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David Webb, the Chief Pharmaceutical Officer for England, acknowledged that the "pressure in the system is high", but urged everyone to "keep our eye on the design" of the NHS plan, adding that the "the objective is to bring the different parts of primary care together" in the patient interest. Speaking during the opening keynote session at the the National Pharmacy Association (NPA) conference held on Thursday (13 October), he added that the NHS plan intends to bring different parts of primary care together to help patients. He said the new integrated care boards (ICBs) are a key strategic framework as they provide the "potential to form partnerships to deliver integrated services across larger populations". "ICBs will want to work with Local Pharmaceutical Committees to plan for the local population and the new community pharmacy clinical leads in ICBs, who have been funded by NHS England, are there to advise." He explained that once an ICB takes over the commissioning of pharmaceutical services (which they are all due to do by April 2023), it could use its funds to commission a local enhanced service as an add on to an advanced service. For instance, a CVD risk assessment could be added to the blood pressure check service.

The British Generic Manufacturers Association (BGMA) has warned that England's 42 integrated care boards (ICBs) may need to allocate an extra £37 million from their budgets annually for the next five years due to the spiralling tax rates. The government's Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) rebate rate increased more than five-fold in the past two years, the BGMA said in its white paper released on Monday (October 30). The report, conducted by consultancy firm Conclusio in consultation with local NHS leaders, examined the potential effects of the VPAS on ICB budgets. BGMA said that due to the elevated VPAS rate, each ICB in England will experience significant increases in expenses for branded generics and biosimilars annually - a consequence of reduced competition.

As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

The Pharmacists Defence Association (PDA) has expressed its keenness to work with the NHS nationally and at the ICB level to discuss how the pharmacist workforce can most effectively be part of the multidisciplinary team, after the publication of Long-awaited NHS England workforce plan. Welcoming its publication Alison Jones, PDA Director of Policy said: "It gives greater clarity around the future direction and strategy for professional development, training, and opportunities for those currently working in the health service or considering their future career. There is a strong emphasis on further development of the clinical role of pharmacists to support better patient care. "However, this is a plan that will take years, indeed decades to come to fruition and its success will need to be underpinned by significant funding for its entire life course. Workplace pressures, reductions in support staff, and a lack of protected learning time are matters of immediate concern for many PDA members, issues which are regularly highlighted through activities, such as the safer pharmacies survey.

The Pharmacists' Defence Association (PDA) is supporting pharmacists in England whose employment has been impacted by the creation of new NHS structures. As a result of the 2022 Health and Care Act, Integrated Care Systems (ICSs) were established in England, and Clinical Commissioning Groups (CCGs) were closed on 1 July 2022. Each of the ICSs includes two key parts: an Integrated Care Board (ICB) and an Integrated Care Partnership (ICP). The association said: "The previous structures in England, established by the Health and Social Care Act 2012, originally had over 200 clinical commissioning groups. This number had reduced over recent years via mergers." "However, this latest shift to just 42 commissioning entities means a significant change to significantly larger geographies and populations covered by each ICS. Although each ICS and its activity can be subdivided into 'places', and within places into 'neighbourhoods', it is at the ICS level that the employer is formed." "Whereas CCGs previously employed many local health professionals, including pharmacists, the new arrangements mean that ICBs are now that employer. The PDA is supporting members who have contacted its Service Centre about the impact of these changes."

NHS West Yorkshire Integrated Care Board (ICB)'s decision to withdraw gluten free prescriptions for people with coeliac disease across Leeds and Calderdale has disappointed Coeliac UK. In a statement released on Thursday, the charity, which provides support and advice to those living with the disease, has raised "grave concerns" about the decision, warning that it will have a detrimental impact on the coeliac community. The policy is currently implemented across the ICB's other places including Bradford district and Craven, Kirklees and Wakefield district, preventing coeliac patients from accessing gluten free bread and flour mix on prescription. NHS West Yorkshire ICB wants to align its gluten free prescribing guidelines across its five places. But the charity is worried that the additional cost of gluten free staple products will poses a real challenge to maintaining the gluten-free diet, which is the only treatment for the condition.

All 42 integrated care boards (ICBs) in England have signed memorandums of understanding for the NHS Independent Prescribing Pathfinder programme, the first nationally-funded prescribing service in the country. Anne Joshua, interim deputy director of pharmacy commissioning at NHS England, made the revelation during the 'Chief pharmaceutical officer bi-monthly webinar' held on 7 March 2024, as reported by The Pharmaceutical Journal. In the initial phase of the programme, 210 community pharmacies across all ICBs will trial independent prescribing, ahead of establishing a commissioning framework for the service. Giving an update on the pathfinder programme, Joshua confirmed that 164 of these potential pathfinder sites had registered for the programme as of 29 February 2024. Additionally, she announced the clinical models to be followed by the participating pharmacies and presented a graph showing an overview of the services they will provide.

After struggling with COVID, Hemant Petal is back to good health, and now he is on a mission to reduce "health inequalities". Speaking at the SIGMA Conference 2023, he spoke about his new role as Clinical Lead, Health Inequalities and Population Health Management, SE Essex Alliance, Essex ICB. "So, my new role is outside pharmacy, nothing to do with pharmacy. But it is important, I feel that I share some of my insights about the work that I'm doing that might benefit you," he said. Elaborating on the role of integrated care boards (ICBs), he said that they are designed to enhance coordination and collaboration across different healthcare providers and settings. The representatives from hospitals, community services, retail and social care meet on a monthly basis to "look at where there are issues to be resolved, perhaps what can be done to improve the healthcare services."

A new Attention-Deficit-Hyperactive disorder (ADHD) taskforce has been launched by National Health Services England (NHSE) to counter the challenges faced by many suffering from the neurodevelopmental condition. The ADHD taskforce aligns with the NHS Long Term Plan's vision to revolutionise mental health services, with a specific emphasis on bolstering community-based care and reducing reliance on inpatient services. The NHS has partnered with the government to tackle the escalating demands including increasing funding, improving system efficiency, altering the service provision model, and clinical prioritisation by bringing together expertise from across a broad range of sectors, including the NHS, education and justice, to help provide a joined-up approach in response to concerns around rising demand. Over the past two decades, there has been a significant expansion in the acknowledgement and successful medical interventions for ADHD, leading to a steady rise in clinical requests throughout the UK.

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.

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare. Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists. Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence. In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.