Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health
and Social Care Committee Steve Brine has said.
Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility
into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a
parliamentary debate focused on the future of community pharmacies on September 14.
From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible
solutions for a sustainable future in the sector.
Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs
Taiwo Owatemi and George Howarth among others.
Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win
outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs
and A&E.
It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you
can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more
pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years.
If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to
consider.
Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of
community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional?
What is the vision for community pharmacy delivering patient care in the next decade?
The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs
to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which
avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.
Health secretary Sajid Javid visited Medicine Chest Pharmacy in London on Friday (January 28) and thanked pharmacy teams across England for delivering well over 20 million Covid-19 jabs.
According to the latest research conducted by the National Pharmacy Association (NPA) and PharmData, independent community pharmacies were the biggest deliverers of Covid-19 vaccines during January 2021 to September 2021 as compared to corporate-run pharmacy sites.
As of January 2022, pharmacies across the whole sector had delivered 22 million Covid jabs, with the majority of them being independents of whom most are NPA members.
In a video message released after the visit, Javid said: "Today I am here at Medicine Chest pharmacy in London to thank them, all pharmacies, the NHS, for the fantastic job they have done particularly over the last few months to get our country boosted. It's because of this phenomenal success that today we are able to return to Plan A as we see Omicron in retreat and we learn to live with Covid."
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
To help pharmacy owner to better understand the negotiating process, Community Pharmacy England (CPE) has published commentary and infographics.
"Our work to negotiate fair funding, as well as changes to NHS pharmacy services, with the Department of Health and Social Care (DHSC) and NHS England is a
crucial part of our role," said CPE.
"Understandably the sector is eagerly awaiting an update on the progress of the current negotiations on the Government's pledge to invest £645m in community
pharmacies and, as part of our ongoing efforts to improve transparency of our work, we have released materials to explain the negotiating process."
Negotiating Team Member Stephen Thomas - who joined the team this year - has written a blog about his experiences.
He has described both the complexity of the process and volume of work undertaken, and recognises the significance of his role on behalf of pharmacy owners across
the country.
Whilst speed is of the essence, even higher on the Negotiating Team's list of priorities is working through a large number of important questions - particularly
around the funding and logistics that need to be put in place.
Eighty-five per cent of adults responding to a survey commissioned by the National Pharmacy Association (NPA) have agreed that community pharmacies are
underfunded and that the sector needs more investment to be able to do the work it does.
The survey of 1,000+ adults in England was carried out online between August 26 and 30 by an agency called Research Without Barriers (RWB) on behalf of the NPA.
Pharmacies in England are now paid less for providing NHS services than they were before the Covid-19 pandemic, after years of real terms cuts.
Seventy-four per cent respondents think it's unfair that community pharmacies in England have had no increase in funding for eight years, despite rising business
costs.
When asked whether it's fair or unfair that pharmacies in England are now paid less for providing NHS services than they were before the pandemic, 81 per cent of
people replied that it's unfair.
Preet Kaur Gill, Shadow Minister for Primary Care and Public Health, has paid a recent visit to a community pharmacy in Staffordshire to personally experience
the services it provides to patients, while staying updated on the latest sector developments.
Her visit to Eason's Pharmacy in Tamworth on September 22nd marked her first since assuming new responsibilities for pharmacy policy matters within Labour's health
team. Gill was also joined by a member of the National Pharmacy Association staff.
The Minister received a comprehensive briefing on Eason's Pharmacy from its third-generation owner, Kieran Eason (R). He outlined the NHS services, which include
the New Medicines Service and blood pressure monitoring, and showcased two consultation rooms and an operational dispensary.
"It's great that Preet came to learn firsthand about the challenges we face and the substantial potential of community pharmacies nationwide," Eason said. "As an
independent prescriber, I have the expertise to provide even more convenient care, but the current funding levels severely limit our contribution."
Community pharmacy bodies have said that the current crippling financial pressures and severe staff shortages will limit the sector from fully supporting the
new health secretary's ambition to improve patient care in England.
Thérèse Coffey announced her plans on Thursday (September 22) which would be looking to reduce the country's reliance on general practice by expanding the range of
services available from community pharmacies and allowing pharmacists more "prescribing powers".
"Pharmacists will be able to manage and supply more medicines, without a prescription from a GP. We will look to go further on enabling pharmacists with more
prescribing powers and making more simple diagnostic tests available in community pharmacy," she said in her foreword to Our Plan for Patients.
However, the National Pharmacy Association has lamented that the plan stops short of promising any fresh funding for community pharmacies to deliver patient care
and develop clinical services.
NPA vice-chair, Nick Kaye, said: "The life is being choked out of independent pharmacy businesses by the continuation of a fundamentally under-resourced contract
in England.
Alitam has announced that it has merged with clinical skills training provider MHRx to upskill UK pharmacists so that its chain of community pharmacies in the
UK can diagnose and treat minor medical ailments "quickly and safely".
This is a second merger deal announced by the group that has 100-plus pharmacies, just days after its merger with Pharmadoctor to "radically transform the UK and
Ireland's community pharmacy sector" into a truly preventative healthcare system.
Following the merger with MHRx, Alitam will now be providing a career development platform for its pharmacy teams, which also include nurses and other healthcare
professionals.
MHRx's training incorporates every aspect of general practice alongside relevant topics including making appropriate patient consultation records in line with NHS
guidelines.
This, Alitam believes, will allow community pharmacies to carry out formal diagnoses, formulate differential diagnosis plans, and perform full clinical examinations.
According to the founder and CEO Feisal Nahaboo, mergers such as these will lead to "a healthcare revolution predicated on building the world's first truly
preventative healthcare model".
On World Pharmacists' Day, the Council of the Pharmaceutical Society NI (PSNI) thanked pharmacists working in every sector of pharmacy in Northern Ireland (NI)
for their continued service to the public.
The theme of this year's International Pharmaceutical Federation's World Pharmacists' Day, (25 September 2022) was 'Pharmacy united in action for a healthier world'.
In acknowledgement of the day, Dr. Jim Livingstone, president of the Council of the Pharmaceutical Society NI said: "The theme of this year's World Pharmacists' Day,
'Pharmacy united in action for a healthier world' highlights pharmacy's positive impact on health around the world and seeks to further strengthen solidarity amongst
the profession.
"In Northern Ireland, pharmacy played a prominent role in primary health care throughout the pandemic and remains the public's most trusted and accessible frontline
health care profession.
"As pharmacy continues to develop additional services for the public and encompasses broader roles for pharmacists than ever before, it is essential, no matter what
pharmacy sector pharmacists practise in, that the Pharmaceutical Society NI's Code (Professional standards of conduct, ethics and performance for pharmacists in
Northern Ireland) remains at the core of pharmacists' practice. It is through this adherence to the Code, that pharmacy remains a united profession, providing
positive health outcomes for patients and maintaining public trust.
The Pharmaceutical Services Negotiating Committee (PSNC) will launch a new influencing campaign to build wider political support for community pharmacies
this week.
The campaign aims to ensure that MPs and Peers across Parliament understand the risks to pharmacy services that the current pressures on the sector are causing.
In a Parliamentary event held today (Tuesday 15 November) MPs and Peers heard from PSNC, LPC and other pharmacy bodies about the current situation.
PSNC briefed them on the urgent need for action to address the pressures on the sector.
The committee will be working with LPCs and contractors to organise a series of pharmacy visits for key Parliamentarians including Minsters, Committee and APPG
Members.
This is happening alongside work to develop a new vision and strategy for the community pharmacy sector, all of which is part of PSNC's strategy to lay the
ground for future CPCF negotiations.
The Company Chemists' Association (CCA) has published a 'pharmacy paradox paper' which outlines how community pharmacy can match the ambition amidst the
workforce crisis.
The sector is experiencing a workforce crisis, exacerbated by NHS recruitment of community pharmacists into primary care networks. Pharmacies are also facing a
significant increase in demand on services.
CCA said, "A stretched and reduced pharmacy workforce is having to deliver more and more. This is unsustainable."
"Unless the tension between ambition and capacity is addressed, there is a risk that community pharmacies will not only not meet their potential, but the existing
offer could be compromised."
Therefore, the association has set out solutions to resolve the current paradox between ambition and reality.
The National Pharmacy Association (NPA) has commissioned Professor David Taylor of University College London to investigate the implications of all-time high
inflation rates on community pharmacies in the UK.
Professor Taylor's will assess rates of inflation affecting community pharmacy across the UK, using public data sources whilst examining inflated costs in the
context of the current five year contractual framework in England (2019-2024).
He would review the EY (Ernst & Young) report into pharmacy funding, to identify whether current inflationary pressures could change any of the findings and
consider the policy implications and impacts of inflationary pressures, including pharmacy's ability to prepare for a more clinically focused future and maintain
current core services.
NPA chief executive Mark Lyonette said: "Inflationary pressures are eating into the limited funds provided by the NHS for pharmacy services. We believe the real
level of inflation for pharmacy businesses could be higher than the CPI inflation rate, which itself is at a 40 year high. Staff and locum costs in the sector as
well as medicines costs have risen dramatically.
Shortage of pharmacists remains a big challenge for community pharmacies as the chief executives of the national community pharmacy bodies met with senior NHS England and NHS Improvement officials to discuss the precarious situation in October-end.
In the last few months, several pharmacy contractors have reported increased staff shortages that caused difficulties in maintaining services, leading to temporary closures in some instances.
The sector is also facing chronic shortage of other staff including van drivers and pharmacy technicians.
During the meeting, NHS England's director for primary care, Ed Waller, and chief pharmaceutical officer Keith Ridge held talks with leaders from across the pharmacy sector on a variety of topics.
There is a state of "emergency" across the community pharmacy sector, the National Pharmacy Association (NPA) has warned.
The organisation is holding a day of protest action, called 'One Day to #SaveOurPharmacies', on 20 June to draw attention to the sector's growing crisis.
During the protest, pharmacy teams across the UK are expected to take a range of symbolic actions - such as turning the lights out for a period, asking their
staff to wear black, blacking out windows, using the day to engage with patients, inviting parliamentary candidates and using #saveourpharmacies on social
media - signifying dark times for the beleaguered community pharmacy sector, the NPA said.
The organisation decided to choose 20 June for the protest as it marks the day from which the average pharmacy across the four nations will be "lossmaking
overall."
PSNC has urged community pharmacy contractors and LPCs to engage with their local MPs on the immense pressures that pharmacies are facing.
The organisaiton has also published some new resources to help pharmacists in this regard.
"PSNC is deeply aware of the funding crisis affecting the sector and is working hard to increase the pressure on [the] government to act now with an urgent funding
uplift. This has included upping investment in influencing activities and working closely with LPCs to take united action," it said.
PSNC has last month launched its Four Point Plan to safeguard the future of community pharmacy, setting out how pharmacy could be the solution to a number of
problems if, and only if, it is properly funded, resourced and supported.
As pressures continue to mount, further briefings now focus solely on the urgent need to resolve the funding squeeze in order to protect existing pharmacy services.
The Pharmacy Supervision Practice Group consisting of members from AIMp, APTUK, CCA, NPA, PDA, PFNI and RPS held its fourth workshop to continue discussions
on the future modelling of pharmacy practice.
The ideas around 'supervision' shared by the organisation earlier formed the basis of the discussion during the workshop and helped to expand understanding of where
there was consensus and disagreement.
Examples of ideas explored during the workshop include: the extent to which a pharmacist should supervise the medicines assembly process, the purpose and extent to
which a pharmacist might be absent from the pharmacy and how this might affect patient safety as well as the nature of whether fixed rules versus a broad framework
were preferable for future practice.
Chair of the group, Dr Michael Twigg, Associate Professor of Primary Care Pharmacy, University of East Anglia, said "Once again the sector bodies have come together
in a collaborative and positive manner to explore the concept of 'supervision' in the context of current and future community pharmacy practice. This session provided an opportunity to constructively challenge assumptions and viewpoints within the group with the aim of moving the discussion forward."
As part of the session, the DHSC, GPhC and PSNI gave an overview of the difference between legislation, regulation and guidance which was helpful to inform the
group's thinking. Each of the organisations have been asked to use the conversation to refine the ideas presented in advance of the next workshop.
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."
The Community Pharmacy England (CPE) has called the recent announcement of six per cent pay rise for the public sector workforce as 'unfair' for the
community pharmacy sector.
On Thursday (13 June), the Department of Health and Social Care (DHSC) announced that pay scales for most doctors and dentists will increase by at least a
six per cent this year after the government accepted the recommendations from the independent pay review bodies in full.
Responding to the recent announcement Chief Executive Janet Morrison, said: "The public sector workforce pay rise will be welcome news for its recipients given
the huge inflationary pressures and the ongoing impact of the cost-of-living crisis. But for community pharmacy owners - who have faced 30% funding cuts in recent
years and who are struggling to meet their rising wage costs - this feels unfair, and very far from good news.
At Community Pharmacy England we are fully focused on the current financial and operational pressures and fighting hard for a sustainable long-term funding
arrangement.
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.