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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).

Tough times for community pharmacies in England are far from over as the industry continues to grapple with major gaps in the workforce. Even though the latest figures released by the Health Education England (HEE) Community Pharmacy Workforce Survey 2021 showed doubling of pharmacist vacancy rate in England to 8 per cent between 2017 and 2021, it flagged the contractors' difficulty level in filling up these positions. The survey report showcased changes in the size and make-up of the community pharmacy workforce since the last survey conducted in 2017. It revealed that 56 per cent of pharmacy contractors reported high difficulty level in recruiting pharmacists, up from 21 per cent in the earlier survey. Moreover, a greater proportion - 60 per cent of contractors found filling up the pharmacy technician role 'fairly' or 'very' difficult. Other roles in the sector considered difficult to fill included accuracy checkers and trained dispensing assistants, both at 58 per cent.

Professional leadership bodies from around the world discussed workforce shortages in community pharmacy and other challenges affecting the sector at a global meeting held in Paris last month. Delegated from Denmark, Australia, Ireland, New Zealand, Portugal, Spain, US and the UK updated the conference on how the profession was progressing in practice, technology and workforce development in their respective countries. The UK was represented at World Pharmacy Council meeting by National Pharmacy Association chair Andrew Lane and chief executive at the Pharmaceutical Services Negotiating Committee Janet Morrison. Lane said: "It's very useful to be part of a global network of pharmacy bodies who are all going through similar challenges as we are in the UK. Sharing intelligence on other pharmacy systems around the world helps us to prepare the right strategy for engaging with the NHS at home. "Hearing some of the strides in services and digital technology in the profession gives us hope for the future of the sector. It's clear however that key challenges such as workforce shortages are starting to have an effect in other parts of the world too."

Community Pharmacy England has submitted a full and detailed written response to the Health and Social Care Select Committee's pharmacy inquiry. The Committee is expected to hold oral evidence sessions when Parliament returns in the Autumn. The commencement of this inquiry follows on from those held on other primary care sectors, including Dentistry and General Practice. According to the Committee website this inquiry 'will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy services'. Key themes of CPE's submission include- Suggestions on future service provision; Challenges with the pharmacy workforce; Longstanding underfunding of the sector; and Current pressures. Janet Morrison OBE, Chief Executive of Community Pharmacy England, said: "This is an extremely important opportunity for all who work with and in the Pharmacy sector, to highlight not only the extreme challenges we face, but also ideas and suggestions for what more we can do to help patients and the public in the future.

The pharmacy inquiry will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy services. It will also consider current challenges around funding, workforce and the digital infrastructure. Planned developments within the profession will enable future pharmacists to be independent prescribers from day one of registration, giving them a greater role within primary care teams. Health and Social Care Committee Chair Steve Brine MP said: "It is clear that pharmacy has a central role to play in the future of the NHS. With a greater focus on personalised and patient-centred healthcare, we will be asking what more must be done to make sure that the profession is in the best shape to meet demand. "Better use of the pharmacy workforce would reduce pressures on general practice and hospitals. However, this will not happen without a planned workforce with the funding, supervision and training to support it. "At the end of the inquiry, the committee will be making recommendations to the government on what action needs to be taken to ensure the potential of pharmacy is realised.

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.

Pharmacy bodies and MPs discussed on support needed to unlock the "full potential" of community pharmacy at the All Pharmacy Party Group (APPG)'s general meeting held in Westminster on Tuesday (01 November). The attendees of the meeting were Janet Morrison OBE, Chief Executive of Pharmaceutical Services Negotiating Committee; Malcolm Harrison, Chief Executive of The Company Chemists' Association; Thorrun Govind, Chair of the Royal Pharmaceutical Society; Sanjeev Panesar, National Pharmacy Association Board Member, and Pharmacist Superintendent and Owner of the Pan Pharmacy Group; and Sandeep Dhami, Association of Independent Multiple Pharmacies member and superintendent at MW Phillips Chemist At the session, 18 parliamentarians were briefed on the myriad of ways pharmacies contribute to the health of the nation. The panel of experts also highlighted that pharmacists are 'running out of fuel' with the growing challenges such as flat funding, workforce shortages and the cost-of-living crisis impacting pharmacies' ability to deliver vital services.

Pharmacy bodies have welcomed the new minister in charge of the profession amid warnings that he will find the sector in a state that is "more fragile that ever" due to "untenable funding and workforce pressures". Neil O'Brien was re-appointed as parliamentary under secretary of state in the Department of Health and Social Care (DHSC) on October 25 and was later assigned the pharmacy brief. The Conservative MP for Harborough - who will have a wide-ranging portfolio of responsibilities, including primary care and pharmacy - has taken over the position from Will Quince MP, who had a brief stint as pharmacy minister but remains at the department on a different role. O'Brien was was handed a junior minister's job at DHSC on 7 September 2022 in the government led by Liz Truss but fellow Conservative Quince was assigned primary care duties including pharmacy. Welcoming him to his new role, The Company Chemists' Association said that the minister would find that the community pharmacy sector was "more fragile than ever" with untenable pressures over funding and workforce.

The General Pharmaceutical Council (GPHC), Royal Pharmaceutical Society (RPS), Company Chemists Association (CCA), Association of Pharmacy Technicians UK (APTUK), National Pharmacy Association (NPA), Guild of Healthcare Pharmacists, Pharmacists' Defence Association (PDA), and Independent Pharmacies Association (IPA) have released a joint statement in response to the far-right riots across the UK. They emphasised their united stance, declaring zero tolerance for racism towards colleagues or the public in any form. The joint statement reads: "We are shocked and saddened by the violent public disorder events in recent days. "We acknowledge how all sectors of the pharmacy profession may be impacted and recognise the challenges that this level of overt aggression can have on people's ability or willingness to live their daily lives. "The pharmacy workforce deserves peace and safety, not fear and harm. We stand united in having a zero tolerance of racism towards our colleagues or the public in whatever form it takes." Meanwhile, Community Pharmacy England (CPE) has expressed concerns that protests and violent disorder in various towns and cities across England may impact the ability of community pharmacies to operate.

The Pharmacy Schools Council (PhSC) has issued a statement urging a cautious approach to the significant expansion of additional UK universities seeking accreditation for new Master of Pharmacy (MPharm) programmes. At least seven more UK universities are seeking accreditation for new Master of Pharmacy (MPharm) programmes, but existing pharmacy school heads are warning that severe staffing shortages could threaten the quality of education. While the council welcomes the increasing interest in the pharmacy profession, it has warned that the "growth is managed not only in the workplace but within the education sector." In a meeting held in April 2024, the council members expressed that while this expansion would increase the number of undergraduate places available for pharmacy students, heads of existing pharmacy schools raised serious concerns about the challenges in recruiting suitably qualified staff to run these programmes. The PhSC highlighted the difficulties in attracting candidates for academic positions, particularly those requiring clinical expertise.

The Royal Pharmaceutical Society's (RPS) second roundtable on workforce wellbeing resulted in a series of collaborative actions to address pharmacy professionals' mental health and wellbeing challenges. The roundtable brought together key stakeholders from the pharmacy sector, including organisations like the General Pharmaceutical Council (GPhC), Community Pharmacy England (CPE), the National Pharmacy Association (NPA), and the profession's independent charity Pharmacist Support (PS). A report detailing the outcomes of the meeting was published on Friday, highlighting the key areas of discussion and the agreed-upon actions by the participants. During the roundtable, participants discussed the importance of understanding the workforce demographics, both nationally and locally, and using data to address wellbeing issues effectively. They also emphasised the need for using supportive standards set by the General Pharmaceutical Council (GPhC) and the Care Quality Commission (CQC) quality statement to support and empower pharmacists' wellbeing positively.

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 Royal Pharmaceutical Society (RPS) in England and the National Pharmacy Association (NPA) have jointly released a report addressing the challenges faced by community pharmacy when accessing designated prescribing practitioners (DPPs). This report is the outcome of a multiprofessional roundtable event held in June, which brought together representatives from employers, unions, regulators, and NHS England. The report proposes solutions and collaborative actions to build on the current work to support pharmacists and trainees in securing access to a DPP, enabling more of the pharmacy workforce to become prescribers. James Davies, RPS Director for England, said: "The report published today demonstrates the importance of working collaboratively across employers, education training providers and the NHS to ensure that we can create the prescribers that our patients need for the future. "While there is significant work to continue to do by all parties, this helps us come closer to addressing some of the current DPP challenges for community pharmacy."

A call to action has been issued by the Company Chemists' Association (CCA) in its submission to the Darzi Review, highlighting the critical need for recognition and revitalization of the community pharmacy sector. The CCA warns that chronic underfunding and a flawed Community Pharmacy Contractual Framework (CPCF) have resulted in a reduction of over 1,200 pharmacies since 2015. This reduction, coupled with increasing workforce pressures, is exacerbating health inequalities, particularly in deprived communities. The CCA's submission stresses that the government must address these longstanding funding issues to fully unlock the potential of community pharmacies in addressing the nation's health challenges. The report argues that while initiatives like Pharmacy First have been positive, they only scratch the surface of the sector's capabilities.

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."

Since the introduction of the 2019 NHS Long-Term Plan, several policy commitments have surfaced, presenting a definitive 'blueprint' for community pharmacy in England. The Company Chemists Association has identified four crucial commitments that, when integrated, hold the potential to revolutionise patient care through community pharmacies. "Each commitment is like a crucial piece of a puzzle," CCA said. "For the transformation of patient access through community pharmacy to be successful, all these pieces must come together harmoniously. Otherwise, the picture will remain incomplete." The four major pieces of the puzzle coined by CCA include: * Building on education and training reforms to increase the size and capability of the workforce. * Expanding the number of clinical services commissioned and delivered in community pharmacy. * Introducing digital enablers which underpin service delivery. * Introducing legislative changes to increase capacity and allow the delivery of more patient-facing clinical care.

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.

MP Steve Brine, the chair of the health and care committee, said that the healthcare in the UK "doesn't work without pharmacy". The inquiry focuses on addressing current issues, particularly around the "funding model, digital infrastructure and workforce recruitment, training and retention." Brine said at the Sigma annual conference on Sunday, that he wants to "focus on the sector", and "drill down into some of the challenges and potential" that lies ahead. "The Health and Social Care Committee, we think about much of our work through the lens of pharmacy, what role it plays, the quality of care that it delivers, and the potential for it to do more," said Brine. He further said that he wants to "build on the groundwork" and to "cover as many of the different pharmacy services within the pharmacy sector as we can, so pharmacy in our communities, in hospitals and general practice".

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".

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".