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Sector leaders have welcomed the NPA ballot results, which demonstrate that community pharmacies are prepared to take collective action if a funding increase is not achieved. Nearly all pharmacy owners, who participated in the NPA ballot, said they were willing to limit their services to protest funding cuts. Commenting on the poll results, Malcolm Harrison, CEO of the Company Chemists' Association (CCA) said: "The results of the NPA ballot serves to underline the huge pressure that pharmacy contractors face, following a decade of underfunding. He emphasised the need to start the Community Pharmacy Contractual Framework (CPCF) renegotiations for 2024/25 without delay. "The government and NHS must uplift all elements of the contractual framework, to stop further reductions in pharmacy opening hours and permanent pharmacy closures, and to ensure that patients can continue to receive the medicines and clinical care and advice they need," he added. Harry McQuillan, Chairman of Numark, stated that while the NPA ballot outcome has once again brought the financial crisis facing the sector into focus, this is "an everyday reality" for many independent pharmacies and that it has reached "breaking point." He warned that rising operational costs including the increase in national insurance and minimum wage will push many more to the brink.

In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels. PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community pharmacy contractual framework to ensure that the services are adequately resourced." Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular and accessible places for people to receive a range of vaccinations. "The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views on the topic. "In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS response to this consultation."

Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems. Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS. "It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework." Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector." "We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."

I have always been passionate about Community Pharmacy and am proud of the way that the sector navigated itself through Covid-19 and is currently navigating itself through all the changes in the NHS landscape. When I started my role in Sep 2019 as the CEO of Kent LPC, I used to say that community pharmacy has changed more in the last five years than the 15 before that, however, I now believe community pharmacy has changed more in the last two years than the 20 before. The year 2019 saw the start of the five-year Community Pharmacy Contractual Framework which set out how community pharmacy would support delivery of the NHS long term plan. What PSNC (or any of us) when negotiating this deal had not envisaged was the Covid-19 pandemic. Whilst the world turned upside down, we saw high street shops close their doors and immense pressure flood the NHS. Community pharmacy did what they always do, they adapted, teams came together, worked through, and showed resilience in the face of adversity. In Kent, I saw us integrate into primary are and into the NHS structure very quickly, in the first few weeks after Covid-19. All the usual red tape was removed, we all worked together to implement services to help patients in a matter of weeks when they would have normally taken months.

The Welsh government has reached an agreement with the NHS and Community Pharmacy Wales (CPW)-the statutory representative body for all community pharmacies-on a six per cent funding increase as part of the 2024/25 Community Pharmacy Contractual Framework (CPCF). The £9.9 million increase will bring the total CPCF funding to £175 million per year, representing a 24 per cent rise in funding since 2017. In a statement published on 20 December 2024, Jeremy Miles, cabinet secretary for health and social care, said that the additional investment will be used to address "both immediate pressures facing community pharmacies and to maintain momentum on our longer-term ambitions for reform." Miles also said that the government would continue to invest in integrating pharmacies in primary care clusters, developing the skills and scope of practice of the wider community pharmacy workforce including pharmacy technicians, and the Choose Pharmacy IT system. In contrast, community pharmacies in England are still awaiting progress on CPCF negotiations for 2024/25. Last month, Community Pharmacy England (CPE) warned of the sector's worsening financial situation, urging ministers to provide immediate funding relief.

The 8th Pharmacy Business Conference, organised by Pharmacy Business, unfolded a dynamic narrative around the theme of 'Pharmacy of Tomorrow', highlighting the trajectory of innovation, adaptation, and the evolving landscape of pharmaceutical services. Attended by over 200 pharmacy owners, industry leaders, and stakeholders, the conference served as a medium for robust discussions and the exchange of valuable insights regarding the future of community pharmacy. Amidst the persistent challenges posed by an underfunded reimbursement system and negotiations with governmental bodies and the NHS for the new community pharmacy contractual framework 2024/25, the conference pivoted towards investing in staff, adapting to change by investing in new technology, and optimising commissioning as pivotal strategies. "Pharmacy professionals are playing increasingly important clinical roles in both primary and secondary care," shared David Webb, Chief Pharmaceutical Officer (CPO), NHS in a video message. He highlighted the NHS's commitment to empowering community pharmacy, with plans to expand services and deprescribe to align with the NHS's focus on preventive healthcare.

Community Pharmacy Wales and the Welsh government have entered an agreement on Thursday (December 16), enabling all pharmacies to deliver provision of contraception, treatment for common minor ailments, and access to repeat medicines in an emergency. Expansion of clinical community pharmacy service will be supported with an increased funding of £20 million a year by April 2024 from the current level of £11.4m. The two bodies have been negotiating the terms of agreement, which also includes plans to roll out a Wales-wide pharmacy prescribing service, allowing trained pharmacists to treat an extended range of conditions that currently require GP visits. The agreement will allow patients to access NHS services closer to home which in turn would free up GP and other NHS services for patients with more complex needs. Eluned Morgan MS, minister for Health and Social Services said: "I welcome the positive approach to negotiations taken by Community Pharmacy Wales, embracing our ambition for a reimagined community pharmacy service, which is an integral part of a strong primary care landscape."

The new board of the National Pharmacy Association (NPA) has adopted 10 principles for transforming the contractual framework in England. The board met for the first time in April, believes that the current Community Pharmacy Contractual Framework is failing NPA members, the wider sector, the NHS, Government and patients. The association's new vice chair, Jay Badenhorst, said: "We can't wait until the current framework limps to its finish line in 2024 before giving serious thought to the new race we must all run in the future." "Before negotiations for a new contract begin in earnest, we want to make our position clear to all of those who will be involved in its development. Years more of the same would be totally unacceptable. Tinkering at the edges of the current arrangements as the basis for a new deal could not achieve the transformation that is needed." Former chair of the NPA, Andrew Lane, listed some of the principles in a speech to industry leaders in January, but this is the first time the approach has been agreed in its entirety, following months of testing with NPA members.

A harsh funding regime that hasn't adapted to changing macroeconomic realities means the viability of large parts of the pharmacy sector is at risk unless the model changes. Very simply, across the sector, revenue has remained largely fixed while costs have increased significantly, making it impossible for many pharmacies to sustain their business models. The sector has seen the closure of more than 1,500 community pharmacies since 2015, with 700 of these closures occurring since 2021. Larger pharmacy operators such as Lloyds, Boots, and Rowlands have seen the biggest decline in numbers, with smaller businesses operating between one and five pharmacies now accounting for almost 50% of the sector. Despite rising inflation and business costs, the NHS pharmacy funding model has remained fixed. Over the period of the current Community Pharmacy Contractual Framework (CPCF) - 2019-2024 - pharmacies have experienced a 30% real terms cut in core funding leading to an annual shortfall of over £750 million, equivalent to £67,000 per pharmacy in England. The current CPCF is due to end in 2024, and there is still no arrangement in place for future funding, leading to delayed and inefficient spending decisions and hampering the ability of the sector to plan and attract much-needed investment.

In response to a recent Parliamentary question regarding pharmacy reimbursement, pharmacy minister Stephen Kinnock stated that pharmacies were permitted to retain £850 million from the medicine margin for 2023/24. The medicine margin represents the difference between the product price reimbursed by the National Health Service (NHS) and the price at which pharmacies buy them. Rebecca Smith, the Conservative MP for South West Devon, inquired about the number and proportion of community pharmacies that had dispensed medications at a loss over the past three years. Kinnock replied that they do not hold this information, and explained that community pharmacy reimbursement arrangements "do not aim to ensure that every pharmacy is paid as much or more than it paid for every product, but aims overall to reimburse as much as they were bought for, plus the allowed medicine margin." Additionally, the minister highlighted that as part of the Community Pharmacy Contractual Framework (CPCF) for 2023/24, pharmacies are allowed to retain "£850 million from the medicine margin, on top of what they are paid for the medicines they purchase as part of providing NHS services."

Community pharmacy representatives and MPs from across all political parties discussed the impact of winter pressures on pharmacies in England during a parliamentary drop-in event held on Tuesday (5 December). As many as 34 MPs attended the event, including Bradford South MP Judith Cummins, who hosted the event. Members of the Community Pharmacy England (CPE) Policy Team and LPC leaders briefed the politicians about the current winter pressures that all NHS community pharmacies are grappling with, and asked them to help get more support. CPE Chief Executive Janet Morrison said: "Community pharmacies play an active role to support their patients throughout the winter period, but the sector needs fair and proper funding to enable its vital services to be delivered in the long term. This event came at a key moment for the sector as we work towards implementing the Pharmacy First service and negotiations begin for the 2024/25 Community Pharmacy Contractual Framework (CPCF).

The government has responded to the Health and Social Care Select Committee's report on community pharmacy, acknowledging 17 of the 19 recommendations. In its report published on 29 May 2024, the Committee recommended, among other things, an overhaul of the Community Pharmacy Contractual Framework (CPCF), closing the funding gap, tackling medicines shortages by introducing generic substitution, and establishing an integrated and fully funded workforce plan for pharmacy. In its response, released today, the government stated that NHS England is currently conducting an economic analysis of the sector, which will inform future proposals for funding and contractual arrangements. On medicine shortages, it mentioned that the Department of Health and Social Care, working closely with NHS England, is taking forward a range of actions to improve their ability to mitigate and manage shortages and strengthen resilience. Additionally, the government has stated that it will "publish a refreshed Long Term Workforce Plan" this summer and is "committed to growing the pharmacy workforce."

Pharmaceutical Services Negotiating Committee expects the next round of negotiations to set the arrangements for the Community Pharmacy Contractual Framework (CPCF) in 2022/23 - Year 4 of the five-year CPCF deal, to begin soon. The negotiator held a meeting on November 24 and 25 to discuss the burning issues affecting the sector and to plan for upcoming negotiations with the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I). It aims to complete these negotiations by April, allowing ample time for contractors to make arrangement prior to the beginning of the financial year. PSNC vice-chair, and independent contractor, Bharat Patel said the entire sector is worried about the "outlook for pharmacies as we head into a difficult winter," and is working to find solutions. He noted that PSNC "will be bringing proposals for additional funding and support, particularly around the treatment of 'walk-in' patients, to the table, along with a heavy dose of realism for government and the NHS about the current challenges in the sector." While expecting a difficult round of discussion with the government, Patel remained optimistic about a favourable outcome for pharmacies.

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'.

Janet Morrison, CEO of Community Pharmacy England (CPE) has emphasised that stabilization of the sector is essential before any solutions can be delivered to fix the "struggling" health service. Speaking at the recent SIGMA UK Community Pharmacy Conference 2024, Janet described the current contract as "unaffordable" and warned that pharmacies are becoming "unsustainable." "Without an urgent funding uplift, the sector is facing a 'house of cards' collapse that will seriously impact communities, patients, and the safety of medicine supply. "So, first of all, we have to secure the stabilization. We have to make sure you can keep the lights on and the doors open, and that's critical," she stated. Janet pointed out that if the sector is stabilized and a fair deal is achieved, community pharmacies could effectively deliver solutions for the government that meet their policy goals. However, she noted that negotiations for the Community Pharmacy Contractual Framework (CPCF) for 2024-2025 cannot resume until the budget is published on October 30.

The National Pharmacy Association (NPA) has commissioned Professor David Taylor of University College London to investigate the implications of all-time high inflation rates on community pharmacies in the UK. Professor Taylor's will assess rates of inflation affecting community pharmacy across the UK, using public data sources whilst examining inflated costs in the context of the current five year contractual framework in England (2019-2024). He would review the EY (Ernst & Young) report into pharmacy funding, to identify whether current inflationary pressures could change any of the findings and consider the policy implications and impacts of inflationary pressures, including pharmacy's ability to prepare for a more clinically focused future and maintain current core services. NPA chief executive Mark Lyonette said: "Inflationary pressures are eating into the limited funds provided by the NHS for pharmacy services. We believe the real level of inflation for pharmacy businesses could be higher than the CPI inflation rate, which itself is at a 40 year high. Staff and locum costs in the sector as well as medicines costs have risen dramatically.

Community pharmacies are being forced to halt certain NHS and public health services due to escalating financial and operational pressures, a recent survey by Community Pharmacy England (CPE) has revealed. In the survey conducted ahead of the June Committee Meeting, an overwhelming 96 per cent of pharmacy owners reported having stopped delivering locally commissioned services over the past twelve months. Additionally, nearly one-third of the pharmacies surveyed indicated they had discontinued providing some Advanced services. The survey also revealed that pharmacy opening hours are being reduced, with 81 per cent of respondents stating they had to stop offering extended hours. In 90 per cent of the cases, pharmacy owners had to cease employing locum pharmacists, likely due to cost constraints. Furthermore, over 20 per cent of the more than 2,100 pharmacies surveyed reported having to discontinue the free delivery of prescription medicines to patients.

In a compelling case for expanding the role of community pharmacies in the UK's vaccination efforts, a new report by a major think-tank has called on NHS England to designate all adult vaccinations as 'advanced services' under the next Community Pharmacy Contractual Framework (CPCF). Published in July this year, the report by Reform discusses the power of prevention and highlights the need to boost vaccine uptakes for better patient outcomes. Calling for the NHSE to allow the 'advanced services' to be routinely delivered by community pharmacies, the report highlights the proven capacity of community pharmacists to reach a wide demographic, particularly in underserved areas. It also emphasises on the strategic advantage of utilising community pharmacies which often have more flexible hours and remain open during the evenings and weekends, making them highly accessible to the public.

The Community Pharmacist Consultation Service (CPCS) will be expanded to enable urgent and emergency care settings to refer patients to a community pharmacist for a consultation for minor illness or urgent medicine supply from Monday (15 May), the DHSC and NHSE said. The service builds on the progress made in GP referrals via the CPCS and hospital referrals under the Discharge Medicine Service. It was originally planned to launch in March, and fee for this service will be the existing CPCS fee of £14, as per the agreement for both year 4 and year 5 of the Community Pharmacy Contractual Framework (CPCF) 2019 to 2024 5-year deal. In an update on the CPCF, published today (12 May), the Department of Health and Social Care (DHSC) and NHS England (NHSE) has also committed to the 4 October 2023 launch date for the Tier 2 of the Pharmacy Contraception Service, subject to a positive evaluation of the pilot. The Tier 1 of the service was launched on 24 April, delayed by over three months. This new service enables community pharmacists to provide ongoing management, via a patient group direction (PGD), of routine oral contraception that was initiated in general practice or by a sexual health clinic. The fees for this service are as follows: a fee for each consultation of £18; and a set-up fee of £900, paid in instalments. The Tier 2 will "enable community pharmacists to also initiate oral contraception, via a PGD, and provide ongoing clinical checks and annual reviews," Alette Addison, deputy director for pharmacy, dental and optical at the DHSC and Ali Sparke, director for dentistry, community pharmacy and optometry at the NHSE, said in a letter.

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.