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The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce. The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit. Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited to general practice: community pharmacies are also suffering the consequences of it." "Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to make ends meet, not least given the rising staffing costs which are being driven up by workforce issues. Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

"Locums are a vital part of pharmacy to ensure branches can remain open and provide vital services to communities and patients across the country," said Jonathon Clarke, CEO and founder of Locate a Locum. In an exclusive email interaction with Pharmacy Business, Jonathon noted that while the demand for locums remains high, there has been a dip from the post-COVID peak, which is also reflected in their rates. Due to the shortage of registered pharmacists, employers are actively seeking locums to cover gaps in their rotas. "Legally, there needs to be a registered pharmacist on site or else a pharmacy is unable to open resulting in an NHS fine," he highlighted. Whether employed or working as self-employed locums, pharmacists face many issues on a day-to-day basis, such as insufficient staffing or commercial pressure to hit "targets". However, locums also face several unique issues on top of these. According to Jonathon, a significant challenge locums face due to the changing market environment in the UK is the "rising workload" associated with offering advanced services such as Pharmacy First.

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."

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 Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for their services. "Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide the right care for patients," said Govind. "As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health service are struggling to cope. The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams. Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures. "However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open long hours and at weekends."

The Pharmacy First service, set for launch in England at the end of January, is expected to help reduce some of the pressure on the National Health Service (NHS). But the question is - Are pharmacists ready to take the extra workload amidst many issues community pharmacies are currently facing? Nearly 50 per cent of pharmacy workers surveyed by ITV News said they do not feel confident they can provide the new services. Pharmacy leaders told the British news channel that the industry is already in crisis, and they are facing a "potentially fatal cocktail" of rising prices, major supply problems and a lack of funding.

People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP). According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in England last year, rising from 12.8 million in 2022 to 17.6 million. Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for their services due to severe staff shortages. Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five years ago. Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and unsustainable workloads" and "we can't keep doing more with less."