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Health and Social Care Secretary Sajid Javid and Madelaine McTernan, head of the HRT supply taskforce, continue to take urgent action to resolve the shortage of HRT medicines by meeting the drug manufacturers and representatives from community pharmacies on Thursday (May 5). In the meeting, manufacturers outlined the steps they're taking to boost supply, and pharmacists shared their experiences on the frontline, as well as sharing their thoughts on wider solutions including improved communications. Aspen Pharmacare, Besins-Healthcare, Gedeon Richter, Novartis, Novo Nordisk, Orion, Pfizer, Theramex, Viatris, and representatives from community pharmacies were part of the meeting. As the government confirmed its intention to work with industry to do what is necessary to fix the HRT supply issue, Javis said he wanted to understand the issues facing suppliers and what can be done to address them. "We will leave no stone unturned in our national mission to boost supply of HRT. Along with appointing Madelaine McTernan as head of the HRT supply taskforce to implement lessons learned from the pandemic, and ensuring prescriptions are issued in shorter cycles for now, we are working collectively with the sector to urgently resolve this issue," he commented. The Association of Independent Multiple Pharmacies (AIMp) said the meeting discussed 'why we got into this position' and the way forward.

National Pharmacy Association (NPA) urged the NHS England to make local impact assessment a key requirement prior to any recruitment into Primary Care Networks (PCNs) and Clinical Commissioning Groups (CCGs), to help tackle workforce crisis. With inputs from LPCs, PCNs and CCGs should consider the impact of the creation of new roles on all health care providers in the area and on their ability to deliver their objectives on behalf of the NHS, it said. The NPA believes that creation of the Additional Roles Reimbursement Scheme (ARRS) programme is impacting community pharmacy services in some areas and contributing to the ongoing workforce shortage. In a letter addressed to Ed Waller, director of Primary Care for NHS England, NPA chief executive Mark Lyonette highlighted the challenges emerged following a shortage of pharmacists and other members of staff.

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.

The National Pharmacy Association (NPA) highlighted the role played by community pharmacies during pandemic to provide urgent care and vital support to people with long-term medical conditions at its opening remark in the Covid-19 public inquiry held on Tuesday (28 February). NPA is the core participant in the Covid-19 public inquiry. lawyer Brian Stanton made an opening statement on the NPA's behalf which focused on three areas- health inequalities and the needs of vulnerable patients; the impact of medicine shortages and medicine price increases and the challenge that community pharmacy faced in responding to the pandemic and maintaining patient services following long-term under investment. Stanton said: "The UK's community pharmacies were on the frontline of efforts to limit the impact of coronavirus and to keep people well, and as well as handling a massive increase in demand for healthcare advice and medicines, they also continued to provide urgent care and vital support to people with long-term medical conditions. "However, there are now very many at risk of closure during to underfunding and when the Inquiry comes to consider its recommendations the NPA would encourage you [the presiding judge] to think about how resilience can be built into future plans." The statement included a compelling account of the commitment typical of so many pharmacies during the pandemic - from husband and wife Pete and Sukhi Johal, both NPA members and pharmacists, who co-own Calow Pharmacy in Chesterfield.

The Department of Health and Social Care (DHSC) has issued a further five new Serious Shortage Protocols (SSPs) for Phenoxymethylpenicillin (Pen V) to enable the continued supply of antibiotics to patients. "The new SSPs, introduced with immediate effect, allow community pharmacists to consider different oral antibiotic preparations, to enable the continued supply of antibiotics to patients and mitigate the ongoing supply disruptions affecting Phenoxymethylpenicillin," said DHSC. On Friday (16 December) SSP043-SSP047 has been authorised by the Secretary of State to provide pharmacists with procedures to follow in providing suitable alternative oral antibiotics to substitute Phenoxymethylpenicillin. "For each SSP, DHSC has included specific patient counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient."

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

Following Community Pharmacy England's Parliamentary drop-in event on medicines supply issues last week, several MPs have since raised questions to the Health Secretary during a Health Questions session on July 18th. According to CPE, MPs from all Parties displayed great engagement with the current pressures facing community pharmacies, particularly regarding medicines supply issues. During last week's event, Mike Amesbury, the MP for Weaver Vale, was present and directed a question to the Health Secretary: "Eighteen community pharmacists in my constituency are reporting challenges with medicine supplies. What further actions will the Minister take to address and resolve this situation effectively?" In response, Health Secretary Steve Barclay MP stated, "We have a dedicated team in the Department that focuses on medical supplies, which are an ongoing concern. Challenges in this area are a routine part of our business."

The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce. The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit. Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited to general practice: community pharmacies are also suffering the consequences of it." "Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to make ends meet, not least given the rising staffing costs which are being driven up by workforce issues. Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

The Department of Health in Northern Ireland has announced an immediate intervention worth over £5.3m in value, and a commitment to progress wider reform arrangements in collaboration with the Community Pharmacy NI (CPNI) to support pharmacies to deal with the ongoing pressure. The Minister and Department are 'very aware of the pressures facing community pharmacies'. They discussed the situation with CPNI representatives at a meeting last week. The scale of the unprecedented budgetary pressures and uncertainty currently facing the Department were spelt out. The Department said: "Notwithstanding these pressures, CPNI were informed that a support package for their sector was being finalised. This package includes immediate interventions worth over £5.3m in value, plus a commitment to progress wider reform arrangements in collaboration with CPNI." Recently, the CPNI highlighted that community pharmacists have issued a stark warning that shortages and skyrocketing prices of many medicines could result in pharmacies being unable to supply important prescription medicines to patients.

In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising issue of medicines supply. "Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary. In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area." The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why will they not do so?

Labour's Paulette Hamilton has raised concerns regarding the increasing reliance on pharmacy technicians in clinical practice due to staffing shortages within pharmacies. At the recent Pharmacy Inquiry session, Hamilton highlighted the mounting pressure on technicians to take on more responsibilities beyond their qualifications, attributing it to the launch of Pharmacy First in January. With almost 50,000 Pharmacy First consultations conducted in the first month alone as per a report by the Company Chemists' Association, Hamilton expressed apprehension about technicians being classified under the broad term of "pharmacy professionals," blurring the distinction between their roles and those of clinical pharmacists. She further drew parallels between this situation and the scrutiny faced by physician associates (PAs) in GP practices following a patient's death due to misdiagnosis and cautioned against technicians performing tasks beyond their expertise and urged policymakers to prevent similar incidents in pharmacy settings. Health Minister Dame Andrea Leadsom responded by defending the current approach, denying any "blurring of the edges" and emphasizing patient safety as the top priority.

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".

The Company Chemists' Association (CCA)'s research has found that between 2015 and 2022 more than 40 per cent of permanent community pharmacy closures took place in the 20 per cent most deprived parts of England. The association has analysed the NHS data and found that between 2015 and 2022, 808 pharmacies closed permanently in England. In that period, only 138 new pharmacies opened - a net loss of 670 community pharmacies. It also examined where permanent closures had taken place. "41% of net permanent closures had taken place in the top 20% most deprived areas in England. Meanwhile, only 9% of net permanent closures took place in the top 20% least deprived areas." Although the latest figures for 2021/22 suggest that the overall rate of closures may be slowing down, the proportion of pharmacies permanently shutting in more deprived areas has only increased. An even larger share of pharmacies that permanently shut in 2021/22 occurred in the most deprived areas compared with the previous fiscal year: 44% of net closures took place within the bottom two IMD deciles.

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".

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).

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 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 PSNC on Friday said it has warned the DHSC about the "very serious impact" of the limited supply of certain antibiotics on pharmacies who are "having to chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse." With higher than usual number of cases of scarlet fever, caused by invasive Group A Streptococci (iGAS) infections, being reported in children across the country, supplies of antibiotics for Group A Strep treatment have seen a surge in demand, leading to limited supply at certain wholesalers and pharmacies. PSNC has urged the DHSC to adopt measures that could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations without prescriber approval, outside of Serious Shortage Protocols. It has also raised concerns on the significant rise in wholesale prices of many oral antibiotics as a result of the surge in demand and the ongoing supply disruptions. PSNC also said they have received reports of some suppliers putting up their prices for any oral antibiotics they do have in stock.

The Pharmaceutical Services Negotiating Committee (PSNC) has called for improved workforce planning to be undertaken by the government and NHS. However, for this to happen, it added, "high quality workforce data for community pharmacy needs to be available." For this reason, the Department of Health and Social Care (DHSC), NHS England and PSNC have agreed that it will be a Terms of Service requirement for contractors to complete the annual Health Education England (HEE) community pharmacy workforce survey, which will then provide a full picture of the community pharmacy workforce, including identifying the number of vacancies and regions where these are particularly hard to fill. PSNC said: "It is acutely aware of the challenges that contractors and their teams are currently facing, so in recognition of the workload associated with completing the annual workforce survey, we have negotiated with DHSC and NHS England that the requirement to undertake an annual patient satisfaction survey will be removed from the Terms of Service from 1st October 2022." This means that contractual requirement will no longer apply to contractors in 2022/23 and going forward.

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.