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Anyone who has studied the finances of an independent pharmacy business knows that money is tight. In many cases, they are perilously close to failure. It's easy to assume they are retail businesses, cashing in on the higher public profile the sector has enjoyed during the pandemic years. But those have been mere words. Certainly, the pandemic represented a halcyon period for the profession. We engendered a feeling of normality, dependable and accessible to society. We played a substantive role in keeping people out of hospitals and giving the vulnerable the ability to live independently from their own homes for longer. We mobilised to smash flu vaccination records and deliver covid jabs. But despite the warm words of a new service based future and the incessant expressions of gratitude contractors desperately need the headroom to prepare, plan and invest. Platitudes, press releases and assurances of a bright clinical future are small comfort to what is needed and that's cash on the table. As the adage goes: "Talk is cheap, money buys houses." Cashflow crisis Since 2016, we have witnessed almost 650 pharmacies fall by the wayside. Some may have merged; the majority, however, have perished due to the relentless need for an increasing cashflow. It is cash, or rather the lack of it, which is killing independent pharmacies.

Two more independent community pharmacists have been appointed to the UK Commission on Pharmacy Professional Leadership. NPA board member Reena Barai and Sheelin McKeagney from Lurgan in Northern Ireland will join 25 other commission members, including Ash Soni who was the only practising community pharmacist on the initial list published in June. Welcoming the announcement, the National Pharmacy Association chief executive, Mark Lyonette, said: "To their great credit, the co-chairs of the commission and the UK's chief pharmaceutical officers have listened to our request for more community pharmacy presence on the commission. They have acted swiftly to achieve a better balance in its membership and we thank them for responding to our representations. "Around 70 per cent of pharmacists practice in the community. With more voices from community pharmacy within the leadership commission, there is a greater sense that the profession as a whole will be able to own the final recommendations when they are ultimately made."

Boots is planning to invest more than £3.5 million to accelerate its capacity to offer prescribing services in its stores across England. The company is inviting 500 of its pharmacists to apply for a bursary which will cover the cost of pharmacist independent prescriber (PIP) courses starting this September. The value of the bursary is up to £7,000 per pharmacist, and it will enable time off work for those who need it to complete the training. The move by Boots will support its current pharmacists to gain this qualification via courses accredited by the General Pharmaceutical Council (GPhC). From 2026, all qualified pharmacists will be able to prescribe as part of new curricula for pharmacy degrees. Under current GPhC guidelines and with an independent prescribing qualification, pharmacists can prescribe autonomously for any condition within their clinical competence. Marc Donovan, the chief pharmacist at Boots, said the ambition of the company was "to have a pharmacist prescriber available at every store".

When I was asked by fellow independent contractors to join the Review Steering Group (RSG) back in late 2020, I said yes, because I wanted, fundamentally, to look for some ways to improve both LPCs and PSNC. Through my experiences with Greater Manchester LPC I had seen the sorts of changes that LPCs could make and the positive impact that those had on local engagement and in allowing us to do more to support contractors: I wanted to help share what we had learned with the rest of the country. I was pretty sure that the national negotiator could make some positive changes as well. It took longer than I had hoped. And it was a lot harder than I had imagined - not least because of the extent of some of the divisions within our sector - but after 15 months of hard work, I'm pleased with where we have got to, and I believe the 37 changes being proposed will help all contractors. Consensus is not a sexy word. It is not something that fires up our imaginations or that we put on our list of key work objectives for the year. It is also not something that might come naturally to us as independent contractors. But consensus is something that matters. It is the thing that allows us, as a vibrant and diverse group of businesses, to see beyond our differences and to fight together for outcomes that benefit every single one of us. Consensus is also the thing that the RSG has been relentlessly focused on throughout its work, and it's at the heart of what will give our LPCs and PSNC a stronger voice for community pharmacy in the future.

The Pharmacists' Defence Association (PDA) says the pharmacy regulator should maintain a two-year post qualification eligibility criteria, in addition to the qualitative measures being introduced which would be in the best interest of patient safety, before a pharmacist is allowed to commence an IP course. The association was responding to an announcement by the GPhC's move to scrap the two year requirement for Independent Prescribing (IP) course. "The PDA accepts that the qualitative approach could mean greater individual consideration of potential IP course candidates and the two-year measure could have sometimes been a blunt tool. However, the PDA is already seeing cases of patient harm and allegations around fitness to practice arising from IP," the association said. The association also said that it supports individual pharmacists with near misses, as well as actual incidents, giving the organisation possibly the most comprehensive understanding of risk. Frontline pharmacists also recognise these issues and in a survey of over 1,000 pharmacists undertaken by the PDA in late 2021, of those who had 2+ years' experience of practice and who were already independent prescribers, 90 per cent said the qualifying period should be two years or more.

DE Group, one of the UK's leading independent pharmaceutical wholesalers, has gone into administration. Pharmacy Business has learnt that the group was put into administration on Monday (May 9), putting hundreds of jobs at risk and stoking fears of a "sudden shock" to pharmaceutical supply chain. A community pharmacy contractor who has done business with the wholesaler for over 20 years told Pharmacy Business: "I fear for the worst. I don't think there will be enough supply of medicines to cope up with a surge at such a short notice." Bharat Shah, founder and CEO of Sigma Pharmaceuticals, another leading short-line wholesaler, said the news will send shock-waves and have "a massive impact on the market" because DE Group enjoyed a "substantial coverage and market share" in the independent pharmacy sector. "It won't be easy for anyone to take on the extra volume as it could jeopardise their own business," he said, adding that Sigma was actively looking into expanding its own operations in the foreseeable future.

The Medicines and Healthcare products Regulatory Agency (MHRA) has advised 'no one should stop taking valproate without advice from their healthcare professional.' The latest data on the use of valproate in England revealed that in the last 6 months the number of pregnant women prescribed valproate in a 6-month period has fallen from 68 women in April to September 2018, to 17 women in October 2021 to March 2022. In light of concerns that the current regulatory requirements for safe use are not being consistently followed, the MHRA conducted a review of the available data and asked for advice from the independent Commission on Human Medicines (CHM). "The CHM has advised that no one under the age of 55 should be initiated on valproate unless two specialists independently consider and document that there is no other effective or tolerated treatment," said MHRA. "Where possible, existing patients should be switched to another treatment unless two specialists independently consider and document that there is no other effective or tolerated treatment or the risks do not apply."

Professor Mahendra Patel OBE, CEO of the Oxford University Centre for Research Equity (CfRE), has been appointed as an independent expert member of the UK Pharmacy Professional Leadership Advisory Board. The newly established Board comprises nine independent expert members (IEMs) with outstanding leadership capabilities, who were appointed through open recruitment, ensuring a "broad, balanced, and diverse" representation. Sir Hugh Taylor KCB, the Independent Chair of the Board, and the UK Chief Pharmaceutical Officers (CPhOs) - Andrew Evans (Wales), Cathy Harrison (Northern Ireland), Alison Strath (Scotland), and David Webb (England) - announced the appointment of IEMs in an open letter to the UK pharmacy professions. "Bringing a wealth of experience and expertise, they will play a pivotal role in the Board's work to deliver an exciting vision through supporting a new and dynamic phase of collaboration," the CPhOs said. As the CEO of CfRE, Professor Patel spearheads efforts aimed at addressing inequalities in healthcare.

Sixty-seven per cent of UK independent pharmacists say the pandemic has positively changed how patients view the clinical services offered by community pharmacy. The research - carried out with an independent panel of more than 100 community pharmacists - revealed that 35 per cent of them had increased their clinical services to fulfil patient demand during the pandemic. Seventeen per cent said they had expanded their private clinical services such as vaccinations and dermatology, with a further 17 per cent adding sexual health services such as emergency contraception and chlamydia screening in their services offer. Thirty per cent introduced NHS health checks and emergency supply NHS services during the pandemic.

The Association of Independent Multiple Pharmacies (AIMp) has called upon all pharmacy organisations to unite and collectively represent the sector. While underlining the need for the sector to adopt a straightforward manifesto that can be presented to the public, politicians, and decision-makers, the association also advocated for a revitalisation of the 'Save Our Pharmacies' campaign, injecting it with renewed energy and a stronger sense of purpose. AIMp pointed out that a lack of cohesion is one of the factors contributing to the sector's struggle in gaining attention. "The current trajectory of community pharmacy is unsustainable," said Dr. Leyla Hannbeck, Chief Executive of AIMp. "To tackle the significant challenges ahead, we must work together cohesively. The most effective approach is to actively engage with Parliament, leveraging politicians from across the political spectrum to advocate for our cause." Meanwhile, the association urged various pharmacy bodies to unite in support of the Pharmacy All Party Parliamentary Group (APPG) to enhance its effectiveness and broaden its influence, rather than working independently.

harac, an NHS-integrated one-stop platform for independent community pharmacies, and the National Pharmacy Association (NPA) have announced their long-term partnership to allow pharmacies to deliver the broad range of services needed to support the public. The NPA and Charac will collaborate with members of the NPA and beyond to accelerate the necessary digital transition of independent community pharmacies, particularly given their importance to poorer communities and less advantaged individuals at high risk due to potential pharmacy closures. The partnership is part of the NPA's efforts to improve the online presence of community pharmacies, including patient application, online booking, website design, and a delivery service. With Charac similarly dedicated to bettering digital interaction with patients, the new joint ecosystem will provide pharmacies with the necessary funding and cutting-edge technology to aid delivery of primary care.

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.

Health Education England (HEE) has invited community pharmacy contractors to a meeting to discuss training of pharmacists to become Independent Prescribers (IP). Earlier, HEE together with NHS England and NHS Improvement has supported a first phase of IP training for community pharmacists from January to March 2022, and is now working to secure a further rounded of funded training from Autumn 2022. The upcoming virtual meeting is aimed to help inform future independent prescribertraining offers by ensuring it is aligned with the needs of the pharmacy workforce.

The Association of Independent Multiple Pharmacies (AIMp) has appointed David Vanns as its non-executive Chairman following the retirement of its long serving Chair Peter Cattee. Vanns will take up the role from April 2023. Cattee, one of the co-founders of AIMp took up the role as its Chairman in 2000. He is also a non-CCA representative on the PSNC. Despite retiring as chairman Cattee will remain on the AIMp board. Commenting on his retirement Cattee said: "It's been my great good fortune to work with almost all of the owners of pharmacy groups throughout England, Scotland and Wales over the years and many other talented people throughout the sector. It's been during a period of increasing consolidation, something which our own business has reflected, and the original founders and Board members Yakub Patel, Kirit Patel, Steve Williams and David Vanns have all been instrumental in shaping pharmacy negotiations to better reflect the views of our natural constituency - pharmacy group owners. A spokesperson for AIMp said: "We thank Peter for his services and dedication to AIMp throughout the years. Our organisation has grown to be a diverse and dynamic organisation representing and supporting pharmacy groups of all sizes, small and large. Our main identity and what unites us in AIMp, irrespective of the size of the pharmacy group, is being Independents, and we are very proud of our identity. We look forward to continuing our work in representing and supporting our members in the best way possible."

Surrogacy is a path that many couples who are unable to have children of their own have chosen due to the intimacy and experiences involved in the process. There are many things that should be taken into consideration before you make the choice of becoming a surrogate mother. You should first speak with an attorney and/or an adoption agency specializing in surrogacy. They can provide you with a list of things to consider and agencies available to start you on your way, educate you on your rights as well as those of the adoptive couple and what you can expect and what is expected out of you. When you consider on becoming a surrogate mother, you also need to decide whether you will be an independent surrogate or agency surrogate. As an independent surrogate, you need to be responsible for your own arrangements, finding the right couple, working out a contract and, if anything goes awry with the arrangements, you will be responsible for finding another couple. As an agency surrogate, all of these arrangements and legalities are managed for you by your agent. Either route you choose, make sure that you have consulted an attorney who specializes in surrogacy and adoption to serve your best interests. The next step in becoming a surrogate involves the physical aspects or extent of the measures you are willing to take to become pregnant. You need to decide if you are willing to undergo artificial insemination, hormone therapy and/or in vitro fertilization. Each of these measures are time consuming and not fail proof, so it is always best to have an alternate plan, if possible, in case your first choice for conception does not work. Finally, once an agency or attorney is employed in your journey to becoming a surrogate mother, psychological and physical tests need to be done to make sure that you are healthy enough to carry a child to term and that there are not any past medical or family histories that may cause pregnancy or genetic issues. Extensive counseling will be

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