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In a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE), Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges. Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival. "There have been no years of financial and operational squeezes applied by the NHS and government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival," he said. Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative initiatives like the Discharge Medicine Service and Contraception Service.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

The Pharmacists' Defence Association (PDA) has republished a three-year-old report which underscores the vital role of community pharmacists and pharmacy t echnicians in a 'modern NHS' amid speculations that the government is set to announce plans to enhance the role of community pharmacy teams. PDA's 2019 report which "took three year to compile" highlighted significant empirical evidence and made recommendations to develop the roles of both community pharmacists and pharmacy technicians, and the skill mix required to meet patients' needs. It examined in detail the role of pharmacy technicians in community pharmacy. The PDA still that pressure on the NHS can be managed much more effectively through the better use of pharmacists and pharmacy technicians. In the community pharmacy setting, it is evident that if the further development of the pharmacist's role is to be facilitated and pharmacists are to become more patient facing in the future, an extended role and greater responsibility for pharmacy technicians is not only desirable, but ultimately it is essential.

I have always been passionate about Community Pharmacy and am proud of the way that the sector navigated itself through Covid-19 and is currently navigating itself through all the changes in the NHS landscape. When I started my role in Sep 2019 as the CEO of Kent LPC, I used to say that community pharmacy has changed more in the last five years than the 15 before that, however, I now believe community pharmacy has changed more in the last two years than the 20 before. The year 2019 saw the start of the five-year Community Pharmacy Contractual Framework which set out how community pharmacy would support delivery of the NHS long term plan. What PSNC (or any of us) when negotiating this deal had not envisaged was the Covid-19 pandemic. Whilst the world turned upside down, we saw high street shops close their doors and immense pressure flood the NHS. Community pharmacy did what they always do, they adapted, teams came together, worked through, and showed resilience in the face of adversity. In Kent, I saw us integrate into primary are and into the NHS structure very quickly, in the first few weeks after Covid-19. All the usual red tape was removed, we all worked together to implement services to help patients in a matter of weeks when they would have normally taken months.

Tase Oputu, Chair of the RPS England Pharmacy Board, has been appointed to the NHS Assembly, to represent the pharmacy profession. The NHS Assembly is a national forum that brings together stakeholders from across the health and care sectors to advise the NHS England board on implementing the NHS Long Term Plan (LTP). Members include national and frontline clinical leaders, patient leaders, staff representatives, health and care system leaders and voluntary, community and social enterprise sector leaders. The NHS Assembly meets four to five times a year. Tase will officially join the Assembly during its meeting on 11 September. Tase highlighted the crucial role of pharmacists and pharmacy teams in the healthcare system while expressing her anticipation of representing the pharmacy profession at the NHS Assembly.

Community pharmacy teams are urged to share their views relating to the new NHS Booking and Referral Standard (BaRS). "This will ensure that the tool supports the needs of pharmacy team members and their patients," said the Pharmaceutical Services Negotiating Committee (PSNC). BaRS is an interoperability standard for healthcare IT systems which should enable booking and referral information to be sent to or from care providers, such as community pharmacies, quickly, safely and in a format useful to clinicians. "The intentions are that the BaRS IT standard will eventually be available in all care settings. The way the standard could be used in pharmacies is currently being considered, including the potential for use for referrals from NHS 111 to community pharmacy." The BaRS team are conducting interviews (usually lasting 30-45 minutes) to hear more the current experiences and the future preferences regarding sending and receiving referral messages.

The Welsh government has reached an agreement with the NHS and Community Pharmacy Wales (CPW)-the statutory representative body for all community pharmacies-on a six per cent funding increase as part of the 2024/25 Community Pharmacy Contractual Framework (CPCF). The £9.9 million increase will bring the total CPCF funding to £175 million per year, representing a 24 per cent rise in funding since 2017. In a statement published on 20 December 2024, Jeremy Miles, cabinet secretary for health and social care, said that the additional investment will be used to address "both immediate pressures facing community pharmacies and to maintain momentum on our longer-term ambitions for reform." Miles also said that the government would continue to invest in integrating pharmacies in primary care clusters, developing the skills and scope of practice of the wider community pharmacy workforce including pharmacy technicians, and the Choose Pharmacy IT system. In contrast, community pharmacies in England are still awaiting progress on CPCF negotiations for 2024/25. Last month, Community Pharmacy England (CPE) warned of the sector's worsening financial situation, urging ministers to provide immediate funding relief.

The Company Chemists Association (CCA) has published a report highlighting the key findings of a roundtable it hosted earlier this month. The CCA convened the virtual roundtable to examine the best practice undertaken by a cross-section of LPCs to promote the delivery of the Pharmacy First service. Key recommendations for how LPCs can help support pharmacy contractors to deliver the Pharmacy First service include: Direct engagement with NHS regions who can supply funding to drive Pharmacy First engagement and promotional activity. Engagement with a variety of staff within GP surgeries, ranging from reception staff to GP partners, to drive referrals, as well as build understanding and awareness of the benefits to General Practice. Harnessing data to inform GP surgeries how they are performing locally Using data to ensure pharmacies close any open referrals promptly. Using multiple channels to promote the service, including the sharing of best practice, myth busting, use of data and creating tools which can be readily used by pharmacies and GPs. Encouraging pharmacy staff to highlight the Pharmacy First service to customers - with specific emphasis on the provision of NHS-funded care, timely access and convenience the service provides. The CCA said the report is intended to support all LPCs and pharmacy contractors as they work together to care for patients requiring urgent NHS care in their community.

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).

Community Pharmacy England (CPE) is gearing up to conduct a vital Pharmacy Advice Audit, calling on pharmacy owners and their teams to help measure the increasing reliance on pharmacies within communities. With years of financial strains impacting the sector, despite the much-needed £645 million recovery plan funding, the sector finds itself on the edge. The launch of Pharmacy First sparked a notable surge in people seeking advice from community pharmacies, both within and beyond the funded service, as revealed by recent sector polling. To accurately assess this trend and advocate for sustainable funding, CPE is initiating an audit to gather data crucial for showcasing the extent of unfunded care provided by community pharmacies. Scheduled to commence this week, the Pharmacy Advice Audit will entail pharmacy teams documenting informal healthcare advice dispensed over a single day.

NHS England announced at the Pharmacy Show this morning that Ministers have decided to amend the Pharmacy First thresholds for the remainder of the year. This decision follows concerns raised by Community Pharmacy England (CPE) regarding difficulties faced by pharmacy owners in meeting the required number of clinical pathway consultations for monthly Pharmacy First payments In response to CPE's representations to the Department of Health and Social Care (DHSC) and NHS England, the threshold was earlier reduced from 20 to 15 in August, and from 30 to 20 in October. At the Pharmacy Show on Monday, Ali Sparke from NHS England announced the revised thresholds, setting them at 20 for November and December 2024. Starting in January and February 2025, the number of clinical pathway consultations needed for the monthly Pharmacy First payment will rise to 25, with a further increase to 30 in March.

The hybrid professional and leadership session underscores the Sigma Conference's significance in offering hope and inspiration to its delegates. This pioneering venture unfolds following meticulous planning, months of deliberation, and the collaboration of experts from various health disciplines across the UK. This session, rich in diversity and expertise, aims to elevate the role of community pharmacy in the ever-evolving landscape of the NHS. It comprises three key components and delves into multi-professional collaboration, insights from NHS Chief Professional Officers from the four devolved nations complimented by the Royal College of Nursing Directorate Wales, and the evolving landscape of Pharmacy Professional Leadership. Multi-Professional Collaboration: Breaking Boundaries The crux of this ground-breaking session lies in appreciating and fostering greater multi-professional collaboration to set the stage for a thought-provoking session on how community pharmacy can be recognised as an important cog in the wheel of an integrated NHS. This convergence creates a dynamic platform for community pharmacy to form wider partnerships and explore opportunities, particularly with the recently launched NHS Pharmacy First Service.

The Conservative Party Prime Ministerial candidate Rishi Sunak visited Bassett Pharmacy in Southampton on Wednesday (Aug 24) - the pharmacy that used to be run by his family. During the visit, Sunak is reported to have said that he intends to reform the NHS and achieve value for money from health spending, should he become prime minister. Giving his reaction to the visit, National Pharmacy Association (NPA) chief executive Mark Lyonette said: "If Rishi Sunak is serious about NHS reform, he would do well to start with a 'pharmacy first' approach to prevention and treatment which has the potential to transform the way people access NHS care. "That can only happen with a sustained increase in funding for our sector, which is facing much harder times now than it ever did when Mr Sunak's parents owned a pharmacy years ago." Earlier in the week, NPA board member Hiten Patel met the former chancellor when he visited West Harrow for a campaign event on August 23. Patel took the opportunity to explain that pharmacies in England are not being properly supported to fulfil their potential within the NHS.

The All-Party Parliamentary Group (APPG) on Pharmacy published a new report on Monday (January 23) that calls for "urgent action" to relieve funding pressure so there are "opportunities" for community pharmacy teams to deliver even more for their patients. The report highlights the need for a new "strategic vision" for pharmacy and highlights opportunities for the network to be empowered to deliver even more for patients. However, the manifesto also underlines that there are the very real risks that this opportunity may be lost if significant and ongoing pressures are not addressed. The recommendations are based on written and oral evidence gathered from frontline pharmacists, GPs, professional bodies and healthcare experts. To harness the potential of pharmacy, the report recommends the Government must take urgent action to relieve the funding pressures on the community pharmacy sector in the short term and review the long-term funding model for pharmacy. It also suggested the Government must harness the power of pharmacy to help the NHS deal with the COVID-19 backlog and the UK's growing healthcare challenges. It further recommended that future commissioning and funding must recognise that community pharmacy is the front door to the NHS for many patients.

The 8th Pharmacy Business Conference, organised by Pharmacy Business, unfolded a dynamic narrative around the theme of 'Pharmacy of Tomorrow', highlighting the trajectory of innovation, adaptation, and the evolving landscape of pharmaceutical services. Attended by over 200 pharmacy owners, industry leaders, and stakeholders, the conference served as a medium for robust discussions and the exchange of valuable insights regarding the future of community pharmacy. Amidst the persistent challenges posed by an underfunded reimbursement system and negotiations with governmental bodies and the NHS for the new community pharmacy contractual framework 2024/25, the conference pivoted towards investing in staff, adapting to change by investing in new technology, and optimising commissioning as pivotal strategies. "Pharmacy professionals are playing increasingly important clinical roles in both primary and secondary care," shared David Webb, Chief Pharmaceutical Officer (CPO), NHS in a video message. He highlighted the NHS's commitment to empowering community pharmacy, with plans to expand services and deprescribe to align with the NHS's focus on preventive healthcare.

Steve McCabe, the Labour MP for Birmingham, Selly Oak says a "vicious" NHS contract has been forcing community pharmacies into bankruptcy. Asking his question in parliament during Prime Minister's Questions on Wednesday (March 8), McCabe said he has heard Rishi Sunak speak fondly about working in his mother's community pharmacy. The MP asked how would the prime minister feel "if 600 pharmacies close this year because of a vicious NHS contract which takes no account of rising costs and is forcing many into bankruptcy?" The prime minister responded by saying that community pharmacies do fantastic work and that his government was looking at ways in which it could support the sector to do even more. Sunak said: "I praise the work that our community pharmacies do. They are fantastic at being on the frontline of delivering primary care. And as I've said previously the government is exploring ways in which we can support them to do even more.

The Community Pharmacist Consultation Service (CPCS) has been running as a national advanced service since October 2019 to relieve pressure on the National Health Service which aims to help with on the day demand in relation to minor illness and medicines. The NHS Community Pharmacist Consultation Service CPCS (NHS CPCS) aims to meet the objectives of the NHS Long Term Plan to use community pharmacists' skills to advise patients, and to build relationships with GP surgeries, primary care teams and wider NHS providers and to assist with urgent care system repeat prescription requests. Referrals from the GP referral pathway and urgent care systems and urgent treatment centres are digitally routed to community pharmacies so that patients can receive same-day appointments and have their queries resolved. The numbers Based on the estimated annual number of minor ailment GP appointments, the service was expected to save the NHS up to £640 million per year . Three years later, the nation has weathered the Covid 19 pandemic, which had widespread effects and put further strain on already overstretched NHS staff. The pandemic impact has resulted in higher numbers of GP appointments than initially anticipated. Nevertheless, this may offer an opportunity to proactively engage pharmacy teams in patient contact help ease strain across the wider NHS.

To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the community pharmacists to to establish a robust relationship between community pharmacies and local general practices. The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services. According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to participate at all in the "groundbreaking" Pharmacy First scheme". In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer patients to the Pharmacy First and other community pharmacy services where appropriate. Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy First will likely require sustained effort over several months or longer.

Analysis by IQVIA revealed that over the past four years, from May 2020 to May 2024, the average number of prescriptions processed by pharmacies has risen by 8 million per month. However, this is happening against the backdrop of a declining number of pharmacies. During these four years, nearly 900 pharmacies have closed in England, with almost 500 of those closures occurring in the last 12 months. Carol Alexandre, vice president at IQVIA, presented the data at the recent SIGMA UK Community Pharmacy Conference 2024, where she shared insights into the dynamics of the UK market, the pharmacy sector, and the Pharmacy First initiative. As of August 2024, there were just 10,059 community pharmacies (excluding distance-selling pharmacies) in England, 1,589 less than in March 2015, when the number stood at 11,647 (source: NHS BSA). There has been a significant shift in the distribution of pharmacy ownership, with independents (single pharmacies and chains with 1-5 stores) and regional chains (pharmacy chains with 6-200 stores) growing at the expense of managed chains.

In response to concerns raised by Community Pharmacy England (CPE), ministers have decided to lower the October threshold for the Pharmacy First service to 20. This decision addresses a major worry for pharmacy owners who have struggled to meet the required number of clinical pathways for monthly Pharmacy First payments, especially as the October increase to 30 pathways approached. CPE has been actively engaged in discussions with the Department of Health and Social Care and NHS England over the past few weeks to address this issue. Commenting on the decision, Janet Morrison, CEO of Community Pharmacy England, said: "It is great that ministers have responded to our concerns about another increase to the Pharmacy First payment threshold: this decision will save many community pharmacies from missing out on a vital payment this month." Morrison added that CPE will continue to monitor service data and, if needed, make further representations to ministers about future months. She also emphasised the need to find a long-term solution, which involves "NHS England marketing Pharmacy First effectively and ensuring that GPs are actively referring people to the service."