The Royal Pharmaceutical Society (RPS) has called pharmacy employers and pharmacy trade unions to come together to a round table meeting to agree on principles
for a way forward that ensures patients benefit consistently from access to high quality, adequately staffed, safe pharmacy services.
It has also urged the governments, NHS organisations and individual pharmacy teams to define clear prioritisation plans, which can be embedded in organisational
business continuity plans which set out the pharmacy services that are essential and must always be provided and can be de-prioritised at specific levels of
pressures.
The challenges for pharmacies are compounded by the escalating cost of living crisis. With unprecedented levels of burnout among pharmacists, pharmacy closures
and the potential for strike action, RPS has called for three things- 'professionalism, respect and prioritisation.'
A new report commissioned by the National Pharmacy Association (NPA) has revealed harsh financial realities faced by community pharmacies in England.
The report by Professor David Taylor of University College London warned that 1000s of community pharmacy closure might take place by 2024 in England if the sector
was not supported with additional funds.
At the launch of the report titled 'Protecting UK Public Interests in NHS Community Pharmacy', Prof Taylor said: "There will be several 1,000s of closures over the
next few years unless we take appropriate action, which doesn't mean to pour money all over it, but it is to fund appropriately when necessary.
"At the moment, if we got a partial collapse in the pharmacy network it would disrupt medicine supply and increase health inequalities… For me, it's missing out on
the future development of better and more accessible care, which would be the tragedy of reducing, harming and damaging the pharmacy network unnecessarily."
The Royal Pharmaceutical Society (RPS) Director for Scotland Clare Morrison participated in the panel discussion alongside representatives from other health
professional organisations on tackling the workforce crisis at the SNP conference in Aberdeen on 8 October.
At the conference, the Cabinet Secretary for Health and Social Care committed to achieving protected learning time for health professionals. Morrison welcomed the
Cabinet Secretary's statement as fantastic news for pharmacists across Scotland.
"RPS Scotland will follow up the discussion by writing to the Cabinet Secretary to request a meeting to discuss achieving protected learning time, the forthcoming
results of our workforce wellbeing survey, and positive examples of how pharmacy teams have improved the well-being of their teams," said the society.
In an oral parliamentary debate on community pharmacy held on Monday (20 March), the government was asked for an indication of 'how much it would cost to
make the best use of community pharmacies'.
A number of Peers at the House of Lords spoke out in support of pharmacies, while others asked when would the government address the current crisis in the sector.
Kicking off the session, Baroness Hodgson asked the responding minister, Lord Evans, about recent pharmacy closures as well as underfunding. She asked whether the
government would 'enter into discussions with PSNC to look at introducing a fairly funded pharmacy first service as soon as possible which will help relieve the
work load on GPs'.
The minister responded: "We have already introduced and funded a range of service in community pharmacy that make use of the clinical skills of pharmacy teams… we
continue to discuss with PSNC how the government can best support the sector to provide support to patients."
The House of Lords oral questions session was opened by Baroness Hodgson on behalf of Baroness Cumberlege as follows: "To ask His Majesty's Government what plans
they have for making the best use of community pharmacies".
The British Generic Manufacturers Association (BGMA) has warned that England's 42 integrated care boards (ICBs) may need to allocate an extra £37 million
from their budgets annually for the next five years due to the spiralling tax rates.
The government's Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) rebate rate increased more than five-fold in the past two years, the BGMA said
in its white paper released on Monday (October 30).
The report, conducted by consultancy firm Conclusio in consultation with local NHS leaders, examined the potential effects of the VPAS on ICB budgets.
BGMA said that due to the elevated VPAS rate, each ICB in England will experience significant increases in expenses for branded generics and biosimilars
annually - a consequence of reduced competition.
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".
People are advised to be prepared and order their repeat prescriptions in time so that they don't run out of their routine medicines over the Christmas and
New Year break when services are likely to be busier than normal.
As GP practices will be closed over the bank holidays and only some pharmacies will remain open, local NHS leaders have urged patients to plan ahead to avoid making
last-minute requests for collecting repeat prescriptions, which can add avoidable pressure for doctors, pharmacies, and other NHS services.
Sati Ubhi, Chief Pharmacist at NHS Cambridgeshire & Peterborough, have cautioned patients that running out of their usual medication can have serious consequences.
"By ordering medicines as soon as possible, it allows enough time for it to be processed and dispensed and helps avoid a last-minute rush," she told Fenland Citizen.
The Department of Health and Social Care (DHSC) has suggested Estradiol patch as an alternative for patients who use 1 pump of Oestrogel daily.
DHSC has updated Annex A of SSP022 and SSP023 for Oestrogel Pump-Pack 0.06 per cent gel to include a dose conversion to a specific alternative Estradiol patch.
Previously, only dose conversions for patients using 2 to 4 pumps daily were included in Annex A of SSP022 and SSP023.
Separately, the supporting guidance for three SSPs which allow quantity restriction have been updated to reflect the requirement to endorse the reduced quantity
supplied in accordance with these SSPs.
SSP019 - Oestrogel pump-pack 0.06% gel
SSP020 - Ovestin 1mg cream
SSP021 - Premique low dose 0.3mg/1.5mg modified release tablets
"When endorsing an SSP for a reduced quantity, contractors must ensure that the correct SSP number is endorsed along with the product name and the reduced
quantity supplied in accordance with the SSP," said PSNC.
Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems.
Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS.
"It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework."
Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector."
"We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."
Besins Healthcare has acquired a pharmaceutical manufacturing site in Drogenbos, Belgium to boost the production of hormonal products including Oestrogel.
Currently, the site which is being used as one of two manufacturing sites for their gel products [the other site being in France], is a strategic purchase to allow
Besins Healthcare to increase production of its own products, offering greater efficiencies and greater integration into the company's supply line.
"In the past year, demand for hormone replacement therapy (HRT) treatment in the United Kingdom and Ireland has dramatically increased, resulting in regrettable
disruption to supply of Oestrogel. We are looking at a range of options for increasing supplies of this product in the short, medium and longer term," said Alexandre
Besins, joint CEO for Besins Healthcare.
"Besins strongly believes that by re-integrating our manufacturing capabilities we will have better control over our ability to meet demand and live up to the trust
that HCPs and patients have put in us."
Community pharmacy workforce is in a fragile condition and faced a shortfall of 3,000 pharmacists in England over a period of five years, a recent research conducted by the Company Chemists' Association (CCA) has revealed.
It noted that over the last five years, the net growth of community pharmacists in England a year stood at 733. This is much lower than the required average growth of 1,025, based on data reported by the Health Education England workforce survey from 2021.
Acknowledging the discrepancies in the data calculation, the paper published by the association has used "the best available data" to highlight recent changes to the community pharmacy workforce in England.
The report noted that despite an increase in the number of pharmacists, many contractors reported an increase in pharmacist vacancies. They also reported a significant increase in locum hourly pay rates, indicating demand exceeds supply.
he Healthcare Distribution Association (HDA) and the Pharmaceutical Services Negotiation Committee (PSNC) have urged the NHS England and the Department of
Health and Social Care (DHSC) to issue urgent communications requesting that all those involved in medicines supply do not hoard, stockpile or over-prescribe Strep
A antibiotics.
In a statement HDA said that the sudden spike in demand for antibiotics used for the treatment of Strep A has meant that there is not enough of these medicines in
the supply chain currently to meet this increased demand. As a result, wholesalers are working extremely hard with manufacturers to increase the supply of antibiotics.
It added: "As regards pricing, the prices charged to pharmacies by HDA wholesale distributors will directly reflect the increase in prices wholesalers are having
to pay for these medicines from manufacturers at the moment, in order to be able to continue supplying these medicines to pharmacies. This will be the case until
supply and demand are more in sync."
The Royal Pharmaceutical Society (RPS) has urged the government to amend medicines legislation to allow pharmacists to make minor amendments to a prescription
without any protocol being needed.
RPS wants to see a change in the law that makes the whole process of supply of medicines easier and quicker, enabling pharmacists to use their knowledge and expertise
in medicines to better support patients.
"At present a prescription can only be changed by a prescriber, which causes unnecessary workload for GPs and delays for patients," said RPS.
RPS President Professor Claire Anderson said: "We want to see all pharmacists across the UK able to supply a different quantity, strength or formulation of a medicine
(for example changing capsules to tablets) when required, to avoid unnecessary bureaucracy and the need for an SSP to be developed, signed and authorised by a
Minister. In effect it would mean that pharmacists can help patients straight away - it would future proof the problem to some degree.
The trade bodies and four largest pharmacy chains in England, have jointly written to the Secretary of State for Health, Steve Barclay, warning that the sector
needs urgent investment for sustainability.
The letter from AIMp, CCA, NPA, PSNC, Boots UK, Lloyds Pharmacy, Well, and Phoenix UK, warned that the 30 per cent real terms funding cuts that pharmacies have faced
over the past seven years have left many businesses in a cashflow crisis.
The letter said that the government is facing a choice over the future of the country's 11,000+ community pharmacies, with permanent closures likely and medicines
supply at risk if no urgent action is taken.
"If the funding situation is not addressed, the sector is likely to move rapidly towards many permanent closures of pharmacies."
The organisations say that once these closures start, they will be hard to stop, as the sector is now so fragile other pharmacies would struggle to pick up the slack.
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.
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.
A report released by Community Pharmacy England (CPE) has warned that pharmacies across England are grappling with daily medicine supply challenges, posing
significant risks to patients' health.
The Pharmacy Pressures Survey 2024: Medicines Supply Report, which is based on the views of the owners of over 6,100 pharmacy premises in England and 2,000 pharmacy
team members, has exposed some alarming trends concerning medicine supply problems in the country.
Almost all pharmacy team members surveyed (97 per cent) reported patients being inconvenienced due to medicine supply issues, and 79 per cent of the participants
said that the worsening situation is putting patient health at risk.
Nearly all respondents reported patient frustration stemming from medicine supply issues, with 84 per cent of them saying they had experienced aggression from
patients.
Additionally, 98 per cent indicated an increase in 'owings,' where patients receive only part of their prescription and must return to the pharmacy for the
remaining medication(s) at a later time."
The States of Guernsey have urged Islanders to plan ahead for their medication needs ahead of the upcoming Easter weekend. With a reduced number of
pharmacies expected to be open during the holiday, residents are being asked to arrange for their repeat prescriptions well in advance.
Alternatively, the government body announced that residents can opt to wait until after the Easter period if they already have an ample supply of medication at home.
This proactive measure aims to provide support to pharmacies and their staff, particularly during a period where demand for healthcare services may be heightened.
A recent report from Healthwatch England has highlighted that while people highly value the accessibility of community pharmacies, both in terms of
location and prompt service, they also encounter challenges in getting the most out of their pharmacy care experience.
The report titled 'Pharmacy: What People' is based on the research conducted by the organisation in November last year, involving 1,650 people who shared their
experiences of pharmacy services in England.
It showed the country's notable dependence on community pharmacies, with 72 per cent of respondents saying they have used a community pharmacy in the past three
months.
Usage of online pharmacies is considerably lower than community pharmacies, with only 18 per cent of individuals having used an online pharmacy in the past three
months, according to the report published on Tuesday (30 April).
Representatives from the National Pharmacy Association (NPA) and the Royal Pharmaceutical Society (RPS) presented their preliminary evidence to the Inquiry,
which is examining the impact of the COVID-19 pandemic on healthcare systems in the UK.
The UK COVID-19 Inquiry began on 28 June 2022 to examine the UK's preparedness and response to the pandemic, aiming to draw insights for the future. Its
investigations are organised into modules, gathering evidence from witnesses, experts and core participants through a series of corresponding hearings throughout
each module.
A preliminary Module 3 hearing for its investigation into was held at Dorland House, 121 Westbourne Terrace, London, W2 6BU on Wednesday 10 April at 10.30am.
NPA calls for funding to boost pharmacy resilience
Presenting its evidence before the inquiry, the NPA highlighted the unsung contribution of pharmacies nationwide in combatting COVID-19 and maintaining health
services throughout the pandemic while calling for funding to create greater resilience in community pharmacies.
