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The Royal College of General Practitioners (RCGP) has warned of a potential 'mass exodus' of qualified GPs due to mounting work pressures. A recent RCGP survey found that over 40 per cent of GPs are unlikely to remain in general practice over the next five years, with a quarter stating it is "very unlikely." The situation is particularly concerning in England, with the highest rate of GPs considering leaving the profession reported to be in the East of England and the South East (47 per cent) and the lowest in the North West (36 per cent). Stress was cited as the main factor for leaving the profession, with more than half of respondents indicating that they find the job too stressful. Additionally, 13 per cent of respondents intend to leave the UK and work overseas. Almost 4 out of 10 GPs said they regularly worked more than 40 hours a week despite fewer than 1 in 10 being contracted to do so. The pressures faced by GPs are so severe that 22 per cent report feeling overwhelmed and unable to cope once or twice a week. The College noted that GPs and their teams have delivered an average of 30 million appointments per month in the past year - over 4 million more each month than in 2019 - despite the number of fully qualified, full-time equivalent GPs decreasing by 601 over the same period.

Responding to a new National Audit Office (NAO) report that indicated that NHS England's Long Term Workforce Plan (LTWP) needs improvements, the Royal College of General Practitioners (RCGP) has expressed concerns that the plan may not adequately address the needs of GPs. Published in June 2023, the workforce plan estimated that the NHS's health workforce will need to grow from 1.4m full-time equivalent (FTE) staff in 2021-22 to between 2.3m and 2.4m FTE workers in 2036-37, an increase of 65 per cent to 72 per cent. However, the NAO report highlighted that the workforce modelling has significant weaknesses, including a complex design; manual adjustments; optimistic future assumptions and limited public communication of their uncertainty; and modelling outputs that could not be fully replicated. To improve the modelling, the report recommended exploring the uncertainty of these assumptions and considering potential outcomes if they do not materialize as expected. Additionally, it suggested including full integration of the different parts of the modelling pipeline to minimise manual adjustments.

A new study published in BMJ Open journal has revealed a significant decline in the number of general practices in England over the past decade, alongside shifts in workforce dynamics and organisational structures. Conducted by researchers from University College London (UCL) and the London School of Hygiene and Tropical Medicine (LSHTM), the study analysed data from NHS England, the Office for Health Improvement and Disparities, and the Care Quality Commission (CQC). They found that, between April 2013 and April 2023, the total number of general practices fell by 20 per cent, dropping from 8,044 to 6,419-an average loss of 178 practices per year. The decline coincided with an 11 per cent increase in the total population registered with a GP practice, which saw average practice list sizes swell by 40 per cent from 6,967 to 9,724 patients. Additionally, the number of unique practice postcodes decreased from 7163 to 5849, representing the loss of 18 per cent practice locations over this period.

As the countdown to the next UK election begins, the King's Fund has identified three priorities to improve public health. The national action would be taken by the future government to fix the "NHS and social care" in the country. The health policy think tank said it would prioritise "improving access to out-of-hospital care", making "careers in health and social care" more attractive and tackling the biggest risk factors affecting people's health. It highlighted that workforce crisis is one of the biggest challenges faced by the National Health Service (NHS) and social care services in England while citing "years of poor planning and fragmented responsibilities" as the reason for widespread staff shortages. As per the King's Fund's data, there were more than 125,000 vacancies across the NHS workforce in England in October 2023, not including primary care vacancies such as GPs, and 152,000 vacant posts in the adult social care workforce.

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.

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.

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 English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of community pharmacy as the third pillar of patient access to essential healthcare. Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC announces no new long-term investment to sustain the sector. Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners. Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated. Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances need open heart surgery not a couple of paracetamol tablets.

The Company Chemist Association (CCA) highlighted its concerns around the recruitment of pharmacists into Primary Care Networks as well as the need for additional investment. Commenting on the Ipsos survey findings, the Malcolm Harrison, the Chief executive of the CCA said: "We welcome the findings of the Ipsos survey, confirming that patients value the quality of service and advice community pharmacies routinely provide. "We are very concerned however that this cancer detection pilot, and all other pharmacy services, are at risk if the NHS is not prepared to inject urgently needed funding into the sector." He stated that without substantial investment, "we will see the continued erosion of the service pharmacies can provide." In addition to the need for critical additional funding the association is also calling on the NHS to pause the recruitment of pharmacists into GP surgeries. He said: "Patients are suffering because the demand for pharmacists in England is now significantly greater than that which the existing workforce can deliver."

NHS England and NHS Improvement published on May 26 the findings of the Fuller 'stocktake' - setting out how primary care can work with partners across health and care to best meet the needs of their local communities. Dr Claire Fuller's report lays emphasis on the essential role of primary care and the potential of integrated neighbourhood teams in reducing the burden of ill health and tackling health inequities. It commends community pharmacy for keeping "its doors open to the public throughout" the pandemic whilst being "among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country". The report highlights "recruitment and retention challenges across the wider primary care workforce" including in community pharmacy. Stressing the importance of community pharmacy teams in urgent care and prevention, including early diagnosis of cancers, the report points out that pharmacists could play "a more active role in signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme".

The All-Party Parliamentary Group (APPG) on Pharmacy published a new report on Monday (January 23) that calls for "urgent action" to relieve funding pressure so there are "opportunities" for community pharmacy teams to deliver even more for their patients. The report highlights the need for a new "strategic vision" for pharmacy and highlights opportunities for the network to be empowered to deliver even more for patients. However, the manifesto also underlines that there are the very real risks that this opportunity may be lost if significant and ongoing pressures are not addressed. The recommendations are based on written and oral evidence gathered from frontline pharmacists, GPs, professional bodies and healthcare experts. To harness the potential of pharmacy, the report recommends the Government must take urgent action to relieve the funding pressures on the community pharmacy sector in the short term and review the long-term funding model for pharmacy. It also suggested the Government must harness the power of pharmacy to help the NHS deal with the COVID-19 backlog and the UK's growing healthcare challenges. It further recommended that future commissioning and funding must recognise that community pharmacy is the front door to the NHS for many patients.