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.
The Health Committee's new report has reminded the government of a much-needed pharmacy workforce plan to support recruitment, training, and retention of staff.
The report makes a number of recommendations to optimise workloads across primary care, reduce pressure on general practice and hospitals, and support the integrated
care systems.
It also recognises the potential of pharmacist independent prescribers to support patient care, backed by appropriate supervision, training, and opportunities for
professional development.
RPS England gave evidence to MPs on the Committee at a public hearing in May, highlighting key issues to support the pharmacy workforce.
RPS director for England, Ravi Sharma, said: "Today's report underlines the urgent need for the Government to set out a comprehensive workforce plan for health and
care.
"It rightly recognises that boosting recruitment and retention, supporting staff wellbeing, fostering inclusion and diversity, and investing in education and
training will be crucial to the future of the NHS.
Pharmacy technicians will soon be recognised as fully regulated healthcare professionals in North Ireland.
Work has begun to bring pharmacy technicians under statutory regulation by the Pharmaceutical Society of Northern Ireland, health minister Robin Swann has announced.
The public consultation was launched in March 2022 on a proposal to introduce statutory regulation of the Pharmacy Technician workforce in Northern Ireland.
The minister said: "This will be a key enabler to enhancing the contribution that pharmacy technicians can make to the delivery of healthcare across all settings.
It will allow the regulator to strengthen its role in protecting patients and promoting high standards, thereby enhancing the public's confidence and trust in
pharmacy practice."
He added: "While there are many practical issues to be worked through with stakeholders, and legislative change required, I have now instructed my Department's
officials to develop a detailed project plan to bring about the statutory regulation of pharmacy technicians by the Pharmaceutical Society of Northern Ireland".
The National Pharmacy Association has announced the theme for this year's 'Ask Your Pharmacist Week' campaign - 'Meet Your Local Pharmacy Team'. The campaign,
scheduled for October 30 to November 6, seeks to enhance awareness of pharmacy services and initiate dialogues with local stakeholders, highlighting the role and
advantages of community pharmacy, the NPA said in a statement.
NPA has organised an array of promotional activities, spanning window displays, social media engagements, partnerships with patient groups, radio and TV interviews,
and visits to pharmacies by local dignitaries and politicians during the week.
"AYP Week 2023 will acquaint individuals with the pharmacist's skill set and the broader community pharmacy workforce, showcasing their collaborative efforts in
delivering a secure and efficient service, encompassing NHS clinical care," said Stephen Fishwick, NPA's Head of Communications. "As always, the NPA will furnish
campaign resources for our members and other participants interested in engaging with this enduring initiative."
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.
The Royal Pharmaceutical Society (RPS) and Pharmacist Support hosted a roundtable on the impact of pharmacy workforce wellbeing on patient safety on Wednesday
(17 May).
It also released its annual Workforce Wellbeing Survey which showed continued pressures on pharmacy teams.
The discussion explored the actions needed to support staff so they can continue providing safe and effective patient care and included representatives from the NHS,
professional bodies, employers, trade unions, education and regulators.
A report of the roundtable will be published in the summer.
Amandeep Doll, RPS Head of Professional Belonging, said: "We know that pharmacy teams go above and beyond for their patients, but are also under enormous pressure.
"Now more than ever, we need to strive to make the pharmacy profession more inclusive and ensure that everyone's wellbeing is supported.
"It is vital that we do all we can to encourage people into pharmacy and to support them so they can enhance their skills, develop their careers, and continue to
deliver high-quality patient care.
"This discussion was a welcome step and showed that making a difference for staff wellbeing requires a concerted effort from stakeholders across the whole of pharmacy.
Despite the challenges confronting pharmacy owners and their teams today, many in the industry hold the belief that the future for community pharmacy is
promising.
In a poll conducted at the beginning of the Pharmacy Business Conference 2024, 58 per cent of participants agreed that the future of community pharmacy is
positive, with 13 per cent expressing strong agreement.
However, 27 per cent expressed disagreement, with 3 per cent strongly disagreeing that the sector's future is optimistic.
By the end of the conference, a higher percentage of individuals (67 per cent) showed a positive outlook for community pharmacy, with over half indicating
strong agreement with its positivity. The number of participants who disagreed with it decreased to 11 percent.
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."
The Company Chemists Association (CCA)'s workforce finding showed that by 2024 eight years' worth of growth of the pharmacist workforce will have been
funnelled away from community pharmacies.
"In 2019, when NHS leaders realised they were unable to find enough GPs to meet the public's needs, they hastily decided to recruit pharmacists and other
healthcare professionals to fill the gaps. This was implemented without any corresponding efforts to increase the supply of pharmacists, creating huge shortages,"
said CCA.
"The bulk of the NHS's recruitment drive was paid for using additional money ringfenced by the NHS - the £2.4bn Additional Roles Reimbursement Scheme (ARRS). We
estimate over the life course of ARRS funding (2019-2024), the equivalent of eight years of growth in the number of pharmacists in England will have been funnelled
directly into primary care at the expense of other sectors.
At the current rate, CCA estimate that community pharmacy will have experienced the equivalent of three fallow years by 2024.
To ensure the pharmacy network is protected and able to take pressure off other parts of the NHS, there are several urgent measures which must be implemented.
Countering the impact of primary care recruitment: Community pharmacists should be commissioned to provide 'packages of care' on behalf of GPs, rather than taking
pharmacists away from accessible high street settings.
Since the introduction of the 2019 NHS Long-Term Plan, several policy commitments have surfaced, presenting a definitive 'blueprint' for community pharmacy
in England. The Company Chemists Association has identified four crucial commitments that, when integrated, hold the potential to revolutionise patient care
through community pharmacies.
"Each commitment is like a crucial piece of a puzzle," CCA said. "For the transformation of patient access through community pharmacy to be successful, all these
pieces must come together harmoniously. Otherwise, the picture will remain incomplete."
The four major pieces of the puzzle coined by CCA include:
* Building on education and training reforms to increase the size and capability of the workforce.
* Expanding the number of clinical services commissioned and delivered in community pharmacy.
* Introducing digital enablers which underpin service delivery.
* Introducing legislative changes to increase capacity and allow the delivery of more patient-facing clinical care.
There is clear evidence that the majority of distance selling pharmacies are operating in breach of their NHS contracts, and a failure to properly
regulate 'pseudo' distance selling pharmacies is leading to local pharmacy closures, the Company Chemists' Association has reported.
According to the CCA's recent findings, 72 per cent of DSPs dispense over 50 per cent of their prescriptions to patients within a single postcode area within
10 miles of the pharmacy.
"Operating within constrained geographical regions, pseudo-DSPs achieve reduced overheads and operational costs by focusing on localised marketing and medicine
delivery. They compete against local brick-and-mortar pharmacies, causing them to lose vital trade," the CCA claimed, based on its recent survey - The Impact of
Pseudo Distance Selling Pharmacies.
"As per their terms of service, DSPs are obligated to provide prescription delivery nationwide, extending beyond local patients," said the CCA, adding that the
financial savings resulting from the lack of patient access are balanced by the necessity to function on a national scale.
Pharmacies have administered more than five million flu vaccinations under the national flu vaccination service in 2022/23, revealed the advanced service flu
report published by the NHS Business Services Authority (NHSBSA).
According to the report, 5,007,578 million vaccinations has been administered by community pharmacies in 2022/23. Whilst in 2021/22 the total number of vaccines
administered in community pharmacies was 4.85 million.
The service has continued to achieve year-on-year growth in the number of vaccinations administered since it launched in 2015.
Commenting on the end-of-season figures, Alastair Buxton, Director of NHS Services, Community Pharmacy England said: "This season's flu vaccination figures are yet
another example of the incredible contribution that our members and their teams make to protect the public and the NHS as part of a key public health programme.
"Given the significant financial and workforce pressures that our members continue to face, this year on year growth is a fantastic achievement and a testament to
their hard work and dedication.
Community Pharmacy England (CPE) has launched its third annual Pressures Survey to uncover the various challenges encountered by individuals owning or
working in a community pharmacy.
The Committee expressed concern that community pharmacies in England are now in a critical situation, significantly affecting workload, stress levels, patients,
and businesses.
The 2024 Pharmacy Pressures Survey is aimed at finding out more about these issues and other areas such as medicines supply problems and workforce challenges as
well as the recently launched Pharmacy First service, it said.
CPE chief executive Janet Morrison said that they were able to receive a huge number of responses in previous surveys and they are expecting to achieve a similar
level of engagement this year too.
The Royal Pharmaceutical Society's (RPS) second roundtable on workforce wellbeing resulted in a series of collaborative actions to address pharmacy
professionals' mental health and wellbeing challenges.
The roundtable brought together key stakeholders from the pharmacy sector, including organisations like the General Pharmaceutical Council (GPhC), Community
Pharmacy England (CPE), the National Pharmacy Association (NPA), and the profession's independent charity Pharmacist Support (PS).
A report detailing the outcomes of the meeting was published on Friday, highlighting the key areas of discussion and the agreed-upon actions by the participants.
During the roundtable, participants discussed the importance of understanding the workforce demographics, both nationally and locally, and using data to address
wellbeing issues effectively.
They also emphasised the need for using supportive standards set by the General Pharmaceutical Council (GPhC) and the Care Quality Commission (CQC) quality
statement to support and empower pharmacists' wellbeing positively.
The National Pharmacy Association (NPA) has called the future prime minister to deliver on the commitments made by the previous health secretaries to reform
primary care through a 'pharmacy first' approach and fairly fund community pharmacies to avoid closures.
In an open letter, the NPA has urged Rishi Sunak and Liz Truss, the two leadership contenders of the Conservative Party and prime ministerial candidates, to think
radically about the role of England's 11,000 pharmacies, which are on the frontline of healthcare across the country.
NPA also highlighted how pharmacies could help clear the NHS backlog, free up millions more GP appointments, dramatically improve access to primary health care and
do more to prevent ill health and support people with long term medical conditions.
"Because of our unparalleled presence in deprived areas, we also have great potential to level up access to healthcare and address health inequalities. We set these
ideas out in How We Can Help, which is an improvement plan already welcomed by many of your colleagues."
The National Pharmacy Association (NPA) has called on the NHS England to uplift funding for pharmacy contractors to enable them to cover higher staffing costs
along with a range of other cost-inflating factors.
This follows latest data released by the recruitment platform Locate a Locum, which showed a huge increase in locum rates for pharmacists in 2021 and predicted the
trend to continue.
The report noted a 71 per cent surge in the cost of employing locum pharmacists in England, from the 2020 average to the second half of 2021.
NPA chief executive Mark Lyonette said: "There is a heavy reliance on locums in community pharmacy to maintain continuity of services with the average pharmacy
operating 50 hours per week. Consequently, increases in locum rates have a big effect on the cost base.
"Pharmacies face a range of general cost pressures beyond locum rates, including much higher energy costs. We hear a lot about the cost of living crisis; our
members are facing a cost of doing business crisis and it's every bit as real.
"The underlying underfunding, significant general inflationary pressures and specific cost increases relating to the locum workforce together make a powerful and
urgent case for new funding."
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.
An executive director of Day Lewis and also board director and member of Association of Independent Multiple pharmacies (AIMp) Jay Patel highlighted the key
issues and on ground challenges faced by the community pharmacies in a meeting hosted by Prime Minister Rishi Sunak and health secretary Steve Barclay in Downing
Street on Saturday (January 7) to tackle the NHS pressure.
In his interview with BBC, he said: "He (prime minister) was very engaging and trying to understand the key issues and practical challenges on the ground."
Patel described the meeting atmosphere as 'collaborative and proactive', and said, "people were genuinely asked their options and there were listeners too."
On BBC, answering to a question on 'how community pharmacies can alleviate the NHS pressure?', Patel said: "Pharmacies is the workplace for this. We have trust of
our patients; we have high skilled workforce both clinically and professionally. One of the opportunities we have is working around the acute treat
Pharmaceutical Services Negotiating Committee (PSNC) has asked the government and the NHS to give more support to all community pharmacies as they gear up for "an extremely challenging winter period."
During talks with NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC) last week, PSNC highlighted that contractors are already under pressure because of workforce crisis, capacity issues and escalated staffing costs.
all these factors could pose a bigger challenge during the busy winter season, it said.
Though PSNC supported the government's aim on booster vaccinations and approval of more pharmacy sites, it expressed concerns over the impact of the vaccination drive on all community pharmacies.
To ease the pressure on pharmacies, the negotiator has sought additional support through regulatory measures, the removal of administrative burdens and changes
to the current Pharmacy Quality Scheme (PQS).