Steve McCabe, the Labour MP for Birmingham, Selly Oak says a "vicious" NHS contract has been forcing community pharmacies into bankruptcy.
Asking his question in parliament during Prime Minister's Questions on Wednesday (March 8), McCabe said he has heard Rishi Sunak speak fondly about working in his
mother's community pharmacy.
The MP asked how would the prime minister feel "if 600 pharmacies close this year because of a vicious NHS contract which takes no account of rising costs and is
forcing many into bankruptcy?"
The prime minister responded by saying that community pharmacies do fantastic work and that his government was looking at ways in which it could support the sector
to do even more.
Sunak said: "I praise the work that our community pharmacies do. They are fantastic at being on the frontline of delivering primary care. And as I've said previously
the government is exploring ways in which we can support them to do even more.
The Department of Health and Social Care (DHSC) has announced 30 pence increase in prescription charges from £9.35 to £9.65 for each medicine or appliance
dispensed.
Board Chair for England at RPS, Thorrun Govind commented: "This is a kick in the teeth for people in England who are already struggling with rising bills and food
prices.
"Patients groups have warned that people are not collecting prescription medicines due to cost and pharmacists are seeing this worrying trend first-hand.
"A Government impact assessment noted the risk of adverse effects of people not taking their medicines, resulting in future health problems for the individual,
potential hospital admissions, and a subsequent cost to the NHS.
"This decision seems to prioritise revenue generation over ill-health prevention and undermines the principle of an NHS free at the point of use.
Department of Health and Social Care (DHSC) has increased the rate of discount deduction for generics from 17.52 per cent to 20 per cent.
The Drug Tariff for April 2023 will contain changes to the discount deduction arrangements for pharmacy contractors, which will include- all concession lines to be
considered as Group Items for Discount Not Deducted i.e. DND or zero discount (ZD) items; and rate of discount deduction for generics to increase from 17.52% to 20%
The Pharmaceutical Services Negotiating Committee (PSNC) and DHSC agreed on the changes for all concession lines to be considered as Group Items for Discount Not
Deducted. Therefore from 1 April 2023, a new category will be introduced into Part II of the Drug Tariff 'Drugs for which discount is not deducted'.
However, the committee had rejected the changes in the rate of discount deduction for generics. It said, "Following pressure from NHS England, Ministers have now
chosen to impose changes to the previously agreed discount deduction arrangements, which come into effect from 1 April, and will be kept under review."
If you have low testosterone levels, there is a good chance you have felt some physical side effects from that. You may have heard that certain physical
activity helps combat the depletion, and there is truth in this. There is a link between increasing and fine-tuning an exercise agenda and raising testosterone
levels. Below, the relationship is explored in more detail.
WHAT DOES TESTOSTERONE DO?
There is more to the function of testosterone than just in relation to your sex drive. Of course, that is important, but it also impacts muscle building, strength,
energy levels, hair growth, and red blood cells. When levels are low, there are big consequences for anybody from hair loss to weak muscles and even exhaustion too.
TESTOSTERONE AND OBESITY
One of the biggest things that affects testosterone is being overweight. If you are carrying a few extra pounds, it would be beneficial to try to get into some
healthier habits if you want to promote an organic increase in T-levels.
HOW EXERCISE PLAYS A ROLE
Exercise seems to be a natural inhibitor of testosterone, especially when you focus on particular strategies and workout styles such as strength training. Levels
have been shown to rise immediately after exercise for anything from fifteen minutes to an hour plus. While it is different for everyone, the link is clear.
The PSNC on Friday said it has warned the DHSC about the "very serious impact" of the limited supply of certain antibiotics on pharmacies who are "having to
chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse."
With higher than usual number of cases of scarlet fever, caused by invasive Group A Streptococci (iGAS) infections, being reported in children across the country,
supplies of antibiotics for Group A Strep treatment have seen a surge in demand, leading to limited supply at certain wholesalers and pharmacies.
PSNC has urged the DHSC to adopt measures that could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations
without prescriber approval, outside of Serious Shortage Protocols.
It has also raised concerns on the significant rise in wholesale prices of many oral antibiotics as a result of the surge in demand and the ongoing supply
disruptions. PSNC also said they have received reports of some suppliers putting up their prices for any oral antibiotics they do have in stock.
There has been a lot of coverage in the national and pharmaceutical press of the prices being charged to pharmacy owners for certain medicines.
Leaving aside the reasons for steep price rises, I have been asked on social media and elsewhere whether pharmacy owners can refuse to supply prescribed medicines
if they would make a significant financial loss.
Legal obligation
The first thing to point out is that the National Health Service Act 2006 imposes a legal duty on the Secretary of State and NHS England to make arrangements for
people to receive sufficient prescribed drugs.
These arrangements involve the publication of the Drug Tariff.
The Drug Tariff includes reimbursement prices or a method for determining prices. Various factors can be taken into account in determining reimbursement prices. The
Drug Tariff does not provide a pound for pound reimbursement for medicines that pharmacies supply on NHS prescriptions.
The Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for
their services.
"Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide
the right care for patients," said Govind.
"As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health
service are struggling to cope.
The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams.
Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping
patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures.
"However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open
long hours and at weekends."
A survey of over six thousands pharmacies has revealed that the community pharmacy sector is buckling under growing cost and capacity pressures.
The survey conducted by the Pharmaceutical Services Negotiating Committee, which also involved two thousand community pharmacy confirms, rising costs, patient
demand and
medicine supply issues continue to grip the sector.
PSNC's 2023 Pharmacy Pressures Survey, run as a follow up to the 2022 pressures survey, provides clear comparative data showing the worsening situation across
the sector.
Govt must act now
The result of the survey indeed paints a bleak picture for community pharmacies and it is clear that without urgent action from government and the NHS this will
only get worse: more community pharmacies will either be forced to reduce the number of services they provide or, in the worst-case scenario, will be left with
no option but to close their doors for good.
The PSNC has urged the government to act now "to save our pharmacies, before it is too late for patients, the public, and the rest of the NHS".
"This year's survey clearly shows that community pharmacies are buckling under growing cost and capacity pressures," said PSNC Chief Executive Janet Morrison.
A group of 20 MPs from the different political parties, including Dame Priti Patel and Judith Cummins, have written a joint letter to health minister Andrea
Leadsom, calling for urgent action to address the pressures faced by community pharmacies.
Taking note of rising pharmacy closures, they have highlighted the need for more investment and support from the government.
Recent NHS figures showed that around 1,400 pharmacies have closed permanently since October 2016, and many more are withdrawing services or reducing their opening
hours, particularly in deprived areas.
The MPs have urged the pharmacy minister to commit to making essential changes including a fair and sustainable core funding model, an effective implementation of
the Pharmacy First service and an expansion into other clinical service areas.
The Pharmacy First service, set for launch in England at the end of January, is expected to help reduce some of the pressure on the National Health Service (NHS).
But the question is - Are pharmacists ready to take the extra workload amidst many issues community pharmacies are currently facing?
Nearly 50 per cent of pharmacy workers surveyed by ITV News said they do not feel confident they can provide the new services.
Pharmacy leaders told the British news channel that the industry is already in crisis, and they are facing a "potentially fatal cocktail" of rising prices, major
supply problems and a lack of funding.
The Royal Pharmaceutical Society in England (RPS) and Community Pharmacy England (CPE) have raised alarm over the impending increase in NHS prescription
charges, slated to take effect from May 1, 2024.
The RPS, represented by Chair Tase Oputu, condemned the rise, labeling it a "dark day for patients" who will now face nearly £10 per prescription item.
Oputu emphasised the disproportionate impact on individuals with low incomes, citing the "relentless annual increases in prescription charges" as exacerbating
the affordability crisis in healthcare.
" Every day pharmacists are asked by patients who are unable to afford all the items in their prescription which ones they can 'do without'" she said.
She further added that the financial barriers to get vital medicines should not be faced by any one and advocated for "the abolition of prescription charges in
England, as has been implemented in other parts of the UK".
The UK Health Security Agency's (UKHSA) Chief Executive, Professor Dame Jenny Harries has expressed concern that measles outbreak could spread to other
towns and cities unless urgent action is taken to increase Measles, Mumps and Rubella (MMR) vaccination uptake in areas at greatest risk.
The virus can spread very easily among those who are unvaccinated, especially in nurseries and schools, she said on Friday (19 January) during a visit to
irmingham to review the ongoing work to contain the spread of the disease.
A rapid rise in cases has been seen in the West Midlands since 1 October 2023, with 216 confirmed cases and 103 probable cases recorded till 18 January.
The majority of the cases (around 80 per cent) were reported from Birmingham, with about 10 per cent in Coventry, mostly affecting children aged under 10 years.
Dame Jenny is calling on all local areas to increase MMR vaccine uptake rates in communities across the country.
The National Pharmacy Association (NPA) has raised concerns over the upcoming increase in the National Living Wage, saying it will make things even worse
for local pharmacies already facing nearly a decade of cuts in real terms.
Scheduled to go up from £10.42 to £11.44 per hour starting April, the National Living Wage rise is expected to put a lot of financial pressure on many pharmacies.
The NPA says "it will cost them over £10,000 in salary bills, and for some, even more, without getting more from the NHS funds. and has asked the government to
deal with the ongoing problem of underfunding for community pharmacies.
The association has warned that without additional funds, pharmacies could face staff layoffs or reduced services to cover the increased wages, calling for
a "comprehensive new funding deal to prevent further closures of vital local services, which have been shutting at the rate of eight a week."
Within 24 hours of the Princess of Wales, Kate Middleton's, cancer diagnosis, National Health Service (NHS) England saw a 373% spike in visits to its
cancer page, highlighting the growing focus on cancer awareness.
Similarly, charities like Macmillan Cancer Support charity experienced increased traffic, with nearly 100,000 visits to their support pages since the announcement.
Traffic to the NHS website's cancer symptoms page surged significantly, recording a remarkable 4,172 visits within three hours of the release of the Princess's
video message.
This sudden increase translated to an average of one visit every three seconds, a substantial rise from the 1,922 visits recorded during the same timeframe a week
earlier.
Notably, visits to the symptoms page peaked immediately after the announcement, with 1,678 visits recorded between 6 pm and 7 pm on the day of the announcement.
Campaigners have submitted an open letter to the Department of Health and Social Care (DHSC), urging the Minister for Primary Care and Public Health to
freeze prescription charges to keep people with long-term conditions alive and well.
The campaign is led by the Prescription Charges Coalition, which represents over 50 organisations, including Royal Pharmaceutical Society (RPS) and Pharmacists'
Defence Association (PDA).
Currently, the prescription charge is £9.65 per item, and campaigners have asked the government to freeze it for 2024 and 2025 as people living with long-term
health conditions in England are "being forced to choose between heating, eating, and taking their vital medication on a daily basis."
In 2023, a study conducted by the Prescription Charges Coalition revealed that almost 10 per cent of survey participants had skipped medication in the previous
year due to the cost of prescriptions. This led to increased physical and mental health problems, as well as impacted the time they took off work.
Laura Cockram, Chair of the Prescription Charges Coalition and Head of Campaigns at Parkinson's UK, expressed deep concern that a further rise in the charge this
year will lead to people skipping or not taking the full dose of their medication, which will affect their health and put more pressure on the already under
pressure NHS.
Poverty not only takes a significant toll on people's health but also leads to additional costs for the National Health Service (NHS). Rise in deep poverty,
cost-of-living crisis, and high pressure on NHS services have worsened the situation, according to a study published by The King's Fund this week.
The report underscored that poverty and deprivation contribute to a greater prevalence of diseases, difficulties in accessing health care, late or delayed
treatment, and worse health outcomes. These challenges could be seen across various NHS services, spanning from emergency care to dental services
Additionally, it revealed that 30 per cent of people living in the most deprived areas have turned to 999, 111, A&E or a walk-in centre because they could not
access a GP appointment.
In 2016, the Joseph Rowntree Foundation (JRF) estimated the cost of poverty on health care at £29 billion (£34 billion in current prices). As the proportion of
people living in deep poverty has Risen, the situation has worsened. In 2021/22, six million people were living in very deep poverty, up from 4.5 million two
decades ago. Currently, more than one in five people in the UK are estimated to be living in poverty, the report noted.
Deprivation is linked to a range of diet-related health problems, including cardiovascular disease and diabetes, as well as mental illness. According to the
report, the depression rate is two times higher among people living in the most deprived areas, compared to the least deprived areas.
People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP).
According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in
England last year, rising from 12.8 million in 2022 to 17.6 million.
Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for
their services due to severe staff shortages.
Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five
years ago.
Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and
unsustainable workloads" and "we can't keep doing more with less."
The government will on Thursday launch a drive to boost childhood vaccination rates, health authorities said, seeking an "urgent reversal" to a fall in
uptake as the country faces a worsening measles outbreak.
Routine childhood immunisations in Britain for diseases including measles, mumps and rubella, diphtheria and polio, have been falling gradually over the past
decade, but dipped more sharply after the Covid-19 pandemic, mirroring a global decline.
Last year UNICEF said people worldwide had lost confidence in the importance of routine childhood vaccines during the pandemic, with misinformation, dwindling
trust in governments and political polarisation contributing to rising hesitancy.
Britons will begin seeing adverts from next week across various media, including a television campaign featuring children reminding parents of the risk of missing
out on vaccinations, the UK Health Security Agency (UKHSA) said.
"We need an urgent reversal of the decline in the uptake of childhood vaccinations to protect our communities," UKHSA chief executive Jenny Harries said in a
statement.
With 118 new cases confirmed by the UK Health Security Agency (UKHSA), the total number of measles cases reported in England since 1 October 2023 has gone
up to 465.
According to the latest data published by the agency, West Midlands continues to see a disproportionately high rate of infections, with a sharp rise in case
numbers over the last six weeks, mainly driven by cases in Birmingham.
In England, there were 17 laboratory-confirmed measles cases in October, 42 in November, 161 in December, 240 in January 2024.
Five more cases were confirmed last week, according to the measles statistics updated by UKHSA on 8 February.
More than 70 per cent (329 of 465) of total confirmed cases were reported from the West Midlands, 13 per cent (62 of 465) from London, seven per cent (32 of 465)
in Yorkshire and The Humber, and the remaining cases from other regions of England.
Responding to an MP's question in the House of Commons, prime minister Rishi Sunak reiterated his deep concern for the future of UK community pharmacies,
stressing their commitment to enhancing the sector with an additional £645 million in funding through the Pharmacy First initiative.
At the recent Prime Minister's Questions last Wednesday, Angela Richardson, the Conservative MP for Guildford, raised the issue of rising pharmacy closures,
revealing that Guildford recently lost two neighbouring pharmacies.
Highlighting that empowering local pharmacies is a key part of this government's plan to cut waiting lists, she asked Sunak whether he would agree that it is
vital for residents to have access to "a good, efficient, and above all, local pharmacy."
In response, Sunak said: "I care deeply about the future of our community pharmacies."
