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In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.

The Department of Health and Social Care (DHSC) has announced 30 pence increase in prescription charges from £9.35 to £9.65 for each medicine or appliance dispensed. Board Chair for England at RPS, Thorrun Govind commented: "This is a kick in the teeth for people in England who are already struggling with rising bills and food prices. "Patients groups have warned that people are not collecting prescription medicines due to cost and pharmacists are seeing this worrying trend first-hand. "A Government impact assessment noted the risk of adverse effects of people not taking their medicines, resulting in future health problems for the individual, potential hospital admissions, and a subsequent cost to the NHS. "This decision seems to prioritise revenue generation over ill-health prevention and undermines the principle of an NHS free at the point of use.

Atorvastatin, a medicine to treat high blood cholesterol, is the most dispensed drug with 59 million items in England in 2022/23, revealed the NHS Business Services Authority (NHSBSA) on Thursday (8 June). While Apixaban (an anticoagulant) was the drug with the highest costs of £430 million. Apixaban 5mg tablets had the largest increase in cost between 2021/22 and 2022/23 in England, with an increase of £280 million. NHSBSA's annual statistics report 'Prescription Cost Analysis-England 2022/23' published also has revealed an eight per cent rise in the prescription items that were dispensed in the community in England. The report highlighted that in 2022/23, 1.18 billion prescription items were dispensed at a cost of £10.4 billion in the community in England, witnessing an increase of eight per cent from £9.69 billion in 2021/22.

Errors of any kind in medical settings can have dire consequences for patients and healthcare systems. Unfortunately, negligence, misdiagnosis, and medication errors aren't uncommon in the UK. In this article, we discuss the nature of medication errors in the NHS, outline potential causes, and delve into how and why technology could be turning the tide on the issue. Prevalence and consequences of medication errors Medication errors are incidents involved with the administering, prescribing, dispensing or monitoring of medicine to patients. It can happen at many different steps in the healthcare process and by any medical professional in the system. Many cases are avoidable. According to analysis from BMJ, there are an estimated 237 million medication errors made in England every year. The majority of these are minor errors, but 1 in 4 cases has the potential to cause moderate to serious harm to patients. Not only do these errors cost the NHS significantly, at almost £100 million every year, but there is a shocking cost to public health. Lives are being lost because of medication errors which is unforgivable and tragic for the families involved. Drains on NHS resources have widespread impacts on public health and the operations of healthcare organisations up and down the country. Individual errors and mistakes may seem inconsequential (in minor cases), but they all add up in the big picture to a significant concern for policymakers.

Two weeks prior to the closing of the hub and spoke consultation, issues around patient safety, costs and competition as well as practicalities such as what to do with uncollected medicines were discussed in a webinar on hub and spoke dispensing on Wednesday (May 26). The webinar was organised by Sigma Pharmaceuticals in association with the National Pharmacy Association (NPA). NPA director of corporate affairs Gareth Jones chaired the event and was joined by Sigma's Hatul Shah and Raj Haria as well as NPA vice chair Nick Kaye and NPA head of advice and support services Jasmine Shah. Kaye said: "There are still many 'unknown unknowns' with hub and spoke and the jury's still out on any potential benefits. I have lots of reservations about cost and it worries me how efficient this is for the business and the long term sustainability for the sector as a whole. Above all we need to think about the patient at the centre of all this and the potential confusion for them." Jasmine Shah felt patient safety was going to be the key in regards to whether the spoke and the hub would hold the ultimate responsibility and "who is going to take the accountability as far as patient care goes". She added: "It is most important that GPhC standards and NHS requirement are both met in identifying all the risks associated with the arrangement with hub and spoke and ensuring that (patient safety) measures are in place. Everything that needs to be looked at is by putting the patient at heart of the arrangement and seeing what is the safest way for them to receive care from both spoke and hub."

There is clear evidence that the majority of distance selling pharmacies are operating in breach of their NHS contracts, and a failure to properly regulate 'pseudo' distance selling pharmacies is leading to local pharmacy closures, the Company Chemists' Association has reported. According to the CCA's recent findings, 72 per cent of DSPs dispense over 50 per cent of their prescriptions to patients within a single postcode area within 10 miles of the pharmacy. "Operating within constrained geographical regions, pseudo-DSPs achieve reduced overheads and operational costs by focusing on localised marketing and medicine delivery. They compete against local brick-and-mortar pharmacies, causing them to lose vital trade," the CCA claimed, based on its recent survey - The Impact of Pseudo Distance Selling Pharmacies. "As per their terms of service, DSPs are obligated to provide prescription delivery nationwide, extending beyond local patients," said the CCA, adding that the financial savings resulting from the lack of patient access are balanced by the necessity to function on a national scale.