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The National Pharmacy Association (NPA) has raised concerns over the upcoming increase in the National Living Wage, saying it will make things even worse for local pharmacies already facing nearly a decade of cuts in real terms. Scheduled to go up from £10.42 to £11.44 per hour starting April, the National Living Wage rise is expected to put a lot of financial pressure on many pharmacies. The NPA says "it will cost them over £10,000 in salary bills, and for some, even more, without getting more from the NHS funds. and has asked the government to deal with the ongoing problem of underfunding for community pharmacies. The association has warned that without additional funds, pharmacies could face staff layoffs or reduced services to cover the increased wages, calling for a "comprehensive new funding deal to prevent further closures of vital local services, which have been shutting at the rate of eight a week."

NHS England has mandated a business continuity plan for pharmacies dealing with temporary closures from the end of this month. Community Pharmacy England (CPE) has put together a briefing and a template plan to help guide pharmacy owners through the process. It explains what is required in the plan, describes how and when to implement it, and outlines some additional considerations. "This could be added as an annex to your pharmacy's existing business continuity plan. A checklist has also been added, which may be used in the event of a temporary suspension," said CPE. "NHS England will be publishing the approved particulars shortly. NHS England is also still to publish guidance on the amendments to the Pharmaceutical Regulations that came into force on 25th May, which will include guidance on these requirements.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."

The recruitment of pharmacists in Primary Care Networks (PCNs) has exacerbated a general shortage of pharmacists, revealed an independent review of Integrated Care Systems (ICSs) published on Tuesday (4 April). The review, Rt Hon Patricia Hewitt, highlighted the impact that the Additional Roles Reimbursement Scheme (ARRS) roles for pharmacists are having on the community pharmacy sector. "Contracts with national requirements can have unintended consequences when applied to particular circumstances. For instance, the national requirements and funding of Additional Roles Reimbursement Scheme (ARRS) roles for community pharmacists within PCNs, has on occasion exacerbated the problem of a general shortage of pharmacists, with some now preferring to work within primary care rather than remain in community pharmacies or acute hospitals, compounding the problem of community pharmacy closures and delayed discharges." It set out to consider the oversight and governance of ICS in England and the NHS targets and priorities for which Integrated Care Boards (ICBs) are accountable, including those set out in the Government's mandate to NHS England. As part of this work, Hewitt and her team engaged with a wide range of stakeholders representing various local health and social care settings, including LPCs.

The National Pharmacy Association (NPA) survey revealed that 93 per cent of respondents experienced 'at least one month' of negative cash flow across their pharmacy business in 2022. Nine out of 10 pharmacy owners responding to NPA survey said they made a net loss dispensing medicines for the NHS during 2022, for at least one month of the year. According to the poll, 48 per cent of them lost money on this core NHS service for six months or more. 45 per cent said their overall outgoings had exceeded overall income in at least six months of the year. NPA Chair Andrew Lane said: "This survey shows the bleak financial reality facing many independent pharmacies after years of underfunding. Dispensing at a loss and negative cashflow is clearly unsustainable." "This funding crisis must be addressed urgently or pharmacies will fall into a spiral of declining services and ultimately widespread closures, he added. "Tragically, the story is playing out very much in line with independent research commissioned by the NPA last year, which warned of a nationwide financial emergency in our sector."

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."

At the recent 'Locum Matters' online event held on June 25, 2024, members of the Pharmacists' Defence Association (PDA) discussed critical issues facing locum pharmacists, with a disturbing trend taking center stage: employers pressuring locum pharmacists to accept lower rates under the threat of potential pharmacy closures. The event, organised in response to feedback from PDA locum members, addressed a range of significant topics including training for the recent Pharmacy First Services, respect for professional autonomy, and the need for adequate rest breaks. However, the issue of rate pressure and pharmacy closures was a focal point. Several locum pharmacists reported that some employers were leveraging the possibility of pharmacy closures to coerce them into working for lower pay. This unethical practice has raised alarm within the locum community, highlighting the precarious working conditions many face.

Community Pharmacy England (CPE) Chief Executive, Janet Morrison met with the new Pharmacy Minister, Dame Andrea Leadsom MP this week and discussed a range of critical topics, including funding and pressures. Janet informed the minister that community pharmacies continue to face immense financial pressures, and highlighted the need for an improved core contract. She told the minister that 35-50 per cent real term cuts and rising costs have led to closures, consolidations and cashflow. This has weakened the capacity for the network to respond to displaced patients, increased risk in terms of the safety of medicine supply, and led to loss of service for communities in the most deprived areas, she said.

The NHS England and Improvement has announced the emergency provisions introduced during pandemic to provide flexible opening hours for pharmacy contractors end today. The flexibilities were enacted in March 2020 when changes to the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 were made following a declaration of emergency at the height of the Covid-19 pandemic. Since March 2020, the flexibilities have permitted temporary opening hours and closures during a specified period due to a genuine Covid-19 related emergency. NHS England and Improvement has advised pharmacy contractors that the emergency declaration will not be extended further and will expire on 31 March 2022. Pharmacy contractors will therefore no longer have the option to close pharmacies within their agreed contracted hours with the NHS.

Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling it "the biggest dis-service ever done" to community pharmacy. The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years. This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector. The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework. The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she assured everyone that the committee was well aware of the pressures the sector was facing. "I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce crisis is critical, leading to temporary closures.

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?

The Pharmacists' Defence Association (PDA) has created a form to help locum and other pharmacists to report about breach of NHS contract by community pharmacy. According to the association, they have been told by increasing number of pharmacists about contractors closing pharmacies, despite a locum readily available to cover the shift. The PDA said this is an issue of NHS contractual breach and creates difficulties for patients, and so they have created the form to assist members to report unnecessary closures to the relevant NHS England & Improvement pharmacy contract team. A locum pharmacist, who does not wish to be named, has alleged that a community pharmacy declined their offer to cover an extra shift for £5 more per hour, and decided to close the store, denying the public access to services. The pharmacist recalled the occasion while writing in the PDA's latest member voice article.

The PDA has raised concerns over the 'deliberate breaches' of the NHS contract by some community pharmacy businesses, saying that it may cause harm to patients and damage the reputation of the profession. The organisation said concerned pharmacists have revealed to them that some businesses are now explicitly saying that if locums will not agree to work for less than a so-called 'maximum' hourly rate, the business will close the pharmacy for either part of, or the whole day. Some of these full or part-day closures are being communicated significantly in advance of the actual day, it added. The union further alleged that several pharmacy businesses seem to have simultaneously implemented identical so-called 'maximum rates' in what could be an anti-competitive behaviour.

The National Pharmacy Association (NPA) has welcomed the Chancellor's commitment to increase the NHS budget, hoping that 'community pharmacies benefit from this investment'. The association is urging the government to address years of underfunding so that community pharmacies can avoid staff lay-offs to cover the increasing costs of the national living wage. The government's uplift of the National Living Wage was confirmed in its latest budget announcement to tackle the cost of living crisis. The NHS budget will also be increased in each of the next two years by £3.3bn. A recent NPA commissioned report by Professor David Taylor from University College London predicted that wage inflation and other cost pressures could combine with funding cuts to lead to cut-backs and pharmacy closures.

Over a century-year-old Boots pharmacy in St James's Street, Brighton shut its doors permanently on Saturday (20 January) leaving the communities disappointed. The branch in Kemp Town, which was opened to the public for the first time in 1914, was supposed to close on November 19 last year but continued trading into the new year, The Argus reported. Locals are not happy with the retailer's decision to close the store as some say it used to be "always busy with prescriptions and people buying things." Another person recalled that Boots had earlier closed two pharmacies, one on Lewes Road, Brighton, and another on Church Road, Hove. The American-owned health and wellbeing chain is in the process of closing more UK branches in the coming months as it's targeting to reduce its store portfolio to 1,900 from 2,200.

The Company Chemists' Association (CCA) says the data from the 'Locate a Locum's annual report' has revealed that the average locum rate rose by 124 per cent in Scotland in 2021 compared to the previous year and that the trend seems to have continued since. According to the report, in Scotland, the average rate has risen from £20.08 to £44.89 which is a massive £24.81 difference. This was in response to the pharmacists Defence Association (PDA)'s statement on 15 times more closure of pharmacy in Scotland by a CCA member. "This clearly demonstrates that demand for pharmacists in Scotland is outstripping supply," said the association. Explaining further, it said: "Our members have been serving Scottish communities and patients without issue for decades. Recent pressures, however, are unprecedented. Workforce challenges are affecting all parts of healthcare across the UK - and community pharmacy is no different. Pharmacists remain on the Home Office's shortage occupation list for this reason."

Pharmacies lead among the list of 16 'most essential' services required for a neighbourhood, as revealed by the 2023 Community Barometer survey commissioned by the Association of Convenience Stores. In June, ACS commissioned Yonder Consulting to conduct a poll surveying the opinions of 1,000 people across the UK. The survey assessed how these individuals value 16 different services in their local area, defined as the region within a 15-minute walk from their homes. The survey's essential services included pharmacies, post offices, convenience stores, banks, petrol stations, restaurants, coffee shops, pubs, specialist food shops, non-food shops, fast food shops, vape shops, charity shops, pawnbrokers, hairdressers, and gyms or sports facilities.

Tesco, one of the leading pharmacy chains in the UK, has been allegedly accused of forcing some locum pharmacists to accept lower rates or it will cancel their booking. The issue has been brought to the notice of the Pharmacists' Defence Association (PDA) by some of its locum pharmacists members. "Some locum pharmacists who had existing confirmed bookings at Tesco stores have reported to the PDA that the company has contacted them to say that if they do not agree to accept lower rates than have already agreed, the company will cancel their booking," said PDA. "The reported messages follow a communication from Tesco setting self-imposed so-called "wage rates" for locums. This is confusing as locums are self-employed and therefore should be able to negotiate rates with their clients just as any other independent supplier can do. Using terminology such as "wage rates" is more indicative of an employer-employee relationship and could undermine the status of the locum market in community pharmacy. Employees are also entitled to various extra benefits and have greater employment rights."

London's Great Ormond Street Hospital and Alder Hey Children's Hospital in Liverpool are poised to introduce groundbreaking gender-related services in England, following the closure of the Gender Identity Development Service (Gids) operated by the Tavistock and Portman NHS Foundation Trust. Amid concerns expressed by hospital executives regarding the closure of Gids, with leaked emails revealing apprehensions about appointment cancellations and inadequate communication with the new services, the National Health Services England (NHSE) has confirmed "its commitment to ensuring continuity of care for patients already accessing endocrine care in GIDS." NHSE's decision to transition to regional services stems from a 2022 interim review, led by Dr. Hilary Cass, which highlighted the need for improved support structures for gender-distressed youth. It emphasized a significant increase in referrals to Gids, surpassing 5,000 in 2021/22, compared to less than 250 a decade ago.

The Pharmacists' Defence Association (PDA) is probing major concerns arising from Boots' communications to pharmacists regarding the company's recently announced pension arrangements. In November, Walgreens Boots Alliance (WBA), the parent company of Boots, transferred the Boots employees' pension scheme to the financial service provider Legal and General (L&G) in a £4.8 billion deal. Boots notified staff that terms allowing an unreduced pension from age 60 have ceased immediately, following its agreement with L&G. The PDA highlighted member concerns regarding Boots management's announcement that an unreduced pension from the age of 60 is a discretionary benefit and not guaranteed under the Boots Pension Scheme (BPS), contrary to some members' assumptions.