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The leading pharmacy bodies have come together to launch the 'Save Our Pharmacies' campaign which highlights the pressure and untapped potential of the sector. Pharmacy bodies- Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC) have agreed to work together on a programme of activities to lobby for fair NHS funding for pharmacies in England, including co-ordinating efforts to mobilise public support. The campaign will focus on highlighting both the pressures that pharmacies are under and the huge untapped potential of the sector - including to offer a Pharmacy First service - if appropriate resourcing is made available. Mark Lyonette, NPA Chief executive, said: "Together we will be cranking up the noise to persuade Government and NHS to make the right choices and back the community pharmacy sector with decent funding. Maintaining patient and public support is critical to our campaigning success, so this will be a key focus in the months ahead. Our joint message is very clear: pharmacies can help get the NHS back on its feet, but not while the sector itself is on its knees." The pharmacy bodies will develop shared resources for effective parliamentary lobbying and mobilising public opinion, in the face of chronic underfunding that threatens further pharmacy closures. They will also work hard to show off the value of pharmacy and to continue pushing for a fully funded Pharmacy First service.

The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the NHS ad campaign highlighting how community pharmacies can support patients with non-health advice amidst the growing pressure on pharmacies. It believes the campaign will only 'worsen' the pressure on pharmacies. "It is always deeply concerning to see campaigns directing people to pharmacies without any regard for the pressures they are under: it is irresponsible and extremely unhelpful," said PSNC Chief Executive Janet Morrison. She called the campaign 'particularly irritating' just weeks after the committee rejected a series of proposals from NHS England and DHSC on relief measures to ease pressure on pharmacies as being totally inadequate. "NHS England Board Members have noted the pressure on pharmacies - so why are their teams so often acting to make these pressures worse? We need to see a radical change in how NHS England treats pharmacies and we're continuing to press for that via our influencing and campaigning work," she added. The NHS launched the new campaign on Monday (27 February) to highlight how high-street pharmacies can support patients with non-urgent health advice for minor conditions including coughs, aches and colds.

Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

NHS England has commissioned the Royal Pharmaceutical Society (RPS) to develop guidance that helps community and hospital pharmacy teams across Britain to reduce the impact of pharmacy services, pharmaceutical care and medicines on the environment. The RPS said the Greener Pharmacy Guidance will enable pharmacies to self-assess their impact against the standards, benchmark and improve through evidence-based activities and actions. "I'm delighted our strong commitment to helping pharmacy reduce its environmental impact can now be taken to the next level through developing guidance and accreditation for pharmacy teams," RPS president Professor Claire Anderson said. "Medicines account for 25 per cent of carbon emissions within the NHS and this initiative underscores our commitment to promoting sustainable healthcare and supporting the NHS's goal of achieving 'net zero' emissions by 2040." Peter Morgan, medicines assistant director at NHS England, commented: "Pharmacy staff are involved in the purchasing and dispensing of almost every medicine used in the NHS and the new Greener Pharmacy Guidance and Self-accreditation scheme will provide support for pharmacy professionals by outlining clear actions to deliver more environmentally sustainable pharmacy practices." The RPS said the guidance and digital self-assessment toolkit will integrate with carbon calculator tools to help pharmacy teams to measure their carbon footprint, action plan to reduce use of carbon and improve sustainability.

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."

As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

The National Pharmacy Association (NPA) has raised its concerns over rising cost of rent for its members. The association highlighted that pharmacy spending is shrinking, and therefore, the NHS Property Services must ensure viability of health centre pharmacies. In May, the NPA wrote to NHS Property Services to voice its concerns over the rising cost of rent after some of its members reported demands for a three-fold increase in rent. Many pharmacies operate in premises of which NHS Property Services is the landlord. In a letter last month to chief executive Martin Steele, NPA said: "The past years have seen far fewer patients in health centres and therefore using the on-site pharmacy - whilst the situation will change somewhat as we move out of the pandemic we expect a permanent impact on workload as practices handle more of their interactions virtually. "The NPA encourages NHS Property Services to review lease agreements involving community pharmacies and consider favourable changes to terms that are in line with current financial realities affecting the sector. This could avoid the loss of a pharmacy service to communities and the resulting loss of rental income to NHS Property Services."

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information. Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of Services (DoS) profile information is kept up-to-date. The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been introduced to make the process as quick as possible and it can be done on either a smartphone or computer. PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."

Wes Streeting's speech at the Labour Party Conference 2024 outlines several key health and social care reforms, which hold significant implications for community pharmacy in England. His focus on reforming and rebuilding the NHS to ensure fair, universal access to care, with prevention and early intervention at its core, presents both opportunities and challenges for community pharmacy. Here are the potential implications: 1. Prevention Focus Streeting's vision of a shift from a reactive, hospital-based model to a preventive healthcare system presents a promising future for community pharmacies. These changes could significantly reduce pressures on GPs and hospitals, integrating pharmacies more closely into primary care networks and enhancing their role in preventive care. 2. Digital Transformation The move from an "analogue to digital" NHS could see community pharmacies adopting more digital tools and systems for service delivery. This would likely involve greater use of digital prescribing, telehealth consultations, and AI-driven services. Pharmacies will need to invest in digital infrastructure and ensure that pharmacy professionals are trained to operate within a more tech-centric environment. 3. Reform and Redistribution of Services Streeting's plans to extend choice and equitable access to services mean that community pharmacies could become integral to providing care in underserved or disadvantaged areas. With a focus on decentralising healthcare and bringing it closer to local communities, community pharmacies could play a more significant role in supporting healthcare delivery in areas where GP services are stretched. This may include expanding access to pharmacy services in the most deprived areas, aligning with Labour's emphasis on addressing health inequalities.

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.

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 National Pharmacy Association (NPA) is calling on NHS England and its member to pause and reflect before further implementing the pharmacy contraception service. NPA board met on Tuesday (25 April) to discuss the Pharmacy Contraception Service and the board decided that - with the community pharmacy sector at breaking point - it cannot support the immediate roll out of this service. The association believes that with no new funding for the service, and all existing funds in effect already allocated to other pharmacy activity, any payments to the sector for delivery of the oral contraception service will ultimately be clawed back by NHS England. Tweeting after the meeting yesterday, the NPA said: "We can't tell pharmacy owners what they can and can't do. But we can tell them the facts; fact number one is that with no new funding currently available everyone will be a loser from the implementation of this service on the current terms." NPA Vice-Chair Jay Badenhorst added: "We cannot be expected to take on more and more services without the increase in funding necessary to deliver them effectively. Meanwhile, taking on additional work when current workload already exceeds capacity risks impacting negatively on the overall quality of care people experience in pharmacies. We still believe this could, in future, be a great new pharmacy service, but not without the extra funding necessary to deliver it safely and effectively. We want to offer women this extra support, but if it's worth doing it's worth doing properly."

"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of their business." Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and the larger role pharmacies play in complementing traditional NHS facilities. Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain information from NHS England regarding protocols and procedures. She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were desperate to take part in the vaccination scheme" in her constituency. Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy closures "should be a real wake up call for the government."

The community pharmacy bodies, along with England's largest pharmacy chains, have urged the Prime Minister, Rishi Sunak to resolve fund and workforce crisis in the sector. In the joint letter the Chief Executives of Association of Independent Multiple Pharmacies (AIMp), Company Chemists' Association (CCA), National Pharmacy Association (NPA) and Pharmaceutical Services Negotiating Committee (PSNC), along with Boots, Lloydspharmacy, Well and Rowlands Pharmacy, said they are pleased to see Government now recognising the key role that community pharmacy' could have in alleviating the strain on other NHS services. However, the associations also warn that although the sector is ready to support, 'this will not be possible unless pharmacy is properly funded.' Janet Morrison, PSNC Chief Executive, said: "The Prime Minister should also know that community pharmacies are also facing a crisis. They need sustainable investment, urgently, if we are to avoid devasting consequences for pharmacies and for their patients." The letter calls on Government to help pharmacy to resolve the funding, workforce and capacity issues engulfing the sector. It said: "Community pharmacies are in crisis and after 7 years of 30% funding cuts have reached their limit."

Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems. Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS. "It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework." Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector." "We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."

National pharmacy bodies have expressed their disappointment on the launch date for Tier 1 of the Pharmacy Contraception Service which has been announced by NHS England (NHSE) as '24th April 2023′. Pharmaceutical Services Negotiating Committee (PSNC) said that this start date for the service has not been agreed with PSNC and is in direct contradiction of our warning to Ministers that no new or expanded services can be rolled out in 2023/24 unless extra funding is put into community pharmacies. Responding to this announcement, PSNC Chief Executive Janet Morrison said: "This is despite our warning last month that without additional funding, the roll-out of Year 5 additional services and the Pharmacy Quality Scheme is neither feasible nor affordable. Community pharmacies are having to work harder and harder for less money and many are at breaking point. And just this week the results of our 2023 Pharmacy Pressures Survey have confirmed the worsening situation. Clearly our view is not because contractors don't see the benefit of the service. This is a much-anticipated service that could deliver real benefits to patients and community pharmacies are always eager to support public health initiatives. But capacity in the sector is now so stretched that more money is needed to safely resource additional work. We have repeated our concerns to the Department in recent days and reminded them of the potential for a properly funded community pharmacy sector to play a greater role in providing clinical solutions and relieving pressures elsewhere in primary care."

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.

The new data from NHS England has revealed that more than 100,000 patients were treated for minor illness by their high street pharmacist in just one month. According to new NHS figures, in June, 118,123 people with minor illnesses such as a sore throat or constipation, or those in need of medicine urgently, received a same-day consultation with their local pharmacist after calling NHS 111 or their GP practice - an increase of more than four-fifths (83%) on the number in the same month last year (64,512). The data comes alongside expanded roles for community pharmacies ahead of winter, announced at the NHS England board meeting today. "From this week, NHS 111 online can directly refer people to their high street pharmacist for a same-day consultation, rather than patients needing to call the phone line," said NHS England. Amanda Pritchard, NHS chief executive, said: "Our local pharmacies ensure hundreds of thousands of people every week get the support and medication they need and today's figures show that in just one month, over 100,000 patients have also had consultations with their local pharmacist for minor illnesses - this means patients are getting the care they need quickly but also in a convenient way that can fit in with their busy lives.

The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists are able to reap the benefits from it. Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies. Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just delighted to have easier access to care," he said. In its first month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an average of 200 interventions per week. "That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a week - that's a huge capability and capacity bump for the NHS," he added. Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.

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.