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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 Welsh government has reached an agreement with the NHS and Community Pharmacy Wales (CPW)-the statutory representative body for all community pharmacies-on a six per cent funding increase as part of the 2024/25 Community Pharmacy Contractual Framework (CPCF). The £9.9 million increase will bring the total CPCF funding to £175 million per year, representing a 24 per cent rise in funding since 2017. In a statement published on 20 December 2024, Jeremy Miles, cabinet secretary for health and social care, said that the additional investment will be used to address "both immediate pressures facing community pharmacies and to maintain momentum on our longer-term ambitions for reform." Miles also said that the government would continue to invest in integrating pharmacies in primary care clusters, developing the skills and scope of practice of the wider community pharmacy workforce including pharmacy technicians, and the Choose Pharmacy IT system. In contrast, community pharmacies in England are still awaiting progress on CPCF negotiations for 2024/25. Last month, Community Pharmacy England (CPE) warned of the sector's worsening financial situation, urging ministers to provide immediate funding relief.

A harsh funding regime that hasn't adapted to changing macroeconomic realities means the viability of large parts of the pharmacy sector is at risk unless the model changes. Very simply, across the sector, revenue has remained largely fixed while costs have increased significantly, making it impossible for many pharmacies to sustain their business models. The sector has seen the closure of more than 1,500 community pharmacies since 2015, with 700 of these closures occurring since 2021. Larger pharmacy operators such as Lloyds, Boots, and Rowlands have seen the biggest decline in numbers, with smaller businesses operating between one and five pharmacies now accounting for almost 50% of the sector. Despite rising inflation and business costs, the NHS pharmacy funding model has remained fixed. Over the period of the current Community Pharmacy Contractual Framework (CPCF) - 2019-2024 - pharmacies have experienced a 30% real terms cut in core funding leading to an annual shortfall of over £750 million, equivalent to £67,000 per pharmacy in England. The current CPCF is due to end in 2024, and there is still no arrangement in place for future funding, leading to delayed and inefficient spending decisions and hampering the ability of the sector to plan and attract much-needed investment.

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.

Health secretary Wes Streeting has pledged to stabilise the community pharmacy system before enabling it to take on a broader role in healthcare, as he addressed the Health and Social Care Select Committee in Parliament on Wednesday (18 December). "Now that we have got the budget set, we will be consulting with Community Pharmacy England shortly in the New Year," Streeting stated. "I do want to reassure pharmacists across the country that we are taking into account the enormous pressures they are under when thinking about allocations so that we can stabilise the system and create the foundations from which to recover." The health secretary emphasised that his top priority is to "stabilise the [community pharmacy] system" before expanding initiatives such as Pharmacy First and independent prescribing. He also expressed a vision for community pharmacies to play "a bigger role… as part of the shift from hospital to community," but stressed that immediate steps are required to address the sector's current financial strain. The announcement that Community Pharmacy Contractual Framework (CPCF) negotiations will commence early in the New Year was reaffirmed by Streeting, echoing a statement made earlier in the week by minister for care Stephen Kinnock during a Westminster Hall debate.

In response to a recent Parliamentary question regarding pharmacy reimbursement, pharmacy minister Stephen Kinnock stated that pharmacies were permitted to retain £850 million from the medicine margin for 2023/24. The medicine margin represents the difference between the product price reimbursed by the National Health Service (NHS) and the price at which pharmacies buy them. Rebecca Smith, the Conservative MP for South West Devon, inquired about the number and proportion of community pharmacies that had dispensed medications at a loss over the past three years. Kinnock replied that they do not hold this information, and explained that community pharmacy reimbursement arrangements "do not aim to ensure that every pharmacy is paid as much or more than it paid for every product, but aims overall to reimburse as much as they were bought for, plus the allowed medicine margin." Additionally, the minister highlighted that as part of the Community Pharmacy Contractual Framework (CPCF) for 2023/24, pharmacies are allowed to retain "£850 million from the medicine margin, on top of what they are paid for the medicines they purchase as part of providing NHS services."

Janet Morrison, CEO of Community Pharmacy England (CPE) has emphasised that stabilization of the sector is essential before any solutions can be delivered to fix the "struggling" health service. Speaking at the recent SIGMA UK Community Pharmacy Conference 2024, Janet described the current contract as "unaffordable" and warned that pharmacies are becoming "unsustainable." "Without an urgent funding uplift, the sector is facing a 'house of cards' collapse that will seriously impact communities, patients, and the safety of medicine supply. "So, first of all, we have to secure the stabilization. We have to make sure you can keep the lights on and the doors open, and that's critical," she stated. Janet pointed out that if the sector is stabilized and a fair deal is achieved, community pharmacies could effectively deliver solutions for the government that meet their policy goals. However, she noted that negotiations for the Community Pharmacy Contractual Framework (CPCF) for 2024-2025 cannot resume until the budget is published on October 30.

The current funding and contractual framework for community pharmacy is not fit for purpose, the Health and Social Care Committee report has concluded, recommending a complete overhaul to reduce its complexity. Published today, the report highlighted the necessity for a new framework to ensure adequate funding and to prevent damaging cross-subsidy between clinical services and prescription dispensing, as is presently observed. The report revealed that community pharmacy funding has fallen by over 30 per cent in real terms since 2015, resulting in an annual shortfall of at least £67,000 per pharmacy for individual owners. More than 1,100 community pharmacies have closed since 2015, of which were serving the most deprived areas, it said. MPs on the committee have urged the government to address medicine shortages, warning that they could undermine flagship initiatives such as 'Pharmacy First' by eroding public confidence in pharmacists. "People living with type 2 diabetes, ADHD, epilepsy and cystic fibrosis, and those experiencing the menopause, have faced challenges accessing the vital medication they need. Many others are facing similar experiences.

A call to action has been issued by the Company Chemists' Association (CCA) in its submission to the Darzi Review, highlighting the critical need for recognition and revitalization of the community pharmacy sector. The CCA warns that chronic underfunding and a flawed Community Pharmacy Contractual Framework (CPCF) have resulted in a reduction of over 1,200 pharmacies since 2015. This reduction, coupled with increasing workforce pressures, is exacerbating health inequalities, particularly in deprived communities. The CCA's submission stresses that the government must address these longstanding funding issues to fully unlock the potential of community pharmacies in addressing the nation's health challenges. The report argues that while initiatives like Pharmacy First have been positive, they only scratch the surface of the sector's capabilities.

The government has responded to the Health and Social Care Select Committee's report on community pharmacy, acknowledging 17 of the 19 recommendations. In its report published on 29 May 2024, the Committee recommended, among other things, an overhaul of the Community Pharmacy Contractual Framework (CPCF), closing the funding gap, tackling medicines shortages by introducing generic substitution, and establishing an integrated and fully funded workforce plan for pharmacy. In its response, released today, the government stated that NHS England is currently conducting an economic analysis of the sector, which will inform future proposals for funding and contractual arrangements. On medicine shortages, it mentioned that the Department of Health and Social Care, working closely with NHS England, is taking forward a range of actions to improve their ability to mitigate and manage shortages and strengthen resilience. Additionally, the government has stated that it will "publish a refreshed Long Term Workforce Plan" this summer and is "committed to growing the pharmacy workforce."

Community pharmacies are being forced to halt certain NHS and public health services due to escalating financial and operational pressures, a recent survey by Community Pharmacy England (CPE) has revealed. In the survey conducted ahead of the June Committee Meeting, an overwhelming 96 per cent of pharmacy owners reported having stopped delivering locally commissioned services over the past twelve months. Additionally, nearly one-third of the pharmacies surveyed indicated they had discontinued providing some Advanced services. The survey also revealed that pharmacy opening hours are being reduced, with 81 per cent of respondents stating they had to stop offering extended hours. In 90 per cent of the cases, pharmacy owners had to cease employing locum pharmacists, likely due to cost constraints. Furthermore, over 20 per cent of the more than 2,100 pharmacies surveyed reported having to discontinue the free delivery of prescription medicines to patients.

Pharmacy contractors, particularly those in England and Northern Ireland, faced an extremely challenging 2024. The general election delayed the new Community Pharmacy Contractual Framework (CPCF) negotiations leaving pharmacies in England having to endure further hardship, as a frankly unfit 2019 contract, was effectively extended. We have witnessed pharmacy closures on a weekly basis and it is clear that an increasing number of English contractors are struggling to pay their wholesaler bills on time. It is unacceptable that the Government have allowed this to happen. In Scotland and Wales settlements have factored in inflation, which is essential for the future. Whilst we should be cautiously optimistic about the NHS plan under the new Labour government, I'm acutely aware that the sector urgently needs an injection of cash to help offset the last five years of chronic underfunding. The next English CPCF must be inflation linked, the sector cannot absorb ever-increasing costs. Pharmacy teams already work incredibly hard to deliver care to their patients and communities.

The 2025/26 pharmacy contract consultation will include a review of the medicine margin and reimbursement arrangements, health and care minister Stephen Kinnock has confirmed. Kinnock made this statement in response to a written question from Nick Timothy, Conservative MP for West Suffolk, who asked the secretary of state for health and social care, if he will review the reimbursement system for pharmacies and GP practices dispensing medicines. Kinnock stated that consultation with Community Pharmacy England (CPE) for the 2025/26 Community Pharmacy Contractual Framework (CPCF) has started and will include "reviewing the allowance for medicine margin as part of funding, and any further changes to the reimbursement arrangements." However, he clarified that there are currently no plans to review the reimbursement system for general practices (GPs) dispensing medicines. Kinnock said: "Dispensing practices receive a dispensing fee, approximately £2.00 to £2.30 per item, which is intended to cover dispensing costs. "This fee is calculated based on forecasted volumes of prescriptions to be dispensed and the size of the funding envelope, according to a methodology agreed by the Department, the General Practitioners Committee (GPC), NHS Employers, and the Welsh Government."

The Pharmacists' Defence Association (PDA) has written to the National Pharmacy Association (NPA) to highlight several important points regarding their proposed "day of action" on 20 June 2024. The NPA describes this initiative as a response to the "emergency across the community pharmacy sector." In a letter addressed to NPA Chair Nick Kaye and Chief Executive Paul Rees, the PDA's director of pharmacy, Jay Badenhorst stressed the need for NPA members to consider their obligations to staff and patients before participating in the planned actions. He stated, "We are supportive of a new contractual framework for the community pharmacy sector." "However, any actions taken must ensure the safety of patients and the operational integrity of pharmacies." The PDA's letter also expressed concerns over the safety and operational impact of the proposed symbolic gestures, including turning off lights and blacking out windows.

The Department of Health and Social Care (DHSC) has notified Community Pharmacy England (CPE) that they will no longer be able to implement the new hub and spoke models from 1 January 2025 as initially planned. The delay comes after the General Election, which put the progress of these amendments on hold. The DHSC is currently briefing new ministers across all policy areas, including hub and spoke dispensing between different pharmacy owners. As this process will take time, the implementation will not proceed as originally scheduled. CPE has stated that it does not yet have a clear timeline and will provide an update to the sector once more information becomes available. Malcolm Harrison, CEO of the Company Chemists' Association (CCA), expressed disappointment over the continued delays in fulfilling commitments made in the 2019 contractual framework agreement to support pharmacies.