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A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

Lloyds Pharmacy's closure of all its 1,300 branches will wake-up the ministers and NHS officials to the reality of community pharmacy sector in England has reached crisis point, expressed Nigel Swift Managing Director of Rowlands pharmacy and Deputy Managing Director of PHOENIX UK. On Friday, The SUN reported that the UK's second largest pharmacy provider - is allegedly in the process of selling its entire estate of 1300 branches. Lloyds Pharmacy will no longer be a High Street presence following its decision to put all its pharmacy branches at the risk of closure. In January it has announced to close its 237 Sainsbury-based pharmacies. Nigel highlighted the fact that community pharmacy is struggling due to insufficient government funding and immense pressures on GPs and A&E departments - an ongoing issue which poses a very real threat to the sector. Commenting on the announcement, he said: "It's not just Lloyds - an independent analysis by Ernst & Young estimated that 75% of community pharmacies will be in financial distress in the coming years. £750 million has been taken out of the English contract due to inflation since it began."

The Pharmaceutical Services Negotiating Committee on Tuesday (June 30) renamed itself as Community Pharmacy England, promising a "strengthened commitment" to champion and engage with the sector. "The name Community Pharmacy England better reflects the breadth of work that we do to both represent and support community pharmacies in England. We are their champion," the pharmacy negotiator said. Explaining that the rebranding exercise was in line with proposals put forward by the Review Steering Group (RSG), it said the rebrand was part of its Transforming Pharmacy Representation (TAPR) work and that it would signal the beginning of a "new engagement strategy" to build stronger relationships with pharmacy owners. "Becoming Community Pharmacy England is much more than a name change or a new logo, it is a driver for cultural change across our organisation. "Our members want us to be more authoritative, representative, and influential, and rebranding gives us a clearer and stronger voice, helping us to better speak out for community pharmacy."

In its response to a Freedom of Information Request (FOI), the NHS Business Services Authority (NHSBSA) has confirmed a net decrease of 101 pharmacies in England - with 371 closures and 270 new contracts. Meanwhile, the General Pharmaceutical Council data projected a drop of 43 registered pharmacies in England, Wales, and Scotland for the year ending March 31, 2023, compared to the preceding period. The data, released by business advisor Christie & Co in its annual pharmacy market review on Sept. 5, revealed a total of 14,328 pharmacies across all four UK country regions as of March 31, 2023, indicating a 0.3 per cent decrease from the previous year. Corporate operators experienced a net reduction of 249 pharmacies, while the total number of independent operators remained consistent with 2022. According to the study, the corporate sector saw the most substantial shift, with a 13.7 per cent reduction in businesses operating 300 or more pharmacies. Following closely, groups managing 11 to 15 pharmacies experienced a 5.6 per cent decrease. Christie & Co attributed this shift in group size to operators acquiring additional pharmacies through corporate disposal opportunities throughout the year.

O'Briens Pharmacy Group has sold Bispham Pharmacy as part of a strategic review of its nine-site portfolio, now reduced to eight, across the Fylde coast region. Christie and Co, the property adviser, recently announced that the group's popular Blackpool pharmacy business has been acquired by first-time buyer, Arif Bhuriya. Bispham Pharmacy, which dispenses around 4,500 items per month, is situated in the heart of Bispham's commercial centre, opposite a bustling shopping area. The community pharmacy has been in this location since February 2021, following a minor contract relocation. O'Briens Pharmacy Group provides pharmacy services across Fleetwood, Thornton-Cleveleys, Bispham, Burscough, Liverpool, and surrounding areas. Aisling O'Brien, owner of O'Briens Pharmacy, explained the rationale behind selling the Bispham site: "When we had a strategic review of our group, we saw Bispham as an ideal site to dispose of, knowing it would fare much better in the current climate as an owner-operated site.

Many community pharmacies are under severe financial strain due to chronic underfunding and a mismatch between medicine costs and reimbursement rates. A report by the National Pharmacy Association (NPA) revealed that NHS underpays pharmacies by up to £75 a pack for common medicines, resulting in losses of thousands of pounds each month. The NPA analysis found that, in many instances, NHS funding covers only one-fifth of their purchase costs for medicines. Nemesh Patel, Managing Director of the Southdowns Pharmacy Group, said the current pharmacy funding contract is "completely broken and beyond farcical." Sharing their struggles, he tells Pharmacy Business: "Our teams are wasting hours and hours trying to just source medication for patients when they could be better using that time to clinically support our patients, and then when it comes to reimbursement, the drug tariff prices or concessionary prices are structured such that on hundreds of medications we dispense per month, we will be making a significant financial loss, each and every single time our pharmacies dispense that medication."

Steve McCabe, the Labour MP for Birmingham, Selly Oak says a "vicious" NHS contract has been forcing community pharmacies into bankruptcy. Asking his question in parliament during Prime Minister's Questions on Wednesday (March 8), McCabe said he has heard Rishi Sunak speak fondly about working in his mother's community pharmacy. The MP asked how would the prime minister feel "if 600 pharmacies close this year because of a vicious NHS contract which takes no account of rising costs and is forcing many into bankruptcy?" The prime minister responded by saying that community pharmacies do fantastic work and that his government was looking at ways in which it could support the sector to do even more. Sunak said: "I praise the work that our community pharmacies do. They are fantastic at being on the frontline of delivering primary care. And as I've said previously the government is exploring ways in which we can support them to do even more.

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.

Stephen Kinnock, Minister of State at the Department of Health and Social Care (DHSC), discussed all primary care contracts, including those related to community pharmacy, during his meeting with Community Pharmacy England (CPE) Chief Executive and two members from the Negotiating Team. The pharmacy minister reiterated that community pharmacies will be central to the new government's health and wider missions. CPE Chief Executive Janet Morrison and her team updated Kinnock on the community pharmacy sector, highlighting the pressures throughout the summer. They underscored the critical challenges facing the sector and the urgent need for a funding lift. They also discussed Pharmacy First and emphasised the broader potential for pharmacies to further support the health of their local communities.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

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 Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first' approach in England as mentioned by his predecessor on numerous occasions. "Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy First' to support patient access to care. I would urge the new Health Secretary to see this through to completion," said chair of RPS in England Thorrun Govind. Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery, including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers. Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures and organisations, and the need for long-term investment in the workforce. "With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.

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.

"Discussions must involve the government on behalf of NHS Scotland, CPS on behalf of the owners, and the PDA as the pharmacists' representative," it said. The association believes that there is a need for discussion and decision-making that listens to and balances the rights and responsibilities of both employers and workers, to generate benefits for individuals, organisations, and society. It added: "Even though Scotland provides the most generous community pharmacy settlement in the UK, recent reports suggest it is not enough for pharmacy owners with CPS's rejection of the latest funding proposal in May. Though the Scottish government found an extra £20M to ease pressures related to medicines price increases, an overall agreement has still not been reached." "The UK-wide chains may be doing less well in the parts of their networks covered by the Westminster government's contract, but the taxpayers and government of Scotland need to be given reassurance that they are in no way subsidising funding shortfalls in England's pharmacy contract." Recently, when LloydsPharmacy's Scotland branches recently came on the market, they appear to have been sold exclusively to existing contractors, including the UK-wide multiple, Rowlands Pharmacy, who have acquired 30 of them. Other small and medium-sized Scottish pharmacy chains have apparently been able to double in size overnight by acquiring branches.

A community pharmacy, Barton Pharmacy located in Woolacombe, Devon has been sold to a local pharmacist and its previous employee, Harminder Chaggar, announced Christie & Co. The business has been owned by Mr Osman Hamid for the last seven years and was brought to market to allow him to concentrate on his other business interests. Barton Pharmacy is dispensing an average of 2,440 items per month. It lies completely unopposed in the highly desirable North Devon coastal village of Woolacombe, in an Area of Outstanding Natural Beauty, and is an ever-popular holiday destination which boasts 'Beach of the Year 2021' as voted for by The Sunday Times. Osman Hamid, previous owner of Barton Pharmacy, comments, "Owning this business for the last seven years has been an enjoyable experience, as we have had full support from the NHS as it has an attached LPS contract and receives an overwhelmingly generous OTC income which is more than the average pharmacy. The business has huge potential to grow and diversify into other avenues that are yet to be explored, and it is lovely to know that it has been passed onto a new owner operator that I trust will do well with the business moving forwards."

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.

Community pharmacies are bracing themselves to withdraw services from patients after an industry ballot supported plans for major action unless the government provided a significant increase in funding for the sector. The National Pharmacy Association (NPA) on Tuesday (12) announced the results of an unprecedented collective action ballot in which nearly all pharmacy owners, who participated in the ballot, voted to limit their services, insisting that a lack of additional funding is jeopardising patients health and safety. Over 63 per cent of NPA members in England, Wales and Northern Ireland took part in the ballot- representing 3,049 independent community pharmacies in England alone, or 3,399 with Wales and Northern Ireland included. Nearly 98 per cent of pharmacy owners in England voted to reduce their opening hours to the minimum required by their contract. This could result in fewer pharmacies remaining open during evenings and weekends. More than 93 per cent voted to stop offering "unfunded" free home deliveries of medicines, and over 96 per cent voted to withdraw from locally commissioned services, including certain addiction support, emergency contraception, and stop smoking services.

Community pharmacy bodies have said that the current crippling financial pressures and severe staff shortages will limit the sector from fully supporting the new health secretary's ambition to improve patient care in England. Thérèse Coffey announced her plans on Thursday (September 22) which would be looking to reduce the country's reliance on general practice by expanding the range of services available from community pharmacies and allowing pharmacists more "prescribing powers". "Pharmacists will be able to manage and supply more medicines, without a prescription from a GP. We will look to go further on enabling pharmacists with more prescribing powers and making more simple diagnostic tests available in community pharmacy," she said in her foreword to Our Plan for Patients. However, the National Pharmacy Association has lamented that the plan stops short of promising any fresh funding for community pharmacies to deliver patient care and develop clinical services. NPA vice-chair, Nick Kaye, said: "The life is being choked out of independent pharmacy businesses by the continuation of a fundamentally under-resourced contract in England.

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.

Parliamentarians continue to highlight the serious challenges faced by community pharmacists, calling for increased support for the sector. On Wednesday, January 8, during Prime Minister's Questions, Marie Goldman, Liberal Democrat MP for Chelmsford, drew attention to the issue of pharmacies dispensing medications at a loss. Goldman cited the case of a pharmacy owner in her constituency who is 'sometimes forced to pay over 100 times more' for a particular mental health drug than the contract reimburses. Dipak, the pharmacy owner, has been serving his community since opening his pharmacy in 1991, often greeting patients by name. However, he is now struggling to keep his business afloat as his NHS contract no longer covers the cost of the drugs he dispenses. "Dipak is dipping into his life savings to keep the pharmacy afloat. I am sure many other pharmacies are doing the same," Goldman stated. She asked the prime minister whether he agreed that "no pharmacist should be forced to use their own money to keep their pharmacy viable."