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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.

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.

Professor Harry McQuillan has said community pharmacists in the UK must change their focus from an 'accuracy of supply' to a 'safety of supply' model when it comes to dealing with patients. "The main take away message from tonight's lecture is for pharmacy professionals to really challenge themselves about whether they are focused on accuracy of supply or safety of supply," he said at this year's UCL School of Pharmacy Lecture in London on Thursday, 15 June. "For our community pharmacists it must be about safety, including prescribing, and ensuring patients and citizens get the maximum benefit from prescribed medicines. "To deliver this, we need to invest in our teams - harness technology and always be willing to take the next step in a more clinical future." The Chief Executive Office of Community Pharmacy Scotland, however, noted that at a time when the UK was grappling with an unprecedented national debt crisis exacerbated by severe cost of living and spiraling inflation, community pharmacy will need to make a "compelling case" of where the priority should be in the sector. Expanding on the financial woes of the country, he compared the current national debt of the UK, which stood at a staggering 270 percent of GDP in September 2022, with the previous record-breaking national debt of 250 per cent at the end of WWII.

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 National Pharmacy Association (NPA) has announced that the Chief Pharmaceutical Officer for England, David Webb will be among the keynote speakers at the Pharmacy Odyssey Conference on 13 October. He and other special guests will discuss the future of community pharmacy within the NHS, during a day of insight and practical advice for pharmacy teams. The NPA promises expert opinion on the current pressures in the sector and a thorough exploration of the long-term picture. NPA Director of Membership, Simon Tebbutt, explains: "With the NPA centenary in 2021 behind us, this will be a foray into the future - mapping the coming decade, and next half-century - as well as covering the many challenges of the present time." The theme of the conference, to be held online and sponsored by Novo Nordisk, is Pharmacy Odyssey: Services, Supply and Sustainability.

The Association of Independent Multiple Pharmacies (AIMp) celebrated achievements of its members during the pandemic at its first annual 'ball and award' ceremony held last week in London. To highlight the important role played by pharmacy teams, the association representing community pharmacy businesses with multiple branches, introduced two award categories - for patient safety and social care. Stephen Walls from H I Weldricks won the Patient Safety Awards and Sandeep Dhami, Nadia Hussain and Sachin Basandrai from MW Phillips won the Social Care Award. Congratulating the winners, Leyla Hannbeck, CEO of AIMp, said that community pharmacy teams "have worked tirelessly to deliver patient care throughout the pandemic." David McNicol, head of sales at AAH Pharmaceuticals, noted that the country and community pharmacy witnessed the toughest 18 months, and the gathering provided an opportunity to discuss ongoing challenges.

Lloyds Pharmacy announced the withdrawal of pharmacy services from all Sainsbury's stores over mounting "industry pressures" faced by the community pharmacies. The company had 77 branches at the beginning of this year - out of which five branches closed their doors and transferred the ownership of the remaining 72 to others. It was announced in June this year that Lloyds Pharmacy branches in Sainsbury's will close its operation throughout 2023. The following decision came after "changing market conditions" put 2,000 jobs on the line across the UK. Four Lloyds Pharmacies inside Wales Sainsbury's stores closed within days of the announcement and one in the Roath suburb of Cardiff as well. The remaining 72 changed hands as confirmed by the figures obtained by WalesOnline on 5 October.

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.

Acknowledging the ongoing challenges in delivering the required IT systems for the scheduled launch of the Pharmacy First service on January 31, NHS England reported progress in fulfilling 'many' commitments outlined in its plan to enhance primary care access during a board meeting on Thursday. However, it noted that the digital infrastructure supporting Pharmacy First, included in the £645 million fresh funding for community pharmacy, will require additional time for implementation. "Delivery remains challenging due to changes needed in digital infrastructure, and we are working with suppliers to support January implementation," NHSE said. "A public campaign is planned for 2024." The Pharmacy First service allows pharmacists to supply prescription-only medicines for seven common health conditions (sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women), eliminating the need for a GP visit. Meanwhile, NHSE is leveraging the widespread accessibility of pharmacies by expanding blood pressure monitoring and introducing direct prescribing of clinically safe oral contraceptives-an initiative that has been well-received.

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.

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."

The Company Chemists' Association (CCA) has highlighted a worrying trend of increasing numbers of pharmacy closures in England, which is disproportionately affecting the most deprived communities in the country. With 338 more pharmacies closed this year, an average of eight pharmacies closed per week, there has been a net loss of 1,008 pharmacies in England since 2015, the CCA said. Between 2015 and June 2023, maximum number of pharmacies were closed in the 20 per cent most deprived neighbourhoods of the country, with 37.5 per cent of the total closures occurring in Indices of Multiple Deprivation deciles 1 and 2. The association has raised concern that "permanent closures will undermine healthcare accessibility in deprived areas, where access tends to be more limited despite greater need."

Lack of appropriate funding is making survival a massive challenge for community pharmacy, a sector relied upon as a vital support system by both primary and secondary care in England. The Telegraph newspaper ran a story on Monday (August 22) which highlighted the dire straits community pharmacy finds itself in. Seasoned pharmacist Ian Strachan told the paper: "Our four pharmacies were the only point of call that was open (during Covid). We were there every single day, even when the virus was prevalent and people were dying." Describing the current situation, he said: "What is happening is we're facing a system that's just not working at all in our favour." Strachan says the issue is that pharmacists are "just not getting the help we need to be able to do this job properly". The sector is hugely dependent on funding from the NHS. The government had agreed in 2019 to set £2.6bn as annual funding for the sector. However, according to a report from EY that amount was already down £200m on the 2016 levels of government funding. "We've been starved of appropriate funding since 2016," Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies told The Telegraph. "It looks grim for businesses. The fees pharmacists get are going nowhere, but now, there's higher utility bills, higher staff fees and higher drug costs."

Patients are highly satisfied with the new Pharmacy First service, which enables pharmacists to assess and treat patients for seven common conditions, according to a survey by the National Pharmacy Association (NPA). Nearly 100 NPA members participated in the snapshot poll conducted at the end of the first full week of the service. Nine in ten respondents (87 per cent) said that "most or all patients expressed satisfaction" with the service they received. However, many independent community pharmacy owners are facing challenges in implementing the service. While 56 per cent of pharmacy owners surveyed expressed feeling "motivated" by the new service, a larger proportion (70 per cent) indicated being "under additional pressure." More than 30 per cent of the respondents found implementation of the service "harder" than they had expected.

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare. Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists. Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence. In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.

The Health and Social Care Select Committee (HSCC) on Tuesday held the first session in their pharmacy inquiry, with a panel of experts discussing the key issues facing community pharmacies in the country. Representatives from community pharmacy associations highlighted some of their biggest challenges and their vision for the future, as well as actions that government and NHS England can take to address those challenges for a better future for the sector. Opening the session, the Committee's vice-chair, Rachel Maskell MP, asked the representatives if they felt the government was ambitious enough in what it believes community pharmacy can do to address NHS pressures, or are pharmacists being held back by issues around workforce funding, contracting, and technological changes. Malcolm Harrison, Chief Executive, Company Chemists' Association (CCA), expressed that the government is not ambitious enough, saying "there's always opportunity to be more ambitious".

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

NHS England and NHS Improvement published on May 26 the findings of the Fuller 'stocktake' - setting out how primary care can work with partners across health and care to best meet the needs of their local communities. Dr Claire Fuller's report lays emphasis on the essential role of primary care and the potential of integrated neighbourhood teams in reducing the burden of ill health and tackling health inequities. It commends community pharmacy for keeping "its doors open to the public throughout" the pandemic whilst being "among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country". The report highlights "recruitment and retention challenges across the wider primary care workforce" including in community pharmacy. Stressing the importance of community pharmacy teams in urgent care and prevention, including early diagnosis of cancers, the report points out that pharmacists could play "a more active role in signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme".

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

Pharmacists, councillors and NHS leaders came together at Portsmouth's first Community Pharmacy Summit to address some of the challenges facing community pharmacy locally. They explored ways to reduce the huge pressures on pharmacy, tackle abuse towards staff, enable pharmacists to undertake training to treat more illnesses, and to protect the current and future workforce. Portsmouth City Council, which hosted the Summit on Wednesday 15 November, also invited representatives from Hampshire and Isle of Wight Constabulary, University of Portsmouth, Hampshire and Isle of Wight Integrated Care Board and businesses to discuss new opportunities to work together. Held at Portsmouth Guildhall, the event was chaired by Cllr Matthew Winnington, Cabinet Member for Community Wellbeing, Health and Care, and Cllr Gerald Vernon-Jackson, Cabinet Member for Transport.