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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.

'Community pharmacy is far too important to be allowed to wither away' desc-Thousands of pharmacies took part in the second day of the 'Save Our Pharmacies' protest organised by the National Pharmacy Association (NPA) on Thursday. Similar to the first day of protest in June, pharmacies carried out several symbolic actions, such as blacking out windows, to warn of the threat of future closures. Meanwhile, NPA chief executive Paul Rees led a delegation of pharmacy leaders to deliver a 350,000-strong petition to No 10 Downing Street, calling for "immediate, fair and sustained funding to safeguard NHS pharmacy services and ensure local pharmacies have a future." The delegation included NPA Chair Nick Kaye; Janet Morrison, CEO of Community Pharmacy England (CPE); Malcolm Harrison, CEO of Company Chemists' Association (CCA), and Gerard Greene, CEO of Community Pharmacy Northern Ireland (CPNI). Steve Race MP, who is the new chair of the All-Party Parliamentary Group on Pharmacy, and Sadik Al-Hassan, one of only two pharmacists in the House of Commons, also joined them.

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.

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.

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.

EMIS Pinnacle, the leading Pharmacy First IT supplier, has begun implementing the GP Connect Update Record feature to all community pharmacies in England that use PharmOutcomes. Starting June 28, this new feature was made available for use with the Hypertension case-finding service and the Pharmacy contraception service, as announced by the Community Pharmacy England (CPE). The GP Connect Update Record will enable community pharmacies to securely share "structured" information with GP practices regarding consultations conducted under the Pharmacy First programme, which includes minor illness and clinical pathways, along with Hypertension Case Finding and Pharmacy Contraception services Live testing is underway with EMIS Pinnacle for Pharmacy First minor illness and clinical pathways. There are plans to expand the system in the future to include updates for urgent supply of medicines under the Pharmacy First service. EMIS Pinnacle is the third CPCF IT system supplier to offer this functionality, following Cegedim's Pharmacy Services system and Positive Solutions' HXConsult system.

"We need to fix the front door to our NHS by investing in community pharmacy," asserts Daisy Cooper as more and more pharmacies "worry about the future of their business." Reflecting on the challenges faced by pharmacists during the pandemic, she emphasised their pivotal role in launching vaccination schemes across communities and the larger role pharmacies play in complementing traditional NHS facilities. Cooper recalls her collaboration with local pharmacies in St. Albans, where she worked hand in glove with them to address challenges faced by pharmacists to obtain information from NHS England regarding protocols and procedures. She told Pharmacy Business reporter that she had to work out something "hand in glove to help them get those vaccinated schemes up and running, as pharmacies were desperate to take part in the vaccination scheme" in her constituency. Describing their unique selling point (USP), Cooper emphasised the convenience and immediacy of pharmacies located in high street areas and warned that pharmacy closures "should be a real wake up call for the government."

In response to concerns raised by Community Pharmacy England (CPE), ministers have decided to lower the October threshold for the Pharmacy First service to 20. This decision addresses a major worry for pharmacy owners who have struggled to meet the required number of clinical pathways for monthly Pharmacy First payments, especially as the October increase to 30 pathways approached. CPE has been actively engaged in discussions with the Department of Health and Social Care and NHS England over the past few weeks to address this issue. Commenting on the decision, Janet Morrison, CEO of Community Pharmacy England, said: "It is great that ministers have responded to our concerns about another increase to the Pharmacy First payment threshold: this decision will save many community pharmacies from missing out on a vital payment this month." Morrison added that CPE will continue to monitor service data and, if needed, make further representations to ministers about future months. She also emphasised the need to find a long-term solution, which involves "NHS England marketing Pharmacy First effectively and ensuring that GPs are actively referring people to the service."

Responding to an MP's question in the House of Commons, prime minister Rishi Sunak reiterated his deep concern for the future of UK community pharmacies, stressing their commitment to enhancing the sector with an additional £645 million in funding through the Pharmacy First initiative. At the recent Prime Minister's Questions last Wednesday, Angela Richardson, the Conservative MP for Guildford, raised the issue of rising pharmacy closures, revealing that Guildford recently lost two neighbouring pharmacies. Highlighting that empowering local pharmacies is a key part of this government's plan to cut waiting lists, she asked Sunak whether he would agree that it is vital for residents to have access to "a good, efficient, and above all, local pharmacy." In response, Sunak said: "I care deeply about the future of our community pharmacies."

Despite the challenges confronting pharmacy owners and their teams today, many in the industry hold the belief that the future for community pharmacy is promising. In a poll conducted at the beginning of the Pharmacy Business Conference 2024, 58 per cent of participants agreed that the future of community pharmacy is positive, with 13 per cent expressing strong agreement. However, 27 per cent expressed disagreement, with 3 per cent strongly disagreeing that the sector's future is optimistic. By the end of the conference, a higher percentage of individuals (67 per cent) showed a positive outlook for community pharmacy, with over half indicating strong agreement with its positivity. The number of participants who disagreed with it decreased to 11 percent.

At last Friday's Clinical Congress Conference, the NHSE Chief Pharmaceutical Officer for England at NHS England, David Webb, announced the upcoming launch of the Pharmacy Stakeholder Forum- an initiative led by NHS England aimed to improve pharmacy professional leadership and foster collaboration within the sector. Webb highlighted the forum's significance as a platform for driving transformative change in pharmacy leadership. "The aim is to deliver collaboration to develop a stronger and more united voice for pharmacy professionals," Webb emphasised. Highlighting the need to drive transformative change in pharmacy leadership, he underscored that "the overarching goal is to address key challenges facing the pharmacy profession and chart a course for future development and innovation." Scheduled to commence in June, the Pharmacy Stakeholder Forum will provide a space for diverse organisations and networks with a vested interest in pharmacy professional leadership to converge.

Nick Kaye, chair of the National Pharmacy Association (NPA), gave evidence to the UK's official COVID-19 Inquiry on Monday (4 November), highlighting the importance of building a "sustainable and resilient community pharmacy network" to enhance preparedness for future pandemics. Kaye also recommended utilising the existing community pharmacy infrastructure for public health initiatives, such as vaccination programmes, and stressed the need to recognise community pharmacists and their teams as integral members of primary care. "Seven pharmacies a week are closing across the four nations, and that is tragic for any future response. So, a resilient community pharmacy network that exists is going to be key," he told the Inquiry. He noted that 90 per cent of most NPA members' income comes from providing NHS services, underscoring the critical role pharmacies play in healthcare delivery. However, Kaye highlighted that pharmacies were often overlooked and underappreciated during the pandemic.

Pharmacy leaders from across the sector need to work together in order to have a stronger voice in the future of the healthcare system, Sir Hugh Taylor, chair of the UK Pharmacy Professional Leadership Advisory Board (UKPPLAB), has told Pharmacy Business. The establishment of this board in April 2024 was the principal recommendation of the UK Commission on Pharmacy Professional Leadership's report, published in February 2023. The report outlined that there is "an urgent need for the pharmacy professions to work collaboratively to deliver on their potential and, together, address a wide range of professional issues". "There's always been a measure of collaboration. And indeed, as we've begun our work, we've begun to unearth more examples of it, which is encouraging. But I think the conclusion that the UK Commission drew was that the fragmented nature of the professional leadership in pharmacy required something more concerted and organised in the form of the board," said Sir Hugh. Setup by the four UK chief pharmaceutical officers, the UKPPLAB is an independent public body, with the aim to enable greater collaboration across the pharmacy professional leadership bodies (PLBs) and specialist professional groups (SPGs), which are its constituent members.

Sustainability also brings financial benefits to businesses. This has been proven by Prabjaudt Singh Channa, Director of Priory Pharmacy. Prabjaudt is a proud winner of the Sustainable Pharmacy of the Year 2023, awarded by Pharmacy Business in association with Teva UK. Prabjaudt thanked the award organisers for acknowledging the importance of sustainability within the sector and for recognising his modest endeavours to reduce environmental impact and safeguard future generations. "I just felt really happy and proud of this recognition because originally when I set myself down on this path, I didn't really think anyone would be that bothered about the small changes that we were trying to make and the impact," says Prabjaudt. In addition to his family's background in the field, his passion for chemistry also drove him to pursue a career in pharmacy. He finds being a pharmacy contractor enjoyable because it allows him to be flexible, pursue various interests and shape his professional path.

As part of its commitment to enhancing business performance and ensuring safe, effective pharmaceutical care, Numark has developed 12 guiding principles to help its members in adapting to evolving skill sets and shaping their future. Numark's future model for community pharmacy practice presents an ambitious vision for the sector, focusing on delivering a range of clinical services, enhancing the health of local populations, and becoming an integrated part of primary care. Harry McQuillan, Chairman of Numark, reveals that these principles were derived from changes in pharmacy education, such as the integration of prescribing into undergraduate courses. He views these principles as a formal recognition of the skills that pharmacists and pharmacy teams have developed over time, particularly in the area of independent prescribing. "These principles formalize those evolving capabilities of pharmacists, especially in independent prescribing," McQuillan tells Pharmacy Business.

Over-the-counter (OTC) medicines can empower customers and pave the way for a sustainable healthcare future. By embracing OTC products, pharmacies can achieve greater freedom, stability, and enhanced profitability. In our exclusive interview with Anna Maxwell, founder and CEO of pioneering consumer healthcare company Maxwellia, we explore their game-changing pharmacy brands leading the way in self-care. Why pharmacies should embrace OTC medicines? There's never been a more critical time for pharmacies to lean into the OTC space. Right now, about 90 per cent of pharmacy income in the UK is tied to NHS funding-a model that's increasingly unsustainable.[1] We all value the NHS, but it simply can't afford to cover every treatment at the point of use indefinitely. If pharmacies could achieve even a modest shift in NHS reliance this would mean more freedom, stability, and profitability for the business. OTC medicines are the key to making that happen, offering a way to quickly provide, effective treatments that help customers while reducing the administrative and financial burdens on pharmacists.

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 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."

Northern Ireland's Health Minister, Mike Nesbitt, has welcomed the launch of the 2024/25 Experiential Learning (EL) Programme, designed to equip future pharmacists with the skills needed for a greater role in clinical care. Starting in 2026, pharmacy undergraduate students will qualify as independent prescribers upon registration, and this programme is designed to prepare them for that responsibility. The EL Programme provides pharmacy students with multi-sector clinical work placements across the region. Speaking at the programme's launch at Ulster Hospital, Minister Nesbitt said: "This is the second year of this successful programme, which will see pharmacy students in Northern Ireland benefit from the training by completing up to twelve weeks of practice-based learning in hospitals, community pharmacies and general practices across NI. "This will provide them with actual practice-based experiences in a range of healthcare settings, facilitating them to interact with patients and engage in interprofessional practice.