Amid the ongoing furore over shortages of Lateral Flow Device (LFD) test kits that led pharmacy staff to bear customers' wrath, the National Pharmacy Association (NPA) and Company Chemists Association (CCA) have jointly appealed the public to be "patient and courteous to pharmacy teams".
In an open letter, the two organisations have urged patients and customers to be patient, courteous and safe while visiting their local pharmacies.
Highlighting the efforts put in by healthcare workers to keep everyone safe through this tough winter, the two organisations said the pressure of Covid-19 and shortage of LFD kits have sometimes led to verbal abuse of pharmacy staff.
Mark Lyonette, NPA chief executive said: "The vast majority of pharmacy customers and patients are polite and understanding. The supply situation with Lateral Flow Tests is stretching people's patience, but that's no excuse for abusive behaviour and people need to understand the constraints on pharmacy teams at this time."
Alongside their routine job of providing medicines, health advice and a range of NHS services, pharmacies have put in extra effort to protect people during the pandemic.
All pharmacy businesses are reporting that they are struggling to find the registered professionals needed to open their pharmacies, clarified the Company
Chemists' Association (CCA) in response to an attack by the Pharmacists' Defence Association.
Last week, PDA allegedly accused some large pharmacy chains of 'orchestrating' full or part-time closures of some of their shops due to the staff shortage.
In its Open Letter published on Tuesday (July 19), PDA demanded urgent action "to protect patients by ensuring that essential community pharmacy services are
provided safely and consistently".
"All parts of the healthcare system are struggling to recruit staff and to assume that pharmacies would be immune to such pressures, seems fanciful," said CCA.
"CCA members are working extraordinarily hard to prevent temporary closures, but recruitment and retention of pharmacists is becoming increasingly tough. The recent
rise in Covid cases and the beginning of the summer holiday season in parts of the UK have only worsened the situation."
The Association also showed data from the PSNC Pharmacy Pressures Survey (April 2022) which found that 91 per cent of pharmacies are experiencing staff shortages,
clearly demonstrating that these shortages are affecting the entire sector.
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.
harmacists in the town of Barnoldswick in Lancashire are reportedly suffering from various problems including a lack of medicines and the movement or loss
of pharmacy staff.
Problems, including delays with supply of insulin, were reported at a recent Pendle Council West Craven meeting.
And this week the head of one pharmacy chain, Whitworth, highlighted a range of issues faced by his teams including supply chains, costs, loss of staff and NHS
reimbursement for contractors.
In Barnoldswick, queues have formed inside and outside pharmacies as people attempt to get prescriptions. Some said they had to wait for days to get what they
needed, had made repeat-visits to pharmacies and were unsure when medicines might arrive.
They also said the number of pharmacies in the area have fallen over the years.
Two town centre pharmacies, Whitworth and Well, are located opposite each other, close to a doctors' surgery. Standing in one queue outside Whitworth was Marilyn
King.
She said: "I have been waiting seven days to get my prescription for blood pressure and some other medicines. This week, I've come back time after time. But the
staff say sorry, they have not got it in because nobody has delivered it.
"I came here on Saturday, when there was a queue. But the pharmacist was not here. I came again on Tuesday and then Wednesday. Then finally, just when I reached
the front of the queue, they asked me to come back in an hour…
Shortage of pharmacists remains a big challenge for community pharmacies as the chief executives of the national community pharmacy bodies met with senior NHS England and NHS Improvement officials to discuss the precarious situation in October-end.
In the last few months, several pharmacy contractors have reported increased staff shortages that caused difficulties in maintaining services, leading to temporary closures in some instances.
The sector is also facing chronic shortage of other staff including van drivers and pharmacy technicians.
During the meeting, NHS England's director for primary care, Ed Waller, and chief pharmaceutical officer Keith Ridge held talks with leaders from across the pharmacy sector on a variety of topics.
The Pharmacists' Defence Association has called on the Scottish government to end unnecessary pharmacy closures and introduce emergency regulations to force
companies that operate Scotland's pharmacies to open on the days and hours they have agreed.
It is concerned that decisions made by some health boards in Scotland have now allowed pharmacy owners to close their pharmacies on Saturdays.
The PDA is worried that a pharmacy closure could have negative impact on patients and other parts of the NHS, including neighbouring pharmacies, addiction and mental
health services, and minor injury and A&E units.
The association claims that there are record numbers of registered pharmacists who are available to work and therefore a decision to close a pharmacy over staff
shortages is misleading.
"The business owners may claim there is a shortage of pharmacists, but when they actively cancel agreed hours of work it does not suggest there is a shortfall of
workers," said the PDA, adding: "These business decisions often include closing their pharmacies at very short notice, even when pharmacists are available and willing
to work."
Pharmacy bodies have urged the Health Select Committee to hold the government to account on pharmacy funding and workforce challenges.
In a show of unity, leaders from the sector came together to write a joint letter to the chair of the committee and former health secretary Jeremy Hunt and bring to
his attention how financial pressures worsened by nearly a decade of a real-term decrease in funding have made the sector virtually untenable.
The Pharmaceutical Services Negotiating Committee (PSNC)'s recently published 'Pharmacy Pressures Survey' confirms how this has had an impact on pharmacy contractors,
their teams as well as patients.
The survey found that 91 per cent of pharmacies are experiencing staff shortages. At the same time, demand for community pharmacists has risen - nine in ten pharmacy
teams reported a significant increase in phone calls from patients about prescriptions, and 86 per cent reported a rise in requests for healthcare advice.
The letter to Jeremy Hunt is signed on behalf of the four chief executives of the PSNC, the Association of Independent Multiple Pharmacies (AIMp), the Company
Chemists' Association (CCA) and the National Pharmacy Association (NPA).
Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching.
More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice.
Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit.
The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists.
Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.
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.
Majority of the pharmacies are facing aggression from patients due to the medicine supply chain issue, a PSNC survey has revealed.
The Pharmacy Pressures Survey by the trade body has seen nearly 83 per cent of pharmacies reporting a significant increase in medicine supply issues in the past year,
leading to extra work and additional stress for staff.
The survey of over 5,000 pharmacy premises and 1,000 pharmacy team members in England took place in early 2022.
Two-thirds of respondents said that medicines supply chain issues are a daily occurrence, with 97 per cent reporting that this led to frustration from patients.
"The results of PSNC's Pressures Survey make distressing reading for anybody in the sector - they tell a story of teams under immense pressures, and of businesses at crisis point," said Janet Morrison, PSNC chief executive.
Digital pharmacy app Charac has raised over £1 million in debt and equity, bringing total funding to date for the London-based startup to £2.5m.
Pharmacy Business understands while the majority of the new finance, worth about £1.2 million, comes from the National Pharmacy Association (NPA) coffer, the
remainder is put forward by a number of individual pharmacy businesses.
The pharmacy sector is in a state of crisis, experiencing nearly two closures per week over the past two years, Charac said in a statement.
According to data from the NHS Business Services Authority, there are now only 11,026 community pharmacies in England, the lowest number since 2015. The current
crisis is attributed to escalating operational costs, a shortage of staff, and diminished government financial support.
Those of us who work in community pharmacy know there is a workforce crisis created in large measure by PCNs actively recruiting pharmacists and pharmacy
technicians from our sector. It is welcome, if long overdue, that this has now been officially acknowledged in a report commissioned by the English Health Secretary.
PCN hiring 'exacerbates pharmacist shortage' says DH-commissioned report, which states such recruitment has "on occasion exacerbated the problem of a general
shortage of pharmacists" which has compounded "the problem of community pharmacy closures."
We have been telling the government this for years only to be told "problem? What problem?"- but now that Steve Barclay has his own official report sitting on his
desk, he and NHSE cannot continue in denial mode. The facts are there for all to see. Time to act. No more dithering, delay or indifference. You asked if there was
a problem and you have been told there is.
In the absence of a holistic workforce strategy and cross-sector career pathways, PCNs poaching from community pharmacy is a zero sum game adding nothing to
improving patient care.
The government has unveiled its much awaited 'NHS Long-Term Workforce Plan' to tackle the staff shortage in the pharmacy sector. The plan set out an ambition
to increase the training places for pharmacists to around 5,000 places by 2031/32.
David Webb, Chief Pharmaceutical Officer for England, in his open letter to pharmacy professionals said: "The NHS LTWP sets out how we can build on changes,
addressing the changing needs of patients over the next 15 years, by closing the current workforce shortfall through funding for increased education and training
places and a comprehensive retention strategy."
The plan commits to expand training places for pharmacists by 29% to around 4,300 by 2028/29 and Grow the number of pharmacy technicians in future years.
"The development of independent prescribing as part of initial education and training is a gamechanger for pharmacists, patients and the NHS, with
approximately 2,800 newly registered pharmacist independent prescribers due to join the workforce every year from September 2026," said Webb.
"This will be transformational for all pharmacy teams, creating improved access and quality of care for patients and, importantly, a more flexible workforce with
skills that are equally applicable in all pharmacy settings, enabling multi-professional clinical teams to work in new ways."
The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England
after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce.
The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to
quit.
Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited
to general practice: community pharmacies are also suffering the consequences of it."
"Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to
make ends meet, not least given the rising staffing costs which are being driven up by workforce issues.
Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt
unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.
A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst
nationwide drug shortages.
According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating
that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients.
"They've got to know when they can get the medications they need," he added.
Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system.
"Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the
tariff price, which is significant and builds up over lots of items," he explained.
Calls have been made for more pharmacies to help with the rollout of the county's coronavirus booster jabs.
Around 25 pharmacies in Kent and Medway have been distributing vaccines to thousands of patients.
This represents just seven per cent of the 320 pharmacies in the county.
The call comes despite staff shortages and growing workload pressures, such as carrying out non-essential tasks, which include patient satisfaction surveys.
Shilpa Shah, the chief executive officer at the Kent Local Pharmaceutical Committee, said: "We have workforce issues, but are pulling together to deliver essential patient services and Covid vaccinations at the same time."
Pharmacies are one of several health organisations working hard to ensure that everyone aged 18 and over will be offered a booster vaccination by the target of January 31, which has been set by the government.
The General Pharmaceutical Council (GPhC) and the Chief Pharmaceutical Officer for England have written a letter to pharmacy professionals thanking them for
providing the best possible services to patients and the public, despite experiencing high and sustained demands and pressures.
GPhC Chief Executive Duncan Rudkin and CPhO David Webb indicated that there will be further challenges over the coming weeks and months due to the ongoing industrial
action, and staff shortages due to sickness or caring responsibilities.
They expressed concerned that increased pressure will have a significant and potentially prolonged impact on pharmacy teams both personally and professionally.
Acknowledging that pharmacy professionals may have to make some difficult decisions as they deal with the pressures they face, the leaders have urged those working
in pharmacy to use "your professional judgement to assess and mitigate risk, and to deliver safe and effective care for your patients within your scope of practice."
National Pharmacy Association (NPA) urged the NHS England to make local impact assessment a key requirement prior to any recruitment into Primary Care Networks (PCNs) and Clinical Commissioning Groups (CCGs), to help tackle workforce crisis.
With inputs from LPCs, PCNs and CCGs should consider the impact of the creation of new roles on all health care providers in the area and on their ability to deliver their objectives on behalf of the NHS, it said.
The NPA believes that creation of the Additional Roles Reimbursement Scheme (ARRS) programme is impacting community pharmacy services in some areas and contributing to the ongoing workforce shortage.
In a letter addressed to Ed Waller, director of Primary Care for NHS England, NPA chief executive Mark Lyonette highlighted the challenges emerged following a shortage of pharmacists and other members of staff.
The Serious Shortage Protocol (SSP), for Estradot 50mcg patches will expire at 23.59pm on Friday 24 February 2023.
Department of Health and Social Care (DHSC) has confirmed that sufficient stock of Estradot 50mcg patches are now available to meet normal demand.
"After 24th February, any prescriptions for Estradot 50mcg patches must be dispensed in accordance with the prescription, and SSP048 will no longer be valid for
use," said DHSC.
Top tips for SSP claims by PSNC:
Where available, use the claim amend facility on the PMR system to rectify any incorrect EPS claims already submitted this month.
For any supplies made in accordance with SSPs, check that the correct number of patient charges are collected and declared on the end of month FP34C submission.
NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA
processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims.
People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP).
According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in
England last year, rising from 12.8 million in 2022 to 17.6 million.
Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for
their services due to severe staff shortages.
Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five
years ago.
Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and
unsustainable workloads" and "we can't keep doing more with less."