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Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million a year - are now being carried out by community pharmacy teams in England. This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year. PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations were recorded, with the average pharmacy completing 19 consultations per day. This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week. The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy coming from these routes; grossed up to a national level that means 117,000 cases per week. These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).

A recent analysis conducted by the Company Chemists' Association (CCA) has revealed stark disparities in patient engagement with the Pharmacy First service across the country, likening the pattern to a 'patchwork quilt'. It indicated that patients in the highest-performing Integrated Care System (ICS) received seven times more Pharmacy First consultations than those in the lowest-performing regions. As of April 21, more than 3,000 CCA member pharmacies had delivered 126,484 Pharmacy First consultations since the programme's launch. However, the analysis found significant regional variations, with nearly 13,000 consultations completed in the North East and North Cumbria ICS, while only 948 were completed in Gloucestershire ICS. The CCA calculated that if every ICS had as many consultations as the highest-performing ICS, there would have been an additional 600,000 Pharmacy First consultations nationwide.

Pharmacies are valuable healthcare assets, meeting increasing public demand. However, a substantial portion of their capacity is consumed by unfunded work. According to Community Pharmacy England's (CPE) 2024 Pharmacy Advice Audit, community pharmacies conduct over 1.3 million unfunded consultations each week, equating to 69 million annually. The average pharmacy completes around 22 of these consultations daily, each taking approximately 5.6 minutes of staff time -adding up to over two hours daily. This represents nearly 50 per cent more consultations than in 2020 and a 78 per cent increase in time spent on unfunded healthcare advice since the 2020 audit. The audit, which surveyed over a third (3,916) of community pharmacies in England earlier this year, also highlights that pharmacies handle nearly 150,000 informal referrals from GPs and NHS 111 each week. All these referrals could have been routed through the Pharmacy First service, which would have potentially secured over £115 million in funding for the sector, the CPE noted.

People in the UK have a high level of trust in pharmacies and many are keen on seeing the Pharmacy First initiative expanded, according to the 2024 STADA Health Report published today (24 June). The 10th annual health report by global healthcare leader STADA Arzneimittel AG, the parent company of Thornton & Ross, involved a survey of over 46,000 respondents across 23 countries, including 2,000 participants from the UK. The UK data showed an overwhelming trust in UK pharmacies, with 94 per cent of those surveyed (more than nine out of 10 Brits) saying they have only ever had good advice from a pharmacist. The report also indicated a strong desire for the Pharmacy First scheme to be expanded, with 44 per cent of respondents advocating for an increase in pharmacists' scope of responsibilities to support doctors.

The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists are able to reap the benefits from it. Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies. Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just delighted to have easier access to care," he said. In its first month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an average of 200 interventions per week. "That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a week - that's a huge capability and capacity bump for the NHS," he added. Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.

Labour's Paulette Hamilton has raised concerns regarding the increasing reliance on pharmacy technicians in clinical practice due to staffing shortages within pharmacies. At the recent Pharmacy Inquiry session, Hamilton highlighted the mounting pressure on technicians to take on more responsibilities beyond their qualifications, attributing it to the launch of Pharmacy First in January. With almost 50,000 Pharmacy First consultations conducted in the first month alone as per a report by the Company Chemists' Association, Hamilton expressed apprehension about technicians being classified under the broad term of "pharmacy professionals," blurring the distinction between their roles and those of clinical pharmacists. She further drew parallels between this situation and the scrutiny faced by physician associates (PAs) in GP practices following a patient's death due to misdiagnosis and cautioned against technicians performing tasks beyond their expertise and urged policymakers to prevent similar incidents in pharmacy settings. Health Minister Dame Andrea Leadsom responded by defending the current approach, denying any "blurring of the edges" and emphasizing patient safety as the top priority.

Pharmacy Minister, Will Quince received flu vaccination and blood pressure check at his visit to a Boots pharmacy in Westminster arranged by the Company Chemists' Association (CCA). The Boots pharmacist, Flavia, explained to the Minister the broad range of services the pharmacy delivers, from the new medicines service to emergency contraception and the community pharmacy consultation service. The Minister witnessed first-hand much of what the community pharmacy sector has to offer patients and the NHS. Malcolm Harrison Chief Executive of the CCA said: "We share the Minister's vision on how community pharmacies and their teams can contribute to the 'Plan for Patients' set out by the Secretary of State. It is great to have the support of the Minister and we are excited for the future of pharmacy.

Alitam has announced that it has merged with clinical skills training provider MHRx to upskill UK pharmacists so that its chain of community pharmacies in the UK can diagnose and treat minor medical ailments "quickly and safely". This is a second merger deal announced by the group that has 100-plus pharmacies, just days after its merger with Pharmadoctor to "radically transform the UK and Ireland's community pharmacy sector" into a truly preventative healthcare system. Following the merger with MHRx, Alitam will now be providing a career development platform for its pharmacy teams, which also include nurses and other healthcare professionals. MHRx's training incorporates every aspect of general practice alongside relevant topics including making appropriate patient consultation records in line with NHS guidelines. This, Alitam believes, will allow community pharmacies to carry out formal diagnoses, formulate differential diagnosis plans, and perform full clinical examinations. According to the founder and CEO Feisal Nahaboo, mergers such as these will lead to "a healthcare revolution predicated on building the world's first truly preventative healthcare model".

Since its launch on January 31st, the Pharmacy First service by the Company Chemists Association (CCA) has achieved a significant milestone, completing over 200,000 consultations to date. This milestone underscores the service's vital role in providing same-day NHS care through community pharmacies across England. Recent analysis by the CCA has revealed a pressing need to bolster GP referrals, with disparities observed between different Integrated Care System (ICS) areas, resulting in what's described as a 'postcode lottery' for patients. CCA Chief Executive, Malcolm Harrison, emphasised the importance of sustained funding for Pharmacy First beyond 2025, ensuring its availability for patients, community pharmacies, and the wider NHS.

Health secretary Wes Streeting has pledged to stabilise the community pharmacy system before enabling it to take on a broader role in healthcare, as he addressed the Health and Social Care Select Committee in Parliament on Wednesday (18 December). "Now that we have got the budget set, we will be consulting with Community Pharmacy England shortly in the New Year," Streeting stated. "I do want to reassure pharmacists across the country that we are taking into account the enormous pressures they are under when thinking about allocations so that we can stabilise the system and create the foundations from which to recover." The health secretary emphasised that his top priority is to "stabilise the [community pharmacy] system" before expanding initiatives such as Pharmacy First and independent prescribing. He also expressed a vision for community pharmacies to play "a bigger role… as part of the shift from hospital to community," but stressed that immediate steps are required to address the sector's current financial strain. The announcement that Community Pharmacy Contractual Framework (CPCF) negotiations will commence early in the New Year was reaffirmed by Streeting, echoing a statement made earlier in the week by minister for care Stephen Kinnock during a Westminster Hall debate.

Community Pharmacy England (CPE) has taken an interesting step to increase public awareness and understanding of the Pharmacy First service. The organisation has launched a new video animation that provides clear and concise information about the service, highlighting the seven conditions covered, the eligible age ranges within the clinical pathways consultations, and explaining how patients can access these services. Pharmacy owners and their teams are encouraged to use the new animation with existing resources to communicate the benefits and scope of the service to their  patients. The animation can be linked to pharmacy social media content and downloaded for display on digital screens in pharmacies. General practices are also encouraged to use the animation on digital screens in their practice waiting areas.

Community pharmacies in Cornwall have delivered more than 8000 face-to-face consultations over last 12 months. Walk In Consultation Service (WICS) began 12 months ago when pharmacies in Cornwall started offering face-to-face consultations for a wide range of minor ailments, and NHS treatment as required - the first service of its kind in England. Cornwall & Isles of Scilly Scilly Local Pharmaceutical Committee (LPC) Chief Officer Nick Kaye joined Operations Manager Drew Creek in Parliament recently by invite of Steve Double MP, St Austell and Newquay to meet with Minister for Health Neil O'Brien MP to present the service to them and Senior Civil Servants from DHSC and NHSE with a view to rolling this service out nationally. The data from these consultations show that over 6000 GP appointments were averted as a result of the service being available. After each consultation a record was sent to the patient's GP for information.

Community pharmacy chain Jardines Pharmacy has partnered with patient relationship management platform Charac to launch a new app designed to digitalise its services, enhance operational efficiency, and elevate customer satisfaction. The app allows patients to order repeat prescriptions, access medicine home delivery and book consultations with their pharmacist all in one place, enabling faster pharmacist-to-patient care. By incorporating Charac's platform into its business, Jardines is able to boost prescription dispensing efficiency, helping reducing wait times for patients. Additionally, its delivery feature enables patients to track their orders directly through the app, thereby streamlining the overall patient experience. The app also minimises administrative and manual tasks for pharmacists, giving them more time to focus on helping patients and delivering the outstanding customer service. Patients of Jardines can also use the app to book appointments digitally for Pharmacy First consultations, blood pressure checks, earwax removal, travel vaccinations, and emergency contraception services. Santosh Sahu, Founder and CEO of Charac, said: "We are pleased to support Jardines Pharmacy and its patients across England. Our mission is to ensure that community pharmacies are empowered to digitalise, making care easier and more accessible for patients.

Researchers from the London School of Hygiene & Tropical Medicine (LSHTM) have been tasked to evaluate the impact, safety and effectiveness of the Pharmacy First service, which was launched across England in January 2024. They have been awarded £2.4million by the National Institute for Health and Care Research (NIHR) to generate evidence on the new service that allows pharmacies to provide advice and treatment for seven common conditions without the need for a GP appointment. After consultation, if necessary, a community pharmacist can supply some prescription-only medicines to treat earache, sore throat, sinusitis, impetigo, shingles, infected insect bites or uncomplicated urinary tract infections in women. The LSHTM researcher team will be working together with experts at the UK Health Security Agency (UKHSA) and the Universities of Oxford, Manchester and Nottingham on the project. Dr Rebecca Glover, assistant professor in Antimicrobial Resistance at LSHTM, who will lead the three-year project, said they will evaluate "Pharmacy First's impact on GPs and the wider NHS, pharmacy services and patients."

A recent report by the Company Chemists' Association (CCA) has revealed a significant disparity in patient engagement with the Pharmacy First service across the UK. In response, Santosh Sahu, Founder and CEO at Charac, has emphasised the need for technological reform to address "the interoperability gap between pharmacists and GPs". Sahu identified the lack of GP referrals for Pharmacy First consultations as a key issue, attributing it to inadequate IT infrastructure. He urged the sector to "implement technological reforms to enhance interoperability between pharmacists and GPs, enabling them to share patient records, identify care pathways, and address health needs more effectively".

Community pharmacists in England have launched a new digital platform called My Local Surgery, enabling patients to access Pharmacy First consultations online. This initiative, a part of the NHS Pharmacy First scheme, facilitates free video consultations for six common conditions, connecting patients with community pharmacists for clinical advice and treatment. The platform, spearheaded by a team of pharmacy, tech, and clinical services experts, including experienced community pharmacists Darren Lingaloo and Gulraj Dhillon, tech specialist Nav Ramiah, and Dr. Adam Kirk, a seasoned NHS and digital healthcare professional, seeks to meet the rising demand for clinical services. Darren Lingaloo, co-founder and chief pharmacist at My Local Surgery, said: "The evolving role of pharmacists is long overdue and has the potential to save millions of GP appointments every year.

The Royal Pharmaceutical Society (RPS) and the charity Marie Curie have developed a consultation on 'professional standards for palliative and end of life care for community pharmacy'. The consultation will be open for four weeks for community pharmacists, organisations with a role in community pharmacy or palliative/end of life care, or patients or carers with first-hand experience of palliative and end of life care to share their views until 1st December 2022. Through this consultation, Society aims to that ensure the standards are clear, relevant, current, and fit for purpose from the perspective of the community pharmacy team, the wider health team and patients/carers. "The final standards will be published in 2023 and will help community pharmacies across the UK to self-assess and continuously improve their palliative, end of life and bereavement care," said RPS.

Armstrong's Pharmacy in Sheffield, South Yorkshire has been sold for the first time in 67 years for an undisclosed price. Located on the corner of Gleadless Road, three miles south-west of Sheffield City Centre, the pharmacy dispenses an average of 11,332 items per month, according to Christie and Co, the broker that facilitated the sale. Owned and operated by the Armstrong family since 1957, the business has been acquired by a husband-and-wife team of first-time buyers. The new owners, whose identities were not disclosed, plan to expand the pharmacy by adding more consultation rooms and increasing services offered to the local community. Chris Armstrong, the previous owner, ran the business with his wife Jane before deciding to sell in preparation for their retirement. Commenting on the sale, Chris said: "It was a big decision to sell our multigenerational business but, when it was time to retire, we were glad that Christie and Co were able to quickly market the business successfully."

Talk of hub and spoke models has been rumbling on for as long as I can remember. The topic has once again hit the headlines as the government announced a fresh consultation for its proposed changes, calling on all interested parties to submit their views by 8th June. The argument for hub and spoke is to allow independents to have the same level playing field as the larger groups who have been operating this model for some time. The government also sees significant efficiency gains in centralisation, arguing this will free pharmacists time away from dispensing to focus on clinical services. The latest consultation advocates two models being created. In the first model, the dispensed medication is sent back to the spoke. In the second model, the completed medication can be sent out directly to the patient. The latter is a new concept which could open up new opportunities in how services are delivered. Pharmacies could effectively outsource the entire dispensing and delivery to housebound patients and care homes allowing pharmacies to take on new business without having to worry about logistics and geography.