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.
It's no secret that as pharmacists we are navigating a new and more demanding healthcare landscape. Our role has changed significantly since the start of the 21st century due to increased expectations from the public, advances in science and technology and changing workforce pressures.
The Community Pharmacy Contractual Framework for England has placed a higher focus on clinical service. In addition, the Covid-19 pandemic resulted in significant
acceleration in changing how we work day-to-day and the public perception of our role.
Community pharmacy owners and staff have been under relentless pressure for the last two years. Dispensing volumes are continually increasing but dispensing revenues
are being replaced by launching new services. We must find solutions to reduce the time it takes to dispense medication so we can focus on these new revenue generating services.
To not just succeed, but to thrive, it is becoming increasingly important to understand and embrace the technology available.
Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015.
It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders.
The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector.
The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a
result, maintaining prescription and medication adherence services is challenging to say the least.
Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report
launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local
pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services
since the start of COVID.
This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported
clinically by pharmacists.
This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations
a year - a staggering rise of 44 per cent in the last 24 months alone.
With the Pharmacy First services scheduled for launch end of this month, legislators explored the potential of community pharmacies to offer specific
diagnostic and treatment services in the second public evidence session of pharmacy inquiry this week (January 16).
The new service, which will enable pharmacists to offer advice and prescribe treatment for seven minor ailments, is expected to alleviate the pressure on the
NHS, reduce GP workload, and cut waiting lists.
But MPs and healthcare leaders also acknowledged that there's hesitancy and the mindset of 'GP first, not Pharmacy First' among members of the public.
"We must accept that many patients are used to seeing their GP as their first port of call for many health conditions. Pharmacy First is welcome, but there are
going to be some restrictions on how quickly some patients will want to take up some of those services, rather than seeing their GP," said William Pett, Head
of Policy, Public Affairs and Research, Healthwatch England.
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.
The Health Select Committee Expert Panel has concluded in its report published on Tuesday (25 July) that the funding aspect in the community pharmacy sector
'requires improvement' based on the evidence received.
The Expert Panel reviewed nine Government commitments, seven of which were from the Community Pharmacy Contractual Framework.
It was found that available funding was not sufficient to keep pharmacies open, struggling financially with increased demand for dispensing, workforce pressures
and rising costs due to inflation. One of the other commitments requiring improvement covered a scheme intended to protect access to local physical NHS pharmaceutical
services in areas where there were fewer pharmacies.
Professor Dame Jane Dacre, Chair of the Expert Panel, said: "Pharmacy plays a key role in the delivery of care so it's disappointing that progress overall to
deliver on the Government's commitments was rated as 'requires improvement'.
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 National Pharmacy Association (NPA) has announced that the Chief Pharmaceutical Officer for England, David Webb will be among the keynote speakers at the
Pharmacy Odyssey Conference on 13 October.
He and other special guests will discuss the future of community pharmacy within the NHS, during a day of insight and practical advice for pharmacy teams.
The NPA promises expert opinion on the current pressures in the sector and a thorough exploration of the long-term picture.
NPA Director of Membership, Simon Tebbutt, explains: "With the NPA centenary in 2021 behind us, this will be a foray into the future - mapping the coming decade,
and next half-century - as well as covering the many challenges of the present time."
The theme of the conference, to be held online and sponsored by Novo Nordisk, is Pharmacy Odyssey: Services, Supply and Sustainability.
Patients are highly satisfied with the new Pharmacy First service, which enables pharmacists to assess and treat patients for seven common conditions,
according to a survey by the National Pharmacy Association (NPA).
Nearly 100 NPA members participated in the snapshot poll conducted at the end of the first full week of the service.
Nine in ten respondents (87 per cent) said that "most or all patients expressed satisfaction" with the service they received.
However, many independent community pharmacy owners are facing challenges in implementing the service.
While 56 per cent of pharmacy owners surveyed expressed feeling "motivated" by the new service, a larger proportion (70 per cent) indicated being "under
additional pressure."
More than 30 per cent of the respondents found implementation of the service "harder" than they had expected.
Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching.
More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice.
Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit.
The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists.
Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.
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.
Community Pharmacy England (CPE) has expressed dissatisfaction with the spring budget as it brings "no specific relief" for the community pharmacy sector,
which is grappling with "soaring costs and severe medicine supply and pricing issues."
UK Chancellor Jeremy Hunt announced his Spring Budget on Wednesday, confirming an extra £2.5 billion in day-to-day revenue funding for the NHS in England in 2024-25
and a new NHS productivity plan worth £3.4bn to modernise IT systems.
The Chancellor said that day-to-day spending would grow by 1 per cent per year on average in real terms, and the productivity plan is estimated to "unlock £35
billion worth of savings" from 2025-26 to 2029-30.
However, CPE chief executive, Janet Morrison commented that the budget has "no obvious good news" for community pharmacies who need "urgent relief from the ongoing
unsustainable funding and operational pressures" they are facing.
Morrison described the investment in Pharmacy First as "the most significant investment in pharmacies in a decade", but emphasised the need for further support to
stabilise the sector and its core contractual arrangements.
The Pharmaceutical Services Negotiating Committee (PSNC)'s members are seeking immediate rescue packages for the sector to help with energy bills and to ease
capacity constraints.
In a meeting held on 14th and 15th September, the committee members expressed their anger and frustration on the reluctance of NHS England and government to fund
pharmacy sustainably.
The meeting was held to consider practical steps to ease the pressures on the community pharmacy sector, and to oversee the progress of negotiations on the Community
Pharmacy Contractual Framework (CPCF) and other work.
Committee members, as pharmacy contractors, shared their experiences of the current pressures on all contractors, including the inability to deliver some services
and to maintain core service levels; the capacity and workforce crises facing the sector; the critical need for funding support this winter; and the urgent need for
Government to adapt the Price Concessions system to meet the needs of contractors.
"The Price Concessions system is no longer working for contractors in the current volatile medicine supply environment and PSNC is clear this is not acceptable,"
said the committee.
The Pharmaceutical Services Negotiating Committee (PSNC) has rejected Department of Health and Social Care (DHSC) and NHS England's proposal on price
concessions reform and relief measures to ease pressure on pharmacies.
The Committee called the proposal 'insufficient' to meet the sector's needs considering the impact of the current crisis, reflecting on the economic pressures
that accelerated through the autumn and winter.
The Ministers and other decision-makers have shown their interest in the potential role of community pharmacy, particularly in using a Pharmacy First approach
and making use of PGDs and the skills of independent prescribers.
But the Committee had made clear to them that without new money this is all a pipedream. "We need an urgent injection of funds into the sector, otherwise we will
continue to see a degradation of services and eventual collapse of the network. The Committee is clear that there is no further place for warm words while pharmacy
collapses," said PSNC.
The Committee reflected that the 5-year CPCF agreement had been based on working together to create the capacity and context necessary to deliver the shift towards
greater service delivery. Not only has that capacity-release not happened due to slow progress by Government, but pharmacies have also been burdened with these
additional, and insurmountable, challenges.
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.
Ninety-six per cent of community pharmacists surveyed in the Royal Pharmaceutical Society (RPS) Workforce Wellbeing survey said they were at 'risk of burnout'.
A higher number of respondents working in community pharmacy (20%) reported not being offered breaks compared to all other sectors (8%) and were more likely to
experience verbal or physical abuse from patients and the public (69% vs an average 44%).
The annual Workforce Wellbeing survey also revealed that 88 per cent of pharmacists surveyed are at high risk of burnout due to winter pressure. Therefore, RPS is
calling for workforce planning for pharmacy to address skill mix and staffing levels so that workloads can be effectively managed.
Top factors causing poor mental health and wellbeing revealed by the survey include inadequate staffing (70%), lack of work/life balance (53%), lack of protected
learning time (48%) and lack of colleague/senior support (47%).
This is the fourth survey RPS has run in partnership with the charity Pharmacist Support on the state of mental health and wellbeing in pharmacy.
The findings demonstrate continued pressure on pharmacists and trainees across the workforce, especially in community pharmacy where 96% of those surveyed said they
were at risk of burnout.
The large majority of adults in the England knew that flu jabs are available in many pharmacies, just over half were aware of the GP Community Pharmacist
Consultation Service or the New Medicine Service, according to a new survey by the National Pharmacy Association (NPA).
The new survey revealed the need to raise the public awareness of key NHS services such as the New Medicine Service.
According to the survey, 56 per cent of those asked believed that pharmacies in England offer NHS consultations for people newly prescribed a medicine for a
long-term condition.
While 48 per cent believed that many pharmacies in England offer blood pressure monitoring (NHS or private). 51 per cent believed it to be true that GPs can
formally refer patients for same-day clinical advice from their local pharmacist about minor ailments.
A full CPE Committee Meeting was organised in London on April 17 and 18, 2024, to discuss crucial sectoral issues.
Key topics discussed during the two-day meeting included intolerable pressures on pharmacy owners, the ongoing Community Pharmacy Contractual Framework (CPCF)
negotiations, implementation of the Pharmacy First service, and governance changes.
Committee Members reviewed the progress of CPCF negotiations with the Department of Health and Social Care (DHSC) and NHS England. These critical negotiations
are being led by the Negotiating Team (NT), which includes independent pharmacy owners and representatives of CCA and non-CCA multiples.
The CPE has been advocating for an uplift to the core global sum, margin write-offs, an agreed mechanism for regular funding increases linked to activity and
inflation, annual uplifts to service fees, more fundamental reform of the margin delivery framework and an economic review of the medicines supply chain.
The Committee also discussed the results of the 2024 Pharmacy Pressures Survey, which was conducted during March and April.
Pharmacists, councillors and NHS leaders came together at Portsmouth's first Community Pharmacy Summit to address some of the challenges facing community
pharmacy locally.
They explored ways to reduce the huge pressures on pharmacy, tackle abuse towards staff, enable pharmacists to undertake training to treat more illnesses, and to
protect the current and future workforce.
Portsmouth City Council, which hosted the Summit on Wednesday 15 November, also invited representatives from Hampshire and Isle of Wight Constabulary, University
of Portsmouth, Hampshire and Isle of Wight Integrated Care Board and businesses to discuss new opportunities to work together.
Held at Portsmouth Guildhall, the event was chaired by Cllr Matthew Winnington, Cabinet Member for Community Wellbeing, Health and Care, and Cllr Gerald
Vernon-Jackson, Cabinet Member for Transport.
Community pharmacy chain Jardines Pharmacy has partnered with patient relationship management platform Charac to launch a new app designed to digitalise
its services, enhance operational efficiency, and elevate customer satisfaction.
The app allows patients to order repeat prescriptions, access medicine home delivery and book consultations with their pharmacist all in one place, enabling
faster pharmacist-to-patient care.
By incorporating Charac's platform into its business, Jardines is able to boost prescription dispensing efficiency, helping reducing wait times for patients.
Additionally, its delivery feature enables patients to track their orders directly through the app, thereby streamlining the overall patient experience.
The app also minimises administrative and manual tasks for pharmacists, giving them more time to focus on helping patients and delivering the outstanding
customer service.
Patients of Jardines can also use the app to book appointments digitally for Pharmacy First consultations, blood pressure checks, earwax removal, travel
vaccinations, and emergency contraception services.
Santosh Sahu, Founder and CEO of Charac, said: "We are pleased to support Jardines Pharmacy and its patients across England. Our mission is to ensure that
community pharmacies are empowered to digitalise, making care easier and more accessible for patients.