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Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

The Pharmaceutical Services Negotiating Committee on Tuesday (June 30) renamed itself as Community Pharmacy England, promising a "strengthened commitment" to champion and engage with the sector. "The name Community Pharmacy England better reflects the breadth of work that we do to both represent and support community pharmacies in England. We are their champion," the pharmacy negotiator said. Explaining that the rebranding exercise was in line with proposals put forward by the Review Steering Group (RSG), it said the rebrand was part of its Transforming Pharmacy Representation (TAPR) work and that it would signal the beginning of a "new engagement strategy" to build stronger relationships with pharmacy owners. "Becoming Community Pharmacy England is much more than a name change or a new logo, it is a driver for cultural change across our organisation. "Our members want us to be more authoritative, representative, and influential, and rebranding gives us a clearer and stronger voice, helping us to better speak out for community pharmacy."

Community Pharmacy England (CPE) is inviting community pharmacy owners to share their insights and views about increasing Pharmacy First thresholds and the effects of GP collective action on their pharmacies. This feedback will be discussed at the upcoming Community Pharmacy England Committee meeting in September. During the meeting, the Committee members will also discuss urgent matters including the 2024/25 negotiations, collaboration with the new government, and their ongoing strategies. A key point of discussion will also be the effects of GP work-to-rule action on community pharmacies. CPE has raised concerns that many pharmacies might face challenges meeting the scheduled increases in the monthly Pharmacy First payment threshold, noting that pharmacy owners are already considering their options if they start failing to meet the threshold. In response to concerns from Community Pharmacy England, Ministers have recently agreed to lower the August threshold from 20 to 15.

In celebration of World Pharmacy Technician Day today, we have gathered some significant achievements from this year that highlight the growing recognition of pharmacy technicians as integral members of the pharmacy team. During the Association of Pharmacy Technicians UK (APTUK) Conference in September, NHS England's Chief Pharmaceutical Officer, David Webb, announced 530 apprenticeships for community pharmacy pre-registration pharmacy technicians (PTPs) for the 2024/25 period. "This announcement shows a real investment in pharmacy technicians. It will impact all areas of practice, not just within community pharmacies," said Nicola Stockmann, APTUK President, in an exclusive interview with Pharmacy Business. In August, the Centre for Pharmacy Postgraduate Education (CPPE) was allocated funding to offer 80 NHS England-funded places in its Accuracy Checking Pharmacy Technician (ACPT) programme. This 3-12 month course is designed to help pharmacy technicians develop a range of competencies, ensuring they can deliver safe and effective patient care. Up to 10 NHSE-funded spots will be available each month on a first-come, first-served basis for pharmacy technicians working in community pharmacies, NHS hospitals, and health and justice settings. The funding will remain available until all 80 places are filled or until March 2025.

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.

A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

Community Pharmacy England (CPE) is gearing up to conduct a vital Pharmacy Advice Audit, calling on pharmacy owners and their teams to help measure the increasing reliance on pharmacies within communities. With years of financial strains impacting the sector, despite the much-needed £645 million recovery plan funding, the sector finds itself on the edge. The launch of Pharmacy First sparked a notable surge in people seeking advice from community pharmacies, both within and beyond the funded service, as revealed by recent sector polling. To accurately assess this trend and advocate for sustainable funding, CPE is initiating an audit to gather data crucial for showcasing the extent of unfunded care provided by community pharmacies. Scheduled to commence this week, the Pharmacy Advice Audit will entail pharmacy teams documenting informal healthcare advice dispensed over a single day.

The Local Pharmaceutical Committees (LPCs) has rebranded to be known as Community Pharmacy to present a strengthened and unified identity to the local NHS, local government and other stakeholders, as the local voice of community pharmacy. "There are now 58 LPCs in England. The number of LPCs has reduced from 69, with further consolidation expected by April 2024 to a network of 48 local organisations," said Community Pharmacy England. "The changes mean there will be better alignment between LPCs and the 42 NHS Integrated Care Systems in England, who have taken on the responsibility for commissioning pharmaceutical services delegated by NHS England." "This marks a significant milestone, as similar to Community Pharmacy England, LPCs have been undergoing changes to respond to the Review Steering Group (RSG) recommendations on pharmacy representation. The sector voted in favour of the RSG proposals in the summer of 2022, and since then progress has been made on many of the changes at both local and national level as part of the Transforming Pharmacy Representation (TAPR) Programme."

The Welsh government has reached an agreement with the NHS and Community Pharmacy Wales (CPW)-the statutory representative body for all community pharmacies-on a six per cent funding increase as part of the 2024/25 Community Pharmacy Contractual Framework (CPCF). The £9.9 million increase will bring the total CPCF funding to £175 million per year, representing a 24 per cent rise in funding since 2017. In a statement published on 20 December 2024, Jeremy Miles, cabinet secretary for health and social care, said that the additional investment will be used to address "both immediate pressures facing community pharmacies and to maintain momentum on our longer-term ambitions for reform." Miles also said that the government would continue to invest in integrating pharmacies in primary care clusters, developing the skills and scope of practice of the wider community pharmacy workforce including pharmacy technicians, and the Choose Pharmacy IT system. In contrast, community pharmacies in England are still awaiting progress on CPCF negotiations for 2024/25. Last month, Community Pharmacy England (CPE) warned of the sector's worsening financial situation, urging ministers to provide immediate funding relief.

In response to concerns raised by Community Pharmacy England (CPE), ministers have decided to lower the October threshold for the Pharmacy First service to 20. This decision addresses a major worry for pharmacy owners who have struggled to meet the required number of clinical pathways for monthly Pharmacy First payments, especially as the October increase to 30 pathways approached. CPE has been actively engaged in discussions with the Department of Health and Social Care and NHS England over the past few weeks to address this issue. Commenting on the decision, Janet Morrison, CEO of Community Pharmacy England, said: "It is great that ministers have responded to our concerns about another increase to the Pharmacy First payment threshold: this decision will save many community pharmacies from missing out on a vital payment this month." Morrison added that CPE will continue to monitor service data and, if needed, make further representations to ministers about future months. She also emphasised the need to find a long-term solution, which involves "NHS England marketing Pharmacy First effectively and ensuring that GPs are actively referring people to the service."

England's chief pharmaceutical officer (CPhO) David Webb has promised his "wholehearted support" for the community pharmacy sector at the board meeting of the National Pharmacy Association (NPA) on 28 June in St Albans. After hearing the CPhO at the meeting, NPA chair, Andrew Lane, later declared: "David is someone we can do business with." Webb thus listed his priorities as head of profession: integration of independent prescribing as part of pharmacy practice by 2026; promotion of inclusive pharmacy practice for all pharmacy professionals; assurance of post-registration practice; developing the role of pharmacy technicians; support for Integrated Care Systems and Primary Care Network pharmacy teams (including community pharmacy); medicines optimisation; and strengthening of professional leadership for community pharmacy. He also reported that NHS England had recently increased its team of regional pharmacy integration leads from seven to 14, creating seven new senior posts. Webb told NPA board members: "I want sincerely to thank community pharmacy teams for everything they are doing and to say that you have my wholehearted support. I believe in the importance of community pharmacy and will listen and engage as I've already demonstrated.

Analysis by IQVIA revealed that over the past four years, from May 2020 to May 2024, the average number of prescriptions processed by pharmacies has risen by 8 million per month. However, this is happening against the backdrop of a declining number of pharmacies. During these four years, nearly 900 pharmacies have closed in England, with almost 500 of those closures occurring in the last 12 months. Carol Alexandre, vice president at IQVIA, presented the data at the recent SIGMA UK Community Pharmacy Conference 2024, where she shared insights into the dynamics of the UK market, the pharmacy sector, and the Pharmacy First initiative. As of August 2024, there were just 10,059 community pharmacies (excluding distance-selling pharmacies) in England, 1,589 less than in March 2015, when the number stood at 11,647 (source: NHS BSA). There has been a significant shift in the distribution of pharmacy ownership, with independents (single pharmacies and chains with 1-5 stores) and regional chains (pharmacy chains with 6-200 stores) growing at the expense of managed chains.

EMIS Pinnacle, the leading Pharmacy First IT supplier, has begun implementing the GP Connect Update Record feature to all community pharmacies in England that use PharmOutcomes. Starting June 28, this new feature was made available for use with the Hypertension case-finding service and the Pharmacy contraception service, as announced by the Community Pharmacy England (CPE). The GP Connect Update Record will enable community pharmacies to securely share "structured" information with GP practices regarding consultations conducted under the Pharmacy First programme, which includes minor illness and clinical pathways, along with Hypertension Case Finding and Pharmacy Contraception services Live testing is underway with EMIS Pinnacle for Pharmacy First minor illness and clinical pathways. There are plans to expand the system in the future to include updates for urgent supply of medicines under the Pharmacy First service. EMIS Pinnacle is the third CPCF IT system supplier to offer this functionality, following Cegedim's Pharmacy Services system and Positive Solutions' HXConsult system.

'Community pharmacy is far too important to be allowed to wither away' desc-Thousands of pharmacies took part in the second day of the 'Save Our Pharmacies' protest organised by the National Pharmacy Association (NPA) on Thursday. Similar to the first day of protest in June, pharmacies carried out several symbolic actions, such as blacking out windows, to warn of the threat of future closures. Meanwhile, NPA chief executive Paul Rees led a delegation of pharmacy leaders to deliver a 350,000-strong petition to No 10 Downing Street, calling for "immediate, fair and sustained funding to safeguard NHS pharmacy services and ensure local pharmacies have a future." The delegation included NPA Chair Nick Kaye; Janet Morrison, CEO of Community Pharmacy England (CPE); Malcolm Harrison, CEO of Company Chemists' Association (CCA), and Gerard Greene, CEO of Community Pharmacy Northern Ireland (CPNI). Steve Race MP, who is the new chair of the All-Party Parliamentary Group on Pharmacy, and Sadik Al-Hassan, one of only two pharmacists in the House of Commons, also joined them.

As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the community pharmacists to to establish a robust relationship between community pharmacies and local general practices. The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services. According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to participate at all in the "groundbreaking" Pharmacy First scheme". In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer patients to the Pharmacy First and other community pharmacy services where appropriate. Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy First will likely require sustained effort over several months or longer.

The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million a year - are now being carried out by community pharmacy teams in England. This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year. PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations were recorded, with the average pharmacy completing 19 consultations per day. This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week. The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy coming from these routes; grossed up to a national level that means 117,000 cases per week. These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).

Data crunched by an online pharmacy delivery company paints a concerning picture for the pharmacy sector in England. Gophr's 'Prescription For Pressure' initiative reveals a challenging time for the sector and is supported by separate analysis by the BBC showing that the number of pharmacies in England is at its lowest since 2010. In addition, new powers being introduced for pharmacists to prescribe common prescription drugs and perform routine tests create an even greater workload for already overstretched pharmacists. Gophr's data reveals that: * Each pharmacy in England serves an average of 6,078 people. * In 2022, pharmacists dispensed 1.043 billion prescriptions, 26.3 million more than 2021. * A single pharmacy in England dispensed 248 prescriptions a day on average in 2022. Based on the most up-to-date statistics from the Office for National Statistics, NHS England and Statista, Gophr's calculations show that pharmacists have around 116 seconds to dispense a prescription, which is less time than the 180 seconds it takes to make a Quarter Pounder at McDonald's.

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).

A group of 20 parliamentarians has written to health secretary Wes Streeting MP, calling for urgent government action to address the growing financial crisis facing community pharmacies. In the cross-party letter, supported by Community Pharmacy England (CPE), the MPs warned of a real risk of more pharmacy closures, with one in six pharmacy owners saying that they are unsure if their pharmacy will survive the year. They have urged the Department of Health and Social Care (DHSC) and NHS England (NHSE) to prioritise long-term planning for pharmacies, including the implementation of the Community Pharmacist Prescribing Service. The MPs have also highlighted the need for more effective marketing for Pharmacy First to increase both walk-ins and referrals to this critical service. CPE chief executive Janet Morrison welcomed the support of 20 cross-party parliamentarians and recognising the vital role pharmacies play in the local community. She stressed the urgent need for immediate government intervention to ensure the survival of the sector and to maximise its potential in providing accessible care.