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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.

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.

Community pharmacists across the UK are looking for ways to reduce operational costs and find new sources of revenue. This is a pressing issue for the sector: reversing a decade of cuts to pharmacy funding will be a mammoth task, while pharmacists have taken on new primary care responsibilities under Pharmacy First. This means that fresh sources of revenue and lower costs will overwhelmingly come from new technology and the efficiencies they can bring. As Britain's 11,500 community pharmacies assume a larger role on the frontlines of primary care, pharmacists should rapidly implement cost-effective tech solutions that provide pharmacies with a one-stop-shop to drive down costs and increase revenue. Opportunity in PGD reform New technology will be key for community pharmacists to benefit fully from reforms to PGDs. The scope of PGDs is now significantly expanding: as of June 26, pharmacy technicians are now on the list of registered healthcare professionals who can make use of PGDs. These reforms can benefit community pharmacies in several ways. For one, they will allow more pharmacy staff to administer 'frontline services' such as vaccinations - reducing costs and generating revenue. Further, the wider range of services that pharmacies can offer under Pharmacy First will make these procedures, as well as other kinds of preventative care, more accessible and convenient - increasing footfall. With international travel and tourism now growing apace, increased demand for travel vaccinations means that, according to research from Charac, the average UK community pharmacy can expect to generate £46,800 a year through travel health services.

Prime Minister Rishi Sunak, during today's (15th May ) Prime Minister's Questions (PMQs), reiterated his commitment to supporting community pharmacies amidst growing concerns over pharmacy closures. Addressing questions regarding the Pharmacy First initiative, Sunak assured the House of Commons of his dedication to bolstering resources for these vital healthcare providers. In response to a query raised by Member of Parliament, St Ives MP Derek Thomas, citing statistics from the National Pharmacy Association (NPA) about "committing to directing funds towards Community Pharmacy to alleviate financial pressure and prevent closures, Sunak remarked that he "cares deeply about the future of community pharmacies." Sunak acknowledged the indispensable role played by community pharmacists in alleviating pressure on urgent care services, emphasising the importance of initiatives like Pharmacy First in government's commitment to supporting community pharmacies. "There are over 10 and a half Community pharmacies across the country working incredibly hard to serve their patients," Sunak said praising the community pharmacists and highlighted the concerning trend of pharmacy closures, citing a significant increase compared to the previous year.

Achieving the community pharmacy vision necessitates legal adjustments and additional funding beyond recent boosts, the pharmacy vision document published by Nuffield Trust and The King's Fund has revealed. It says community pharmacies in England must adapt to changing population needs amidst unprecedented health and care challenges. Commissioned by Community Pharmacy England, the report titled 'A Vision for Community Pharmacy', published on Sept. 19, is a result of almost a year of research and extensive consultation with the sector and wider stakeholders, advocating for community pharmacy. The think tanks detail a shift in the community pharmacy sector, highlighting how pharmacies can contribute to crucial policy objectives regarding population health, prevention, and the increasing demand in primary care. "The health and care needs of the population are evolving, and pharmacies in England, like all components of the health and care system, must adjust to address these changes," said Helen Buckingham, Director of Strategy at Nuffield Trust.

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 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.

Pharmacy minister Stephen Kinnock has pledged to enhance the role of community pharmacies, particularly in deprived areas, by making better use of the skills of pharmacy teams. In a video message at the SIGMA UK Community Pharmacy Conference 2024 on Sunday, Kinnock also announced plans to expand the Pharmacy First initiative and introduce an independent prescribing service, making prescribing an integral part of the service delivered by community pharmacies. He said: "Since taking on the role of minister of state for care in government, my message has been very clear: we must get our fantastic primary care sector back on its feet to be able to deliver for our patients. "This government is committed to shifting care from hospital to community, from analogue to digital, and from sickness to prevention, and pharmacies will play a vital role in that." Kinnock acknowledged the pressures faced by the sector and expressed concerns that so many community pharmacies have exited the market over the past decade.

A group of 20 parliamentarians has written to health secretary Wes Streeting MP, calling for urgent government action to address the growing financial crisis facing community pharmacies. In the cross-party letter, supported by Community Pharmacy England (CPE), the MPs warned of a real risk of more pharmacy closures, with one in six pharmacy owners saying that they are unsure if their pharmacy will survive the year. They have urged the Department of Health and Social Care (DHSC) and NHS England (NHSE) to prioritise long-term planning for pharmacies, including the implementation of the Community Pharmacist Prescribing Service. The MPs have also highlighted the need for more effective marketing for Pharmacy First to increase both walk-ins and referrals to this critical service. CPE chief executive Janet Morrison welcomed the support of 20 cross-party parliamentarians and recognising the vital role pharmacies play in the local community. She stressed the urgent need for immediate government intervention to ensure the survival of the sector and to maximise its potential in providing accessible care.

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 Department of Health (DoH) in Northern Ireland has published a new Strategic Plan for Community Pharmacy, highlighting the vision and key priorities for the sector over the next 10 years. Co-developed by the DoH and Community Pharmacy Northern Ireland (CPNI), the representative body for community pharmacy owners, the plan aims to fully realise the potential of community pharmacy services to support better health outcomes from medicines and prevent illness. The vision outlined in the plan sees community pharmacies offering more clinical services, leveraging the skills of their teams to provide the public with safe, convenient, and faster access to care. According to DOH, the vision will be realised through four major reform programmes focusing on services, legislation, workforce, and digital enablers, alongside six strategic priorities. Together, these initiatives are anticipated to transform the role of community pharmacy within the Health and Social Care (HSC). Health Minister Robin Swann has extended his support to the new Community Pharmacy Strategic Plan, which builds on the previously agreed 3-year community pharmacy commissioning plan.

Prime Minister Rishi Sunak was questioned whether he 'will take urgent action to prevent pharmacy closure'. At Prime Minister's Questions (PMQs) in Parliament held on Wednesday (26 April) he replied, "we will continue to do everything we can to support community pharmacies." Labour MP for Knowsley and All-Party Pharmacy Group member, George Howarth said: "Given the chronic lack of capacity in the NHS, the Prime Minister will be aware that community pharmacy can help deal with minor illnesses. But there is a problem on average 10 Pharmacy close every month in England." Prime Minister was further asked "will he take urgent action to prevent further closing and commission a properly funded 'Pharmacy First' service for minor illnesses? Sunak replied: "I've been a wholehearted champion and believer in the role that community pharmacists can play. we want to make sure that they can do everything to ease some of the pressures in primary care.

Pharmacies are the lifeblood of community healthcare, being a vital pathway to care and support in every borough of the UK. There are 11,600 pharmacies across the country, amongst which yours stands proudly. Pharmacies obviously have a duty of care to their patients and customers, and rigorous safety practices surrounding the safe storage and dispensation of medicine - but that duty of care also extends to fellow staff. This is to say that health and safety is a paramount concern for any pharmacy or pharmacist, and that great care should always be taken to uphold the highest possible standards with regard to health and safety. With this in mind, what follows is a refresher on some of the key hazards that could give way to workplace injury in your pharmacy - and how to mitigate the risk of injury. Biological Hazards Biological hazards are ever-present, and prescient in the aftermath of the coronavirus pandemic. Though the COVID-19 virus was eventually shown not to be particularly resilient on surfaces, good practice was still to regularly disinfect surfaces and handles where possible - something which should still be a part of regular routine in your pharmacy. Likewise, face masks are a solid way to reduce the risk of infection or contamination, particularly where the handing over of biological samples is concerned.

Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs and A&E. It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years. If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to consider. Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional? What is the vision for community pharmacy delivering patient care in the next decade? The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.

Sector leaders have welcomed the NPA ballot results, which demonstrate that community pharmacies are prepared to take collective action if a funding increase is not achieved. Nearly all pharmacy owners, who participated in the NPA ballot, said they were willing to limit their services to protest funding cuts. Commenting on the poll results, Malcolm Harrison, CEO of the Company Chemists' Association (CCA) said: "The results of the NPA ballot serves to underline the huge pressure that pharmacy contractors face, following a decade of underfunding. He emphasised the need to start the Community Pharmacy Contractual Framework (CPCF) renegotiations for 2024/25 without delay. "The government and NHS must uplift all elements of the contractual framework, to stop further reductions in pharmacy opening hours and permanent pharmacy closures, and to ensure that patients can continue to receive the medicines and clinical care and advice they need," he added. Harry McQuillan, Chairman of Numark, stated that while the NPA ballot outcome has once again brought the financial crisis facing the sector into focus, this is "an everyday reality" for many independent pharmacies and that it has reached "breaking point." He warned that rising operational costs including the increase in national insurance and minimum wage will push many more to the brink.

The National Pharmacy Association (NPA) has lashed out at the British Medical Association (BMA) after GP leaders voted in favour of the motion to terminate pharmacy blood pressure checks with immediate effect and redirect the funds into pharmacy dispensing fees. Commenting on the BMA's vote, NPA chair Nick Kaye said: "It benefits no-one, least of all patients, for one set of health care professionals to talk down the services provided by another." He emphasised the importance of investment and collaboration across the healthcare system, particularly between general practice and community pharmacies, to provide the best possible care for patients. Furthermore, Kaye stressed the value of pharmacy-based NHS clinical services in improving access to care, while also providing more convenient care for patients and relieving pressure on other parts of primary care. "It would be terribly shortsighted to row back on preventative services such as hypertension case finding, which will be cost-saving as well as lifesaving in the long term," he warned. He noted that the NHS will only meet the growing needs and expectations of the ageing population by making the most of capacity and skills across the whole system.

The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday (15 November). The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on the front-line and were briefed on the urgent need for action to address the pressures on the sector. Outline of the four-point plan: Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to get through this winter. Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free up capacity and freed from red tape that does not enhance patient care. Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.

The National Pharmacy Association (NPA) has called the future prime minister to deliver on the commitments made by the previous health secretaries to reform primary care through a 'pharmacy first' approach and fairly fund community pharmacies to avoid closures. In an open letter, the NPA has urged Rishi Sunak and Liz Truss, the two leadership contenders of the Conservative Party and prime ministerial candidates, to think radically about the role of England's 11,000 pharmacies, which are on the frontline of healthcare across the country. NPA also highlighted how pharmacies could help clear the NHS backlog, free up millions more GP appointments, dramatically improve access to primary health care and do more to prevent ill health and support people with long term medical conditions. "Because of our unparalleled presence in deprived areas, we also have great potential to level up access to healthcare and address health inequalities. We set these ideas out in How We Can Help, which is an improvement plan already welcomed by many of your colleagues."

Pharmacy minister Stephen Kinnock highlighted the role of community pharmacies in the Labour government's proposed healthcare reform during his speech at the 24th annual Pharmacy Business Awards on Wednesday. He outlined the government's vision for three strategic shifts: from hospital to community, from analogue to digital, and from sickness to prevention. Emphasising the crucial role that community pharmacies will play in achieving these changes, he said: "Pharmacies are based in, and recruit from, and are part of their communities, and we have to put you right at the heart of those three shifts if we are to deliver the change that our country so desperately needs." Kinnock also acknowledged the contribution of pharmacies in safeguarding the nation's health. He stated: "I've already heard, just in the short time that I've been in government since 4 July, of many examples of just how much patients and communities rely on your services and the lengths to which you go to deliver care."

Community pharmacies will be able to deliver approximately 15 million blood pressure screenings by 2026, revealed the Company Chemists' Association (CCA)'s new research. This will also prevent 15,000 people from suffering heart attacks or strokes. CCA has called the Government to take up their offer and commission pharmacies as the first port of call for cardiovascular care. "Thousands of lives can be saved with ambitious commissioning and the investment to match," said CCA. There is an opportunity to use the expertise of community pharmacy to go further and provide the care these newly identified patients' need. To do this the sector needs funding and workforce. The association said: "Community pharmacy is under great financial pressure, suffering a real term funding cut of over 30% over 8 years. With funding, the sector can transform to deliver this critical need for patients. Whilst there are plans to train Independent Prescribers (IPs), there are no clear roles for them to use these skills. There is a need to accelerate training plans to allow pharmacists to deliver the service described here and play their part in CVD management."