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Wales has begun the rolled-out of a community pharmacy prescribing service as part of reforms agreed by the Welsh health minister last December. Eluned Morgan approved wide-ranging changes following re-negotiation of the Community Pharmacy Contractual Framework with Community Pharmacy Wales, the representative body for community pharmacies in Wales. The roll out will allow appropriately trained community pharmacists to treat an extended range of conditions that currently require people to visit their GP. Initially pharmacist prescribers will be able to prescribe medicines, including antibiotics for acute illnesses like urinary tract and upper respiratory tract infections, and also prescribe routine contraception. The first of its kind in the UK, the service is being rolled out progressively across Wales, building on local schemes which are already in place.

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."

Several medium-sized pharmacy chains and multiples in Scotland are increasing in size by purchasing numerous LloydsPharmacy sites that were closed last month. The Pharmacists Defence Association (PDA) Regional Committees met to dwell on the issues faced by the community pharmacists across the UK. The PDA's Scottish regional committee highlighted the impact of Lloyds Pharmacy's closure in their third committee meeting of 2023. It said: "Davidsons who have purchased various businesses in Tayside. Rowlands has purchased 30 branches across central Scotland and the PDA has been in touch with members affected. These members will be supported to ensure that they are properly subject to a TUPE transfer (Transfer of Undertakings Protection of Employment) as they should be when a business changes ownership." Most discussion amongst the Scottish Regional Committee members was around community pharmacy. Reports suggest that negotiations between the Scottish government and the pharmacy owners' body, Community Pharmacy Scotland (CPS) have broken down. As the independent voice of the frontline employed and locum pharmacists that deliver the contract, the PDA wants to see an agreement found for the benefit of patients, taxpayers, and health professionals.

The Pharmaceutical Services Negotiating Committee (PSNC) has urged community pharmacy to plan and ensure patients are able to access their prescription if they have to close in an emergency situation for a short period. It has prepared a guidance which can be undertaken by pharmacy in the event of a closure and the contractor's business can resume easily and effectively once the emergency has passed. In its guidance, PSNC has stated a few actions that can be taken by pharmacy in advance: Plan ahead - be ready before a closure is needed. Don't wait until your pharmacy needs to be closed before you consider how you will manage and what you can put in place to mitigate the impact. Make sure your business continuity plan is up to date and relevant to the current situation. For example, try not to rely on family and friends as part of your plan; if you're having to isolate because of infectious illness, your close contacts may need to do so as well. Ensure your SOPs are accurate, up to date and easy-to-find for someone completely unfamiliar with your pharmacy. Emergency numbers will be crucial. Normal, everyday business continuity issues are still going to arise and anyone on-site needs to know how to address them:

The Pharmaceutical Services Negotiating Committee (PSNC) has initiated the process for the regional representative election for the North-East and Cumbria region after Mark Burdon's resignation from the committee earlier this year. The North-East and Cumbria region covers Community Pharmacy County Durham, Community Pharmacy Cumbria, Gateshead and South Tyneside LPC, North of Tyne LPC, Sunderland LPC and Tees LPC. PSNC said that Pharmacists who are independent chemists and members or officers of these LPCs are eligible to stand for election as a new regional representative. "An independent chemist is defined in the PSNC constitution as a chemist operating retail pharmacy businesses' from no more than nine premises in England from which NHS Pharmaceutical Services or Local Pharmaceutical Services are provided and a person who is not a member of the Association of Independent Multiple pharmacies (AIMp)," said PSNC. The following PSNC briefing sets out the election process and the actions required by those seeking to stand for election.

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.

In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels. PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community pharmacy contractual framework to ensure that the services are adequately resourced." Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular and accessible places for people to receive a range of vaccinations. "The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views on the topic. "In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS response to this consultation."

The Pharmaceutical Services Negotiating Committee announced last week that it is in discussions with the Department of Health and Social Care (DHSC) and NHS England about relieving capacity pressures, such as a relaxation of pharmacy opening hours requirements. PSNC is also scheduling webinars to talk with contactors about the steps they might be willing to take in future, to cut costs, should emergency financial relief fail to materialise. The pharmacy regulator reported that many of its members felt that it was no longer tenable for pharmacies to keep offering all of the free and non-core services to patients that they would like to, and that all contractors should consider what steps they could take to try to safeguard their businesses and their core services for patients. PSNC is also keen to talk to contractors about their current situation and the steps they might be willing to take in future, should emergency relief not be forthcoming.

The new Flat Fee payment to roll out in April 2023 to all pharmacy contractors who dispense at least 101 items a month, up to a national total of £70m on an annual basis. "The value of the Flat Fee payment has now been determined at £533 per month and will be introduced in the April 2023 Drug Tariff," said the Pharmaceutical Services Negotiating Committee (PSNC). "As with all payments, the Flat Fee payments are subject to change throughout the year depending on the overall level of funding delivery to Community Pharmacies. This will be carefully monitored by PSNC and DHSC, and any funding changes will be communicated to pharmacy contractors as soon as they are known," said PSNC.

Pharmacy owners discussed the key concerns and priorities for the future at the Community Pharmacy England's (CPE) digital briefing event held last week (on 7 May 2024). More than 500 pharmacy owners and their representatives registered for the event, which provided them an opportunity to learn more about the committee's work in key areas and share their views on important issues. Major concerns raised by them included underfunding, dispensing at a loss, and challenges in implementing Pharmacy First. Attendees described the new service as "slow", "challenging" and "underfunded", while also highlighting the importance of improving GPs' understanding of the service.

The Pharmaceutical Services Negotiating Committee (PSNC) has appointed Robbie Turner as chief transformation officer, to work closely with LPCs as part of its newly launched Transforming Pharmacy Representation (TAPR) programme. PSNC launched the TAPR Programme in response to the contractor vote in favour of the Review Steering Group's proposals. As part of the programme - alongside actioning the recommendations for PSNC - there will be support for LPCs to implement their proposals. Williams will be responsible for leading, driving, and having oversight of the TAPR workstream to increase efficiency and outcomes across the network of LPCs in England. This will include the provision of specialist hands-on guidance and support to LPC members and officers, to promote implementation of the RSG proposals, best practice and challenging the status quo. Williams was formerly chief officer of Community Pharmacy West Yorkshire LPC and subsequently Director for England and Director of Pharmacy and Member Experience at the Royal Pharmaceutical Society.

The government has extended VAT exemption from Monday (1 May) on healthcare services carried out by pharmacy staff under the supervision of pharmacists. HM Revenue and Customs has issued a note detailing the change to the VAT treatment of medical services. The Government said this will bring the VAT treatment of pharmacists in line with other registered health professionals providing medical services to the public. The Pharmaceutical Services Negotiating Committee (PSNC) said: "This is something that PSNC has been seeking Government agreement on for a long time, including in recent CPCF negotiations." PSNC believes that the extension of this VAT exemption will help as community pharmacy businesses try to make better use of the skill mix in their teams both now and in the future. "Not only does it enable contractors to review the VAT status of any locally commissioned services currently provided by non-registered pharmacy staff but also, in time, it could be used to amend nationally commissioned services to allow support staff to provide certain parts. For example, following a recent amendment to the service Directions, pharmacy technicians are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service.

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."

Tesco, one of the leading pharmacy chains in the UK, has been allegedly accused of forcing some locum pharmacists to accept lower rates or it will cancel their booking. The issue has been brought to the notice of the Pharmacists' Defence Association (PDA) by some of its locum pharmacists members. "Some locum pharmacists who had existing confirmed bookings at Tesco stores have reported to the PDA that the company has contacted them to say that if they do not agree to accept lower rates than have already agreed, the company will cancel their booking," said PDA. "The reported messages follow a communication from Tesco setting self-imposed so-called "wage rates" for locums. This is confusing as locums are self-employed and therefore should be able to negotiate rates with their clients just as any other independent supplier can do. Using terminology such as "wage rates" is more indicative of an employer-employee relationship and could undermine the status of the locum market in community pharmacy. Employees are also entitled to various extra benefits and have greater employment rights."

Community pharmacies in England will continue to receive the free protective equipment (PPE) as the Government's scheme has been extended for another year until March 2024. The Department of Health and Social Care (DHSC) has announced that it will continue to supply all categories of PPE, free of charge, for frontline health and social care staff according to demand until the end of March 2024, or when stocks run out. Last year, DHSC implemented a new and improved portal platform for eligible providers to access free COVID-19 related PPE supplies. The Pharmaceutical Services Negotiating Commitee (PSNC) said: "Community pharmacy teams can continue to order PPE from the NHS PPE portal for free for as long as stock is available."

More than 10,000 pharmacy contractors those have declared their March FP34C submission figures through the Manage Your Service (MYS) portal by 5 April will receive earlier advance payments on Monday 11 April, the NHS Business Services Authority (NHSBSA) announced. Around 10,700 pharmacy contractors have made their submissions through MYS portal. They will receive their advance payments some 20 days earlier than the normal payment timetable. However, due to late submission (after April 5), over 500 contractors will not receive any earlier advance payments in April. These contractors will receive their advance payments on 1 May, in accordance with the normal payment timetable. From this month, MYS is the only route available to contractors for all monthly FP34C submissions. The Pharmaceutical Services Negotiating Committee (PSNC) reminded contractors that from this month (for prescriptions dispensed in March), the NHSBSA may apply an administrative deduction of £25 if a prescription bundle is submitted late.

Nearly 9,000 pharmacy contractors benefitted from earlier advance payment in January, Pharmaceutical Services Negotiating Committee (PSNC) said in an update. Contractors who declared their December FP34C submission figures (for the dispensed prescriptions) through the Manage Your Service (MYS) portal by January 6, would have received earlier advance payments on January 12. Meanwhile, all contractors who made submissions after January 6 or used the FP34C paper document, will receive payments as per the normal payment schedule i.e. on February 1, 2022. PSNC encouraged contractors to submit their monthly declaration through the MYS portal by the 5th of the month to avail early payments.

The Pharmaceutical Services Negotiating Committee (PSNC) has appointed Sunil Kumar, an independent contractor from Darlington, as the Regional Representative for the North East and Cumbria region. "Kumar will represent all independent contractors in the region at the PSNC Committee until 31st March 2023, which is the end of the current term for all Regional Representatives," said PSNC. PSNC's North East and Cumbria region covers the areas of Community Pharmacy County Durham; Community Pharmacy Cumbria; Gateshead & South Tyneside LPC; North of Tyne LPC; Sunderland LPC and Tees LPC.

Leaders from across the pharmacy sector and trade bodies dwelled on the challenges faced by the pharmacists at the Sigma Conference held on Sunday (2 October). "If the cost of carrying out regulation is higher than the benefits, it's time for all the bodies to sit together and talk on what can be adjusted accordingly," said Salim Jetha, Chairman, Avicenna. Jetha highlighted the challenges faced by the independent pharmacy and also raised the concern about the 'level playing field' for pharmacists compared to GPs. He said: "GPs get paid for energy cost, premises cost, the staffing cost. We don't get paid for that. So don't be misled by saying we are being exactly the same. Yes, on paper we are, but in reality we are not. I think also the rules of engagement are different." He called for better collaboration with GPs, and urged PSNC and other trade bodies to ensure a level playing field. Janet Morrison, CEO, Pharmaceutical Services Negotiating Committee(PSNC), warned that the pressure in the sector is building up to a 'breaking point'.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed its concerns over sustained pressures on medicines supply that are having a very serious impact on community pharmacy teams and their patients. It has asked contractors and their teams to continue using its regular reporting tools to help them demonstrate the scale of the problems to the Department of Health and Social Care (DHSC) and to support escalations as needed. The committee said: "The sustained increases in price concessions that we have seen so far in 2022 - with more than 100 concessions being granted in some months - show no signs of abating, and we know that many pharmacies now find themselves in a critical situation trying to source medicines in timely manner and facing significant financial risk due to greater uncertainty around expected reimbursement prices for a large number of medicines." "We know that some concessions being imposed by the Department do not match contractors' experience on the ground, and we would ask all contractors to continue reporting pricing issues to us on a regular basis to support our representations: Report product over Drug Tariff price."