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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 Challenges There cannot be anyone working in or with community pharmacy that either feels or sees the pain that emanates from the current operating climate. Pharmacy closures; increased workload and operating costs; increased patient and commissioner expectations; and, more fundamentally, an inadequate, undervalued and poorly structured remuneration and reimbursement contractual framework. As important as they are, we will not focus on these points here as they are not in the control of pharmacy owners and managers. They are the responsibility of those organisations that represent them at a national and local level who must deliver a better outcome as difficult as that may be. However, there are matters which are in the control of pharmacy owners and managers. These include their premises, their team, their systems and processes, their relationships with other healthcare providers and the broader community, their NHS and private service offer, and how they promote and deliver them to give the best patient experience. In order to create the head space to develop and implement a business plan, pharmacy owners and managers must make time to work on their business as well as in it. Then it requires the capacity and capability within their team to deliver the services and that excellent patient experience.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

In a significant move to enhance the working conditions of over 50,000 postgraduate doctors in the National Health Service, NHS England has unveiled a series of measures aimed at providing greater choice and opportunities to the new entrants in the medical profession. With flexible rotas, reducing payroll errors, and easing the financial burden of course fees, the NHS has taken steps to address the issues faced by junior doctors in order to support their well-being. In recent announcement, 83 per cent of senior doctors and dentists accepted the government's pay offer. Alongside the junior doctors who still fighting for fair pay and recognition, the senior medical professionals demanded that the authorities help them tackle issues pertaining underfunding and overworking in the NHS. Junior doctors in training also often face challenges with frequent moves between trusts, leading to short notice changes in work schedules and duplicated inductions when transitioning to new hospitals. As a measure taken by the health serivces, the committee aims to review the minimum legal requirements for statutory and mandatory training, potentially halving the time burden for such training and allowing doctors to spend more time caring for patients as part of the long-term workforce plan.

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.

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

The Pharmaceutical Services Negotiating Committee (PSNC) has published a guidance for community pharmacies to help them in the implementation of the new Prescription Prepayment Certificate (PPC) for hormone replacement therapy (HRT). The new policy will rollout from 1 April 2023, patients who are not already exempt from NHS prescription charges will be able to purchase an annual HRT PPC for the cost of two single prescription charges Major concern raised by PSNC is that the NHS systems have not kept pace with policy, as the certificate is launching without the IT in place to support it. PSNC has been clear that this is totally unacceptable, including raising this with Ministers directly and warning them that introducing the PPC without this infrastructure risks causing confusion for some patients and adding to the burden for pharmacy teams. "Government recognises the challenges but is determined to move forwards with the policy, said the committee. "DHSC has recognised the impact this will have on pharmacies and we are still pressing for appropriate financial compensation. We have also sought guidance for GPs, and now published our own guidance to try to make the launch go as smoothly as it can for pharmacy teams."

Numark Pharmacy is hosting an event today (December 4) to mark the takeover of one of the former Lloyds Pharmacy stores in Cumnock, Scotland. It has renamed the acquired pharmacy on Tanyard as Rowlands Pharmacy Cumnock HC, which will be reopened to the community on Monday. Rowlands Pharmacy Cumnock HC, which is the latest to reopen in Scotland, will be run by Pharmacy manager Meghan Mcewan, supported by a team of colleagues from the local community. At the new branch, the team will oversee prescription dispensary, vaccination services, over-the-counter medications, emergency contraception, and medication review.

Growing up with a family that worked in pharmacy, our dinner time conversation was not like that of other families. Ours would centre around medicines, prescriptions, and the health challenges within our local community. I quickly came to understand the importance of the role played by community pharmacists. So I can't help but be concerned that the current direction being taken by digital health innovation threatens to leave community pharmacies behind. Whilst it is brilliant that patients can easily access their prescriptions through the rise of online pharmacies, many of these cut out the vital knowledge and expertise of local community pharmacists, and threaten to end the traditional close ties between local community pharmacists and their patients. Nine out of 10 NHS users believe that pharmacists play an unrivalled role when it comes to keeping patients in the community safe. We must ensure that digital health does not replace this important source of advice for health problems and injuries, but instead preserves and enhances this vital, personal role and enables pharmacists to continue delivering care in new and effective ways. A vital connection with patients Community pharmacies provide crucial support to local patients with managing their medicines safely, particularly older and more vulnerable people. The specific expertise and knowledge held by pharmacists can help inform the long-term management of a patient's condition and ensure they are kept safe from potential side effects and complications.

Lack of appropriate funding is making survival a massive challenge for community pharmacy, a sector relied upon as a vital support system by both primary and secondary care in England. The Telegraph newspaper ran a story on Monday (August 22) which highlighted the dire straits community pharmacy finds itself in. Seasoned pharmacist Ian Strachan told the paper: "Our four pharmacies were the only point of call that was open (during Covid). We were there every single day, even when the virus was prevalent and people were dying." Describing the current situation, he said: "What is happening is we're facing a system that's just not working at all in our favour." Strachan says the issue is that pharmacists are "just not getting the help we need to be able to do this job properly". The sector is hugely dependent on funding from the NHS. The government had agreed in 2019 to set £2.6bn as annual funding for the sector. However, according to a report from EY that amount was already down £200m on the 2016 levels of government funding. "We've been starved of appropriate funding since 2016," Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies told The Telegraph. "It looks grim for businesses. The fees pharmacists get are going nowhere, but now, there's higher utility bills, higher staff fees and higher drug costs."

Community pharmacy teams in England have broken all previous records by a distance and delivered nearly five million flu jabs in the past season. They have administered over 2.08 million more flu vaccinations under the national programme during 2021-22 than the previous year, which is a a 75 increase, the Pharmaceutical Services Negotiating Committee has reported. According to latest data published by the NHS Business Services Authority in its Advanced Service Flu report community pharmacy has administered 4.85 million vaccinations under the national Flu Vaccination Service in 2021-22. The total number of vaccines administered in community pharmacies in 2020-21 was 2.77 million. Commenting on the end-of-season figures, PSNC chief executive Janet Morrison said: "I am thoroughly impressed to hear it confirmed that community pharmacy has had another record-breaking year of flu vaccination provision. The ability of pharmacy teams to deliver the healthcare services that communities need, despite the challenges and pressures this winter, is simply phenomenal.

The NHS Confederation has urged the government to reconsider its 'living with Covid' plan and introduce mitigating actions that will help avoid further critical incidents being declared at the NHS front-line. The organisation said the high rates of Covid is having a major impact on the delivery of health services and slowing down efforts to reduce large waiting lists, noting that the country has been in the grip of another spike in Covid cases resulting from the Omicron BA.2 variant. With more than 20,000 patients now in hospital with Covid (or who have Covid but are in hospital for other reasons) and high staff absences, NHS is facing huge operational challenges, harming efforts to reduce waiting times in other areas, it said.

The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."

The Royal Pharmaceutical Society (RPS) has published its general election manifesto highlighting some of the key challenges the next Government will face to support patients and the NHS. The manifesto calls on general election candidates to show their support to securing patient access to medicines, a better-connected NHS, enhancing accessible prescribing in local communities, and maximising health improvement through locally accessible pharmacy teams. Candidates are urged to called on the next Government, if elected, to support the pharmacy workforce to deliver patient care, unlock the potential of new advances in medicines, and continue to support funding for the UK science and research community. The manifesto highlights the need for investment in IT infrastructure to support a better-connected NHS to enable all health professionals to access and update a patient's record.

The Pharmaceutical Services Negotiating Committee (PSNC) has published an update on the work it is doing as part of the Transforming Pharmacy Representation (TAPR) Programme to take forward the mandate from contractors to deliver the Review Steering Group (RSG) recommendations. The update is primarily aimed at LPCs - with whom PSNC has been working closely on some of the TAPR work over the summer. The TAPR Programme is being undertaken in support of PSNC's work to address the severe challenges facing the community pharmacy sector at present. Alongside ongoing negotiations with Government and the NHS, two of the TAPR workstreams - focusing on Vision and Strategy, and on Influencing and Negotiation - are essential to supporting CPCF negotiations. "The workstreams are looking at the future of community pharmacy and how best to persuade policymakers to implement a shared vision, with their objective being to put the sector in a stronger position going into future CPCF negotiations," said PSNC.

The Royal Pharmaceutical Society (RPS) has revealed the "differential attainment" gap among Black pharmacy students and Foundation trainees. Research conducted by pharmacy education has revealed unique challenges leading to lower attainment in the registration assessment and an undergraduate awards gap compared to white students. The organisation plans to work with new groups including BPSA, GPhC, NHS England, Pharmacy Schools Council and representatives from Schools of Pharmacy, to achieve a fair and equitable education and training experience for the students. They plan to reach out to student representative organisations to secure their participation in a quarterly meeting of the group. Differential attainment is the unexplained variation between groups who share a protected characteristic, for example, ethnicity, gender and disability.

A recently published report on medicines optimisation highlights the urgent need for transformative changes across all pharmacies to unlock their full potential in delivering integrated care. The report by Public Policy Projects (PPP) is first of the four in the series that emphasises the significant benefits that medicines optimisation can bring to integrated care systems (ICSs). This includes reducing health inequalities and improving population health. Pointing to the "untapped opportunity" that medicines optimisation presents for ICSs facing financial challenges, the report underscores the vital role of pharmacies in enhancing patient outcomes. The launch of the Pharmacy First services has already demonstrated the essential contribution of pharmacies to the health and care system. With "medicines being the second highest cost to the NHS," the report recommends ways "to achieve better value for money while improving patient outcomes".

Professor Harry McQuillan has said community pharmacists in the UK must change their focus from an 'accuracy of supply' to a 'safety of supply' model when it comes to dealing with patients. "The main take away message from tonight's lecture is for pharmacy professionals to really challenge themselves about whether they are focused on accuracy of supply or safety of supply," he said at this year's UCL School of Pharmacy Lecture in London on Thursday, 15 June. "For our community pharmacists it must be about safety, including prescribing, and ensuring patients and citizens get the maximum benefit from prescribed medicines. "To deliver this, we need to invest in our teams - harness technology and always be willing to take the next step in a more clinical future." The Chief Executive Office of Community Pharmacy Scotland, however, noted that at a time when the UK was grappling with an unprecedented national debt crisis exacerbated by severe cost of living and spiraling inflation, community pharmacy will need to make a "compelling case" of where the priority should be in the sector. Expanding on the financial woes of the country, he compared the current national debt of the UK, which stood at a staggering 270 percent of GDP in September 2022, with the previous record-breaking national debt of 250 per cent at the end of WWII.

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.