The health secretary, Steve Barclay was asked over the delay of 'Pharmacy First' model in England that was proposed by the Pharmaceutical Services Negotiating
Committee (PSNC) last year, at the Health Committee evidence session held on Tuesday (31 January).
Taiwo Owatemi MP (Chair of the Pharmacy APPG) asked whether he was adhering to his statutory responsibility to ensure continued access to medicines and cited the
CCA's closures in areas of deprivation research.
Barclay replied that the government is 'investing more'. He said, "We put an extra 100 million on top of the 2.6 billion a year we commit to community pharmacy to
expand the range of clinical services. We've got over 2 million patients that have been referred to community pharmacy from NHS."
He further added: "One of the issues I'm very keen on is to explore what more we can do in pharmacy not least given the pressures on GP and the opportunity to look
at what it is currently people go to GPS for where potentially the risk to do more at the pharmacy and we're already doing that."
Amid media speculations that a large pharmacy multiple was putting all its stores at risk of closure, PSNC supremo Janet Morrison said the sector was in
crisis and in danger of a significant collapse.
Addressing delegates via a video link at Sigma Pharmaceutical's 13th Annual Community Pharmacy Conference held last week (March 4 -9) in Punta Cana, Dominican
Republic, she said while "a lot of consolidation or sales" would continue, a lot of the smaller, independently-owned community pharmacies - which had to work harder
and harder to make ends meet - were just "hanging on in there".
"But I don't know how much longer people can go on," she said, adding that the risk of actual closure was rendering the remaining pharmacies so fragile that "they
may not be able to pick up the slack of many thousands of patients" who would need repeat prescriptions.
"The disruption is frightful and awful. We have got 53 per cent of the population on repeat prescriptions, so that matters."
Her comment on the opening day of the conference was a sober reminder that the sector - which relies heavily on income from prescriptions - couldn't afford to
"carry on with the current format of a contract and the current amount of money" it was paid to deliver numerous tasks which have been heaped on it to share the
burden of a crippling NHS.
The Department of Health and Social Care (DHSC) in recent response to the questions asked by members of the House of Lords addressed the concerning trend
of pharmacy closures in rural areas across the UK.
Led by The Bishop of St Albans, inquiries focused on the number of community pharmacies that had ceased operations over the past five years and the ongoing
financial challenges faced by those remaining in rural regions.
Lord Markham, the Parliamentary Under-Secretary for Health and Social Care, provided insights into the stark reality confronting rural communities.
Highlighting data as per Guide to applying the Rural Urban Classification to data (2019-2023) Markham illustrated the significant closure rates of rural
pharmacies compared to the limited number of new openings between 2019 and 2023.
The figures revealed a fluctuating trend over the past five years, indicating a dynamic landscape within rural pharmacy provision.
In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice
to the Department of Health and Social Care (DHSC) today (16 May).
According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a
result of inadequate funding.
"The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said.
The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care.
NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in
England having to subsidise the dispensing of drugs to the tune of £108m a month.
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 significant event organised by Eastern Eye (EE), a sister publication of Pharmacy Business, political leaders gathered on July 1st to address pressing
issues affecting the Asian community
The EE election debate aimed to amplify their political voice and encourage participation in the political process.
The debate, moderated by Barnie Choudhury, Editor of Eastern Eye, saw prominent figures including Andrew Boff AM of the Conservative Party, Anneliese Dodds
represented Labour as Shadow Secretary of State for Women and Equalities, and Lord Richard Newby from the Liberal Democrats engaged in a robust discussion.
They fielded questions on various issues affecting the UK, including economic and social inequality, immigration, health inequalities, and funding cuts to
community pharmacies.
Amid an audience that included stakeholders from the pharmacy sector, a notable query focused on each party's stance on the role of community pharmacies and
their commitment to funding these vital services.
The recent announcement that Royal Mail will be partnering with distance selling pharmacy (DSP) giant pharmacy2U highlights how standards of regulatory
enforcement are being ignored to accommodate the DSP model.
The brunt of these double standards hinges around the levelling down of temperature enforcement standards by the Medicines and Healthcare products Regulatory
Agency (MHRA) which demands mapping must be audited from the point of dispensing to the patient.
The MHRA has a well recognised duty to ensure medicines reach patients in a safe condition. The current anomaly appears to turn a blind eye to this step in the
supply chain at the point the wholesaler releases goods to the pharmacy hub.
Equally the training on delivering medicines safely and effectively direct to patients should apply fully to all hubs including DSPs. Why is it that DSPs are being
treated differently to bricks and mortar pharmacies? It's essentially the same patients receiving the same medicines from the same wholesalers.
A further regulatory disparity exists around how parcels must be "tracked and signed for" to be reasonably certain medicines are delivered into the hand of the
intended recipient, as per existing regulations.
Clearly an untracked, unsigned package cannot be guaranteed to finish in the hands of the intended recipient.
There is a very real possibility that such omission could lead to community pharmacy closures which will, in turn, lead to unemployment and a reduction in the
care services. At a time when integrated care systems have just gone live, the removal of vital support services leading to further inequalities is the wrong
message for both providers and patients alike.
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.
As Prime Minister Rishi Sunak announces the forthcoming UK general election, pharmacy bodies are calling on all political parties to commit to solving the
issues facing the sector.
The next UK general election will be held on 4 July, Sunak announced it on Wednesday afternoon during a press conference outside 10 Downing Street.
"As the election is called it's imperative that any incoming government addresses the crisis in primary care and the looming cliff edge facing pharmacies, which
for millions of people are the front door to the NHS and a crucial source of frontline health care," said Paul Rees, Chief Executive of the National Pharmacy
Association (NPA).
Noting that the first responsibility of the government is to keep its people safe and healthy, he emphasised the importance of addressing the "deep funding gap
that is pushing record numbers of pharmacies to the edge of closure and beyond, exacerbating the issues of waiting lists for GPs and hospital care."
The National Pharmacy Association (NPA) survey revealed that 93 per cent of respondents experienced 'at least one month' of negative cash flow across their
pharmacy business in 2022.
Nine out of 10 pharmacy owners responding to NPA survey said they made a net loss dispensing medicines for the NHS during 2022, for at least one month of the year.
According to the poll, 48 per cent of them lost money on this core NHS service for six months or more. 45 per cent said their overall outgoings had exceeded overall
income in at least six months of the year.
NPA Chair Andrew Lane said: "This survey shows the bleak financial reality facing many independent pharmacies after years of underfunding. Dispensing at a loss and
negative cashflow is clearly unsustainable."
"This funding crisis must be addressed urgently or pharmacies will fall into a spiral of declining services and ultimately widespread closures, he added. "Tragically,
the story is playing out very much in line with independent research commissioned by the NPA last year, which warned of a nationwide financial emergency in our
sector."
Prime Minister, Rishi Sunak, has backed pharmacists to play a greater clinical role in the health and well-being of the nation, describing them
as "valuable and trusted" members of the community.
Pharmacists have faced a difficult year with 222 community pharmacies closing in just the first six months.
Boots alone will be closing 300 branches over the next 12 months.
Sunak, however, insisted that his government knows the "hard work of pharmacy teams", and that he wants to "enable them to do more to support the NHS."
Speaking at the annual Sigma Conference in London on Sunday (5 November), the prime minister reiterated that community pharmacy is in line for a much-needed
boost in funding.
"Earlier this year, the government announced plans for further investment of up to £645 million over the next few years to support the Pharmacy First service
for patients," Sunak said in a letter read out at the conference by Lord Dolar Popat.
"This means that community pharmacies will be able to assess patients and provide some options to protect them without a GP appointment."
Pharmacies across Northern Ireland are in financial turmoil, reporting that they are dispensing prescription medicines at a loss due to inadequate
reimbursement from the Department of Health (DoH).
This crisis has led to the closure of almost a dozen pharmacies over the past 18 months, with many others struggling to stay open.
Siobhan McNulty, who runs Melvin Pharmacy in Garrison, County Fermanagh, described the dire situation. "We're dispensing medicines at a loss," she said.
"The reimbursement rates don't match the cost of the drugs, and we're left to cover the gap."
McNulty relies on sales of non-pharmaceutical products to keep her business running.
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."
At the recent 'Locum Matters' online event held on June 25, 2024, members of the Pharmacists' Defence Association (PDA) discussed critical issues facing
locum pharmacists, with a disturbing trend taking center stage: employers pressuring locum pharmacists to accept lower rates under the threat of potential pharmacy
closures.
The event, organised in response to feedback from PDA locum members, addressed a range of significant topics including training for the recent Pharmacy First
Services, respect for professional autonomy, and the need for adequate rest breaks.
However, the issue of rate pressure and pharmacy closures was a focal point.
Several locum pharmacists reported that some employers were leveraging the possibility of pharmacy closures to coerce them into working for lower pay.
This unethical practice has raised alarm within the locum community, highlighting the precarious working conditions many face.
Those of us who work in community pharmacy know there is a workforce crisis created in large measure by PCNs actively recruiting pharmacists and pharmacy
technicians from our sector. It is welcome, if long overdue, that this has now been officially acknowledged in a report commissioned by the English Health Secretary.
PCN hiring 'exacerbates pharmacist shortage' says DH-commissioned report, which states such recruitment has "on occasion exacerbated the problem of a general
shortage of pharmacists" which has compounded "the problem of community pharmacy closures."
We have been telling the government this for years only to be told "problem? What problem?"- but now that Steve Barclay has his own official report sitting on his
desk, he and NHSE cannot continue in denial mode. The facts are there for all to see. Time to act. No more dithering, delay or indifference. You asked if there was
a problem and you have been told there is.
In the absence of a holistic workforce strategy and cross-sector career pathways, PCNs poaching from community pharmacy is a zero sum game adding nothing to
improving patient care.
Boots customers were left disappointed as the retail giant closed three more branches, two in Kent and one in Glasgow.
On Sunday 21 January, Boots' branches in Cliftonville and Biggin Hill were closed, forcing locals to find an alternative pharmacy, Express.co.uk reported.
Cliftonville residents have taken to social media to express their disappointment over the closure of their local pharmacy on Northdown Road.
Even though there is another Boots branch in Margate, they said that Cliftonville branch is "much more accessible, with parking available right outside, on
the bus route and surrounded by a residential area within easy walking distance."
One resident has branded the retailer's decision as "crazy", as per the news portal.
In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising
issue of medicines supply.
"Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this
situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary.
In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual
issue; as a matter of routine business, there are often challenges in that area."
The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures
or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and
other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why
will they not do so?
Pharmacists on the temporary register will be automatically removed on April 1, unless they have applied to rejoin the permanent register, the General
Pharmaceutical Council has said.
The government asked the GPhC and other pertinent health professional regulators to close temporary registers by March 31, 2024.
According to the GPhC, this decision is based on the anticipation that the emergency conditions justifying the establishment of these temporary registers will
cease after the approaching winter.
The temporary register was established after the Health and Social Care Secretary asked the Council to utilise its emergency powers to swiftly register pharmacy
professionals for their essential role in the national COVID-19 response.
Pharmacists and pharmacy technicians who had previously opted to withdraw from the GPhC register or failed to renew their registration are now eligible for
immediate re-registration, the regulator added.
Over a century-year-old Boots pharmacy in St James's Street, Brighton shut its doors permanently on Saturday (20 January) leaving the communities disappointed.
The branch in Kemp Town, which was opened to the public for the first time in 1914, was supposed to close on November 19 last year but continued trading into
the new year, The Argus reported.
Locals are not happy with the retailer's decision to close the store as some say it used to be "always busy with prescriptions and people buying things."
Another person recalled that Boots had earlier closed two pharmacies, one on Lewes Road, Brighton, and another on Church Road, Hove.
The American-owned health and wellbeing chain is in the process of closing more UK branches in the coming months as it's targeting to reduce its store portfolio
to 1,900 from 2,200.
The emergency provision of pharmaceutical services, introduced to help maintain pharmacy services during the Covid-19 pandemic, has been extended to March 31, 2022.
The provision allows contractors to make temporary changes to opening hours or temporary closures in condition of adequate reasons for these changes.
Before making such changes contractors have to give 24 hours' notice to the NHS England and NHS Improvement (NHSE&I), and take approval from the department.