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Lack of appropriate funding is making survival a massive challenge for community pharmacy, a sector relied upon as a vital support system by both primary and secondary care in England. The Telegraph newspaper ran a story on Monday (August 22) which highlighted the dire straits community pharmacy finds itself in. Seasoned pharmacist Ian Strachan told the paper: "Our four pharmacies were the only point of call that was open (during Covid). We were there every single day, even when the virus was prevalent and people were dying." Describing the current situation, he said: "What is happening is we're facing a system that's just not working at all in our favour." Strachan says the issue is that pharmacists are "just not getting the help we need to be able to do this job properly". The sector is hugely dependent on funding from the NHS. The government had agreed in 2019 to set £2.6bn as annual funding for the sector. However, according to a report from EY that amount was already down £200m on the 2016 levels of government funding. "We've been starved of appropriate funding since 2016," Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies told The Telegraph. "It looks grim for businesses. The fees pharmacists get are going nowhere, but now, there's higher utility bills, higher staff fees and higher drug costs."

Patients are highly satisfied with the new Pharmacy First service, which enables pharmacists to assess and treat patients for seven common conditions, according to a survey by the National Pharmacy Association (NPA). Nearly 100 NPA members participated in the snapshot poll conducted at the end of the first full week of the service. Nine in ten respondents (87 per cent) said that "most or all patients expressed satisfaction" with the service they received. However, many independent community pharmacy owners are facing challenges in implementing the service. While 56 per cent of pharmacy owners surveyed expressed feeling "motivated" by the new service, a larger proportion (70 per cent) indicated being "under additional pressure." More than 30 per cent of the respondents found implementation of the service "harder" than they had expected.

The Health and Social Care Select Committee (HSCC) on Tuesday held the first session in their pharmacy inquiry, with a panel of experts discussing the key issues facing community pharmacies in the country. Representatives from community pharmacy associations highlighted some of their biggest challenges and their vision for the future, as well as actions that government and NHS England can take to address those challenges for a better future for the sector. Opening the session, the Committee's vice-chair, Rachel Maskell MP, asked the representatives if they felt the government was ambitious enough in what it believes community pharmacy can do to address NHS pressures, or are pharmacists being held back by issues around workforce funding, contracting, and technological changes. Malcolm Harrison, Chief Executive, Company Chemists' Association (CCA), expressed that the government is not ambitious enough, saying "there's always opportunity to be more ambitious".

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare. Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists. Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence. In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.

Pharmacists, councillors and NHS leaders came together at Portsmouth's first Community Pharmacy Summit to address some of the challenges facing community pharmacy locally. They explored ways to reduce the huge pressures on pharmacy, tackle abuse towards staff, enable pharmacists to undertake training to treat more illnesses, and to protect the current and future workforce. Portsmouth City Council, which hosted the Summit on Wednesday 15 November, also invited representatives from Hampshire and Isle of Wight Constabulary, University of Portsmouth, Hampshire and Isle of Wight Integrated Care Board and businesses to discuss new opportunities to work together. Held at Portsmouth Guildhall, the event was chaired by Cllr Matthew Winnington, Cabinet Member for Community Wellbeing, Health and Care, and Cllr Gerald Vernon-Jackson, Cabinet Member for Transport.

The Pharmaceutical Services Negotiating Committee (PSNC) has published an update on the work it is doing as part of the Transforming Pharmacy Representation (TAPR) Programme to take forward the mandate from contractors to deliver the Review Steering Group (RSG) recommendations. The update is primarily aimed at LPCs - with whom PSNC has been working closely on some of the TAPR work over the summer. The TAPR Programme is being undertaken in support of PSNC's work to address the severe challenges facing the community pharmacy sector at present. Alongside ongoing negotiations with Government and the NHS, two of the TAPR workstreams - focusing on Vision and Strategy, and on Influencing and Negotiation - are essential to supporting CPCF negotiations. "The workstreams are looking at the future of community pharmacy and how best to persuade policymakers to implement a shared vision, with their objective being to put the sector in a stronger position going into future CPCF negotiations," said PSNC.

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.

Workforce issues, staff retention and capacity continues to be a big concern for the Local Pharmaceutical Committee as it discussed the topics at a recent meeting with the Pharmaceutical Services Negotiating Committee (PSNC). The meeting, attended by delegates from 66 LPCs, focused on the current challenges faced by community pharmacies as well as the planning for the next year. Around 64 per cent of delegates said workforce was the top challenge faced by pharmacy contractors, and suggested reducing the migration of pharmacists to Primary Care Networks (PCNs). Other suggestions included - "improving the development opportunities available for pharmacists and their teams, and rebranding the profession to make community pharmacy a more attractive route for young graduates." On the development of Integrated Care Systems (ICS), the majority of respondents were positive about their LPC's engagement in the new setting.

Community Pharmacy England (CPE) Chief Executive, Janet Morrison met with the new Pharmacy Minister, Dame Andrea Leadsom MP this week and discussed a range of critical topics, including funding and pressures. Janet informed the minister that community pharmacies continue to face immense financial pressures, and highlighted the need for an improved core contract. She told the minister that 35-50 per cent real term cuts and rising costs have led to closures, consolidations and cashflow. This has weakened the capacity for the network to respond to displaced patients, increased risk in terms of the safety of medicine supply, and led to loss of service for communities in the most deprived areas, she said.

The Pharmaceutical Services Negotiating Committee (PSNC) has called for improved workforce planning to be undertaken by the government and NHS. However, for this to happen, it added, "high quality workforce data for community pharmacy needs to be available." For this reason, the Department of Health and Social Care (DHSC), NHS England and PSNC have agreed that it will be a Terms of Service requirement for contractors to complete the annual Health Education England (HEE) community pharmacy workforce survey, which will then provide a full picture of the community pharmacy workforce, including identifying the number of vacancies and regions where these are particularly hard to fill. PSNC said: "It is acutely aware of the challenges that contractors and their teams are currently facing, so in recognition of the workload associated with completing the annual workforce survey, we have negotiated with DHSC and NHS England that the requirement to undertake an annual patient satisfaction survey will be removed from the Terms of Service from 1st October 2022." This means that contractual requirement will no longer apply to contractors in 2022/23 and going forward.

A recently published report on medicines optimisation highlights the urgent need for transformative changes across all pharmacies to unlock their full potential in delivering integrated care. The report by Public Policy Projects (PPP) is first of the four in the series that emphasises the significant benefits that medicines optimisation can bring to integrated care systems (ICSs). This includes reducing health inequalities and improving population health. Pointing to the "untapped opportunity" that medicines optimisation presents for ICSs facing financial challenges, the report underscores the vital role of pharmacies in enhancing patient outcomes. The launch of the Pharmacy First services has already demonstrated the essential contribution of pharmacies to the health and care system. With "medicines being the second highest cost to the NHS," the report recommends ways "to achieve better value for money while improving patient outcomes".

Leaders from across the pharmacy sector and trade bodies dwelled on the challenges faced by the pharmacists at the Sigma Conference held on Sunday (2 October). "If the cost of carrying out regulation is higher than the benefits, it's time for all the bodies to sit together and talk on what can be adjusted accordingly," said Salim Jetha, Chairman, Avicenna. Jetha highlighted the challenges faced by the independent pharmacy and also raised the concern about the 'level playing field' for pharmacists compared to GPs. He said: "GPs get paid for energy cost, premises cost, the staffing cost. We don't get paid for that. So don't be misled by saying we are being exactly the same. Yes, on paper we are, but in reality we are not. I think also the rules of engagement are different." He called for better collaboration with GPs, and urged PSNC and other trade bodies to ensure a level playing field. Janet Morrison, CEO, Pharmaceutical Services Negotiating Committee(PSNC), warned that the pressure in the sector is building up to a 'breaking point'.

Community Pharmacy England (CPE) is seeking views from all community pharmacy owners about the pressures faced this autumn season. A survey has been launched as the "November Pre-Committee Opinion Poll" until 6 November to seek views from independents and non-Company Chemists' Association (CCA) members. The results of the poll will be sent to the head offices of CCA multiples next week for discussion at the November Committee Meeting. CPE confirmed: "The results of these polls and the outcomes of the meeting will be reported back to the sector afterwards. They said that the survey "will be used to feed into our ongoing work to press for an uplift to core funding by enhancing our evidence base of what pharmacy owners are experiencing."

The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

Leading pharmacy bodies and associations are looking forward to working with 'reappointed' Secretary of State for Health and Social Care, Steve Barclay, on 'future roles' and 'funding' for the community pharmacy. The Royal Pharmaceutical Society (RPS) England Country Board Chair, Thorrun Govind, hopes that the ministers will now be able to focus on addressing the key challenges facing the health service and the country. "This means not just getting through the winter, but planning for and investing in the future." She added: "It will be crucial to use the skills of all our health professions to support the NHS recovery, reduce health inequalities, manage the growing cost of long-term conditions, and deliver best value from medicines.

Covid-19 has accelerated a culture change for community pharmacists. Throughout the pandemic, they have been the first line of advice, treatment and referral for common illnesses, and they have Successfully prevented countless unnecessary visits to A&E. The commitment of the profession to patient care has been widely recognised by both the government and the public. Despite immense pressure, pharmacy teams have risen to the challenges posed by a Global pandemic. "The extent to which pharmacists went over and above the call of duty, acting outside of their licences from a humanity point of view was extraordinary," said Tess Player, vice president and global head of expert and health influencers at GSK Consumer Healthcare, calling them the "unspoken heroes" of Covid-19. Pharmacy teams from around the world have shared with her their experiences. Pharmacists in China remained open round the clock and sourced face coverings for their community and metered out the short supply for their patients.

Following Community Pharmacy England's Parliamentary drop-in event on medicines supply issues last week, several MPs have since raised questions to the Health Secretary during a Health Questions session on July 18th. According to CPE, MPs from all Parties displayed great engagement with the current pressures facing community pharmacies, particularly regarding medicines supply issues. During last week's event, Mike Amesbury, the MP for Weaver Vale, was present and directed a question to the Health Secretary: "Eighteen community pharmacists in my constituency are reporting challenges with medicine supplies. What further actions will the Minister take to address and resolve this situation effectively?" In response, Health Secretary Steve Barclay MP stated, "We have a dedicated team in the Department that focuses on medical supplies, which are an ongoing concern. Challenges in this area are a routine part of our business."

The Pharmacists' Defence Association (PDA) has urged the community pharmacies to complete a short survey on the availability of commonly prescribed medicines. PDA is hearing from members working in community pharmacy about challenges they are facing in fulfilling prescriptions for some of the most common medicines, including antibiotics. It wants to hear from pharmacists on the front line about their recent experiences. The association said: "Whilst at this time of year the incidence of infections and illnesses can be heightened, demand is seemingly higher than usual, and we would like to hear more about how this is impacting on you and the patients in your care,"