Achieving the community pharmacy vision necessitates legal adjustments and additional funding beyond recent boosts, the pharmacy vision document published
by Nuffield Trust and The King's Fund has revealed. It says community pharmacies in England must adapt to changing population needs amidst unprecedented health
and care challenges.
Commissioned by Community Pharmacy England, the report titled 'A Vision for Community Pharmacy', published on Sept. 19, is a result of almost a year of research
and extensive consultation with the sector and wider stakeholders, advocating for community pharmacy. The think tanks detail a shift in the community pharmacy
sector, highlighting how pharmacies can contribute to crucial policy objectives regarding population health, prevention, and the increasing demand in primary care.
"The health and care needs of the population are evolving, and pharmacies in England, like all components of the health and care system, must adjust to address
these changes," said Helen Buckingham, Director of Strategy at Nuffield Trust.
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.
Representatives from the national community pharmacy bodies will brief the MPs on the severe challenges facing community pharmacies on Tuesday (21 March) at a
roundtable summit.
The roundtable summit will include discussions on the urgent action needed to address the current severe challenges being faced by community pharmacy, as well as the
sector's role in the upcoming Primary Care Recovery Plan, said PSNC.
The Parliamentary event this week has been coordinated by PSNC as part of the joint #SaveOurPharmacies campaign which exceeded 30,000 signatories in a week.
The Association of Independent Pharmacies (AIM), the Company Chemists' Association (CCA), the National Pharmacy Association (NPA) and PSNC will take part at the
event.
A spokesperson for the #SaveOurPharmacies campaign group said: "30,000 signatures in a week indicates a high level of underlying public support for community pharmacy
and it's a good start to the #SaveOurPharmacies campaign. A petition by itself won't change the world, but it works as a kind of drumbeat for the campaign, giving
forward momentum, and it's a really easy way to express your opinion.
We hope the new window poster - along with all the resources available at saveourpharmacies.co.uk - will help as many pharmacies as possible to drum up support from
their patients, and we're really grateful to Communications International Group for helping us to print and distribute this.
"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of
their business."
Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and
the larger role pharmacies play in complementing traditional NHS facilities.
Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain
information from NHS England regarding protocols and procedures.
She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were
desperate to take part in the vaccination scheme" in her constituency.
Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy
closures "should be a real wake up call for the government."
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).
The 'SaveOurPharmacies' roundtable held on Tuesday (21 March) to discuss severe challenges faced by the community pharmacies in England witnessed the support
of 15 MPs.
Janet Morrison, Chief Executive, Pharmaceutical Services Negotiating Committee (PSNC); Andrew Lane, independent pharmacy owner and Chairman, National Pharmacy
Association (NPA) and Ian Strachan, independent pharmacy owner and Board Member, Association of Independent Multiple Pharmacies (AIM) attended the summit, which
was chaired by Stephen Hammond MP, to brief MPs on the severe challenges facing the sector.
MPs in attendance were Stephen Hammond, Sally-Ann Hart, Peter Aldous, Anna Firth, Taiwo Owatemi, Bob Seely, Derek Thomas, David Rutley, Lilian Greenwood, Tulip
Siddiq, Hillary Benn, Sarah Olney, Christian Wakeford, Daisy Cooper (researcher) and Victoria Atkins (researcher)
The title of the event 'Community pharmacy's role in the Primary Care Recovery Plan' which is expected imminently, is set to include a variety of measures aimed at
helping primary care to recover from the impact of the pandemic.
PSNC has been pressing for the plan to include a fully-funded national Pharmacy First service as this is the best chance for getting significant additional funds
into community pharmacies.
The 8th Pharmacy Business Conference, organised by Pharmacy Business, unfolded a dynamic narrative around the theme of 'Pharmacy of Tomorrow', highlighting
the trajectory of innovation, adaptation, and the evolving landscape of pharmaceutical services.
Attended by over 200 pharmacy owners, industry leaders, and stakeholders, the conference served as a medium for robust discussions and the exchange of valuable
insights regarding the future of community pharmacy.
Amidst the persistent challenges posed by an underfunded reimbursement system and negotiations with governmental bodies and the NHS for the new community pharmacy
contractual framework 2024/25, the conference pivoted towards investing in staff, adapting to change by investing in new technology, and optimising commissioning
as pivotal strategies.
"Pharmacy professionals are playing increasingly important clinical roles in both primary and secondary care," shared David Webb, Chief Pharmaceutical Officer
(CPO), NHS in a video message.
He highlighted the NHS's commitment to empowering community pharmacy, with plans to expand services and deprescribe to align with the NHS's focus on preventive
healthcare.
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.
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).
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.
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."
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.
Munira Wilson, the Liberal Democrat MP for Twickenham, highlighted the impact of the community pharmacy closures in the Hampton area, and the severe
financial challenges facing community pharmacies across England during an adjournment debate in the House of Commons on Friday.
She also raised concerns about the impenetrable bureaucratic processes surrounding new pharmacy license applications and closures.
Wilson highlighted the closure of two Boots pharmacies in Hampton last autumn, including one in the deprived ward of Hampton North.
The Tangley Park pharmacy closure left the entire ward, which lacks adequate public transport, without a pharmacy, severely affecting elderly and vulnerable
residents.
"The nearest pharmacy is now a mile away on foot, a distance which is difficult to cover for the elderly and those with mobility issues, certainly more than
a 20-minute walk, the measure that previous ministers like to use to highlight pharmacy accessibility," she said.
Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government
addresses supply problems and resolves the critical financial state of community pharmacies.
CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select
Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients.
Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy
businesses fighting for survival.
"As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said.
Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also
face the consequences.
A combination of factors, including the doctors' strike, medicine shortages, and funding scarcity, indicates that this upcoming winter could be the most
challenging period for both community pharmacies and the NHS, Community Pharmacy England has said.
In a September 4 blog post, CPE Chief Executive Janet Morrison emphasised that the relentless pressures show no signs of easing. "Pharmacy businesses, like
numerous other sectors, are grappling with the challenges of staying afloat in the current economic climate, compounded by the detrimental effects of historical
funding cuts."
"The doctors' strike, despite ongoing assurances from the Health Secretary that their pay deal is final, will inevitably exacerbate the demand for both primary
and secondary care, leading people to turn to their local pharmacies for assistance," she added. "This, in turn, will heighten the pressure on community pharmacies."
"Whatever the coming winter brings I am sure of two things: that community pharmacies are going to be more critical to the health of the population than ever
before, and that your representatives here will be fighting on all fronts to get you the help that you need."
The Royal Pharmaceutical Society (RPS) has urged people across Scotland to be kind to their pharmacy teams this winter through its campaign called 'Be Kind'.
The pharmacies are facing lot of pressure and challenges during winter, RPS has heard from its members that abuse towards pharmacy teams, particularly those in
community pharmacy, has 'unfortunately' risen.
The campaign has been running throughout December, to promote 'be kind' message to the public at a time when pharmacy services are particularly stretched by winter
pressures and other factors, including the recent shortages of antibiotics.
"Throughout December, leading figures have provided a series of powerful videos, which all encourage the public to be kind to their pharmacy teams. The campaign has
highlighted personal video messages from many figures including Jason Leitch, Scotland's National Clinical Director, Maree Todd, Minister for Public Health, Women's
Health and Sport, and Andrew Carruthers, RPS Scottish Pharmacy Board Chair," said RPS.
We have been specialising in community pharmacy sector for over 30 years and have helped many pharmacists acquire their first pharmacy. We have seen several
of those first-time buyers transition into multiple pharmacy owners under our specialist guidance and support through the years.
Acquiring the first pharmacy can be a challenge to most pharmacists especially when they do not have the necessary skill in reading the numbers presented in terms
of the target pharmacy's performance and how to interpret these in order to arrive at a valuation for the purpose of submitting an offer.
Without the guidance of a specialist accountant in community pharmacy, one of the major risks is that one could end up paying more than what the pharmacy is worth.
Once the offer is accepted, there are other challenges to overcome to get the deal over the line.
1) Assessing the risk
2) Valuation of the business
3) The negotiation process
4) Asset or company purchase
5) Financial due diligence
6) Asset/share purchase agreement
7) Finance the purchase
In a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE),
Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges.
Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival.
"There have been no years of financial and operational squeezes applied by the NHS and
government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival,"
he said.
Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative
initiatives like the Discharge Medicine Service and Contraception Service.
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.
Growing up with a family that worked in pharmacy, our dinner time conversation was not like that of other families. Ours would centre around medicines,
prescriptions, and the health challenges within our local community.
I quickly came to understand the importance of the role played by community pharmacists. So I can't help but be concerned that the current direction being taken by
digital health innovation threatens to leave community pharmacies behind.
Whilst it is brilliant that patients can easily access their prescriptions through the rise of online pharmacies, many of these cut out the vital knowledge and
expertise of local community pharmacists, and threaten to end the traditional close ties between local community pharmacists and their patients.
Nine out of 10 NHS users believe that pharmacists play an unrivalled role when it comes to keeping patients in the community safe. We must ensure that digital health
does not replace this important source of advice for health problems and injuries, but instead preserves and enhances this vital, personal role and enables
pharmacists to continue delivering care in new and effective ways.
A vital connection with patients
Community pharmacies provide crucial support to local patients with managing their medicines safely, particularly older and more vulnerable people. The specific
expertise and knowledge held by pharmacists can help inform the long-term management of a patient's condition and ensure they are kept safe from potential side
effects and complications.