book a GP or consultant appointment. With rates of cancer forecast to rise throughout Europe , and cancer patients likely on average to visit hospital less often, community pharmacists are well-placed to look to support cancer patients with managing the side-effects of their treatment.

The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce. The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit. Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited to general practice: community pharmacies are also suffering the consequences of it." "Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to make ends meet, not least given the rising staffing costs which are being driven up by workforce issues. Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

The General Pharmaceutical Council (GPhC) has proposed a 7.5 per cent increase in all fees for pharmacies, pharmacists, pharmacy technicians, and foundation trainees, including those for registration and renewal from April 2024. According to the GPhC's proposal the pharmacist renewal fee would increase by £19 from £257 to £276; the pharmacy technician renewal fee would increase by £9 from £121 to £130 and the pharmacy premises renewal fee would increase by £27 from £365 to £392 Any changes would be effective from April 2024, which means fees will remain at current levels for this financial year, giving registrants and applicants time to prepare for any increase in subsequent years. Fees have been frozen for the last two years (2022 and 2023) to help reduce pressure on both pharmacy professionals and pharmacy owners. Chief Executive, Duncan Rudkin, said: "In the last few years, we have been able to avoid raising many of these fees by improving our efficiency and by using our financial reserves to cover any gap between our income and our outgoings. While we are continuing to look for ways to make savings, we now have to consider increasing fees.

Pfizer said on Thursday (June 1) data from late-stage trials showed its experimental combination of antibiotics was effective in treating deadly infections caused by drug-resistant bacteria. Deaths from antibiotic-resistant bacteria, also known as superbugs, have been on the rise globally, and health regulators have called for the development of newer treatments as resistance to older antibiotics grows. The late-stage studies compared the experimental combination of the antibiotics aztreonam-avibactam (ATM-AVI) and existing generic drug metronidazole with a combination of two older antibiotics - meropenem and colistin - to treat complicated intra-abdominal infections and types of hospital-acquired pneumonia. Hospital-acquired pneumonia occurs in patients at least two to three days after being admitted, or in those who have life-threatening lung infections with high mortality rates and who are on mechanical breathing machines. Pfizer said the data from the studies shows the antibiotic combination of ATM-AVI is effective and well-tolerated in treating infections caused by gram-negative bacteria. The cure rate in patients with complicated intra-abdominal infections with Pfizer's combination therapy, along with existing generic drug metronidazole, was 76.4%, versus 74% using the other antibiotics.

Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015. It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders. The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector. The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a result, maintaining prescription and medication adherence services is challenging to say the least. Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services since the start of COVID. This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported clinically by pharmacists. This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations a year - a staggering rise of 44 per cent in the last 24 months alone.

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Labour MP Barry Gardiner has raised concerns that the £645 million cash injection announced by the government for community pharmacy is, in effect, 'frozen funding' for the next two years. Speaking on Tuesday (May 9) on the BBC's Politics Live, Gardiner said funding for community pharmacies "was cut before 2015, then it was frozen and now the latest announcement says that it's going to be frozen for a further two years." He said with a current national contract, which already represented a 25 per cent funding cut in real terms, it was not appropriate to ask for community pharmacy "to take on more work" without adequate support. "I heard the prime minister earlier this morning (May 9) on TV saying 'we are investing more in pharmacies'. "No you are not. You just concluded a contract that says for the next two years it will be absolutely flatlined." He added that "there will be no more money" for community pharmacy and that steeply rising costs due to inflation were "eating into that contract's health". Gardiner said community pharmacists "do a phenomenal job" but regretted that from a total of just 11,000, some 700 pharmacies have been lost due to funding cuts.

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).

Walgreens Boots Alliance on Tuesday (June 28) scrapped the plan to sell its UK high street pharmacy chain saying no third party was able to make an adequate offer due to the turmoil in global financial markets. Walgreens' move to call off the sale comes as private equity bidders Apollo Global and TDR faced headwinds in raising financing for the deal, as banks were wary of underwriting large chunks of the financing due to tough market conditions. Boots was initially valued at as much as £8bn with the auction process being led by Goldman Sachs. Global economic uncertainty and rising inflation have triggered a spike in interest rates as central banks have rushed to take action in the most widespread tightening of monetary policy for more than two decades, making deal financing costlier and harder to access. Walgreens had put its Boots UK business up for sale after announcing a strategic review in January as the second-largest US pharmacy chain renewed its focus on domestic healthcare. The company said the decision to retain Boots and No7 Beauty Company was also underpinned by their ongoing strong performance.

Boots UK will offer a staring salary of £42,000 per annum to newly qualified pharmacists joining the pharmacy chain. The company also revealed that "in addition, any existing pharmacists in the bargaining unit currently receiving less than £43k." The newly announced hike in the salary - following an agreement reached between the multiple and and the Pharmacist Defence Association - will be effective from 1 August 2022. "This enhanced offer for Newly Qualified Pharmacists and further investment in those in the early stages of their careers at Boots is a key part of our commitments to pharmacists," the company said. Boots and PDA Union also announced in a joint statement that they will conduct a further formal review of all pharmacists' pay in accordance with the collective agreement, effective from 1 November 2022.

All pharmacy businesses are reporting that they are struggling to find the registered professionals needed to open their pharmacies, clarified the Company Chemists' Association (CCA) in response to an attack by the Pharmacists' Defence Association. Last week, PDA allegedly accused some large pharmacy chains of 'orchestrating' full or part-time closures of some of their shops due to the staff shortage. In its Open Letter published on Tuesday (July 19), PDA demanded urgent action "to protect patients by ensuring that essential community pharmacy services are provided safely and consistently". "All parts of the healthcare system are struggling to recruit staff and to assume that pharmacies would be immune to such pressures, seems fanciful," said CCA. "CCA members are working extraordinarily hard to prevent temporary closures, but recruitment and retention of pharmacists is becoming increasingly tough. The recent rise in Covid cases and the beginning of the summer holiday season in parts of the UK have only worsened the situation." The Association also showed data from the PSNC Pharmacy Pressures Survey (April 2022) which found that 91 per cent of pharmacies are experiencing staff shortages, clearly demonstrating that these shortages are affecting the entire sector.

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.