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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.

In celebration of World Pharmacy Technician Day today, we have gathered some significant achievements from this year that highlight the growing recognition of pharmacy technicians as integral members of the pharmacy team. During the Association of Pharmacy Technicians UK (APTUK) Conference in September, NHS England's Chief Pharmaceutical Officer, David Webb, announced 530 apprenticeships for community pharmacy pre-registration pharmacy technicians (PTPs) for the 2024/25 period. "This announcement shows a real investment in pharmacy technicians. It will impact all areas of practice, not just within community pharmacies," said Nicola Stockmann, APTUK President, in an exclusive interview with Pharmacy Business. In August, the Centre for Pharmacy Postgraduate Education (CPPE) was allocated funding to offer 80 NHS England-funded places in its Accuracy Checking Pharmacy Technician (ACPT) programme. This 3-12 month course is designed to help pharmacy technicians develop a range of competencies, ensuring they can deliver safe and effective patient care. Up to 10 NHSE-funded spots will be available each month on a first-come, first-served basis for pharmacy technicians working in community pharmacies, NHS hospitals, and health and justice settings. The funding will remain available until all 80 places are filled or until March 2025.

Community Pharmacy England (CPE) is inviting community pharmacy owners to share their insights and views about increasing Pharmacy First thresholds and the effects of GP collective action on their pharmacies. This feedback will be discussed at the upcoming Community Pharmacy England Committee meeting in September. During the meeting, the Committee members will also discuss urgent matters including the 2024/25 negotiations, collaboration with the new government, and their ongoing strategies. A key point of discussion will also be the effects of GP work-to-rule action on community pharmacies. CPE has raised concerns that many pharmacies might face challenges meeting the scheduled increases in the monthly Pharmacy First payment threshold, noting that pharmacy owners are already considering their options if they start failing to meet the threshold. In response to concerns from Community Pharmacy England, Ministers have recently agreed to lower the August threshold from 20 to 15.

Analysis by IQVIA revealed that over the past four years, from May 2020 to May 2024, the average number of prescriptions processed by pharmacies has risen by 8 million per month. However, this is happening against the backdrop of a declining number of pharmacies. During these four years, nearly 900 pharmacies have closed in England, with almost 500 of those closures occurring in the last 12 months. Carol Alexandre, vice president at IQVIA, presented the data at the recent SIGMA UK Community Pharmacy Conference 2024, where she shared insights into the dynamics of the UK market, the pharmacy sector, and the Pharmacy First initiative. As of August 2024, there were just 10,059 community pharmacies (excluding distance-selling pharmacies) in England, 1,589 less than in March 2015, when the number stood at 11,647 (source: NHS BSA). There has been a significant shift in the distribution of pharmacy ownership, with independents (single pharmacies and chains with 1-5 stores) and regional chains (pharmacy chains with 6-200 stores) growing at the expense of managed chains.

Community Pharmacy England (CPE) is gearing up to conduct a vital Pharmacy Advice Audit, calling on pharmacy owners and their teams to help measure the increasing reliance on pharmacies within communities. With years of financial strains impacting the sector, despite the much-needed £645 million recovery plan funding, the sector finds itself on the edge. The launch of Pharmacy First sparked a notable surge in people seeking advice from community pharmacies, both within and beyond the funded service, as revealed by recent sector polling. To accurately assess this trend and advocate for sustainable funding, CPE is initiating an audit to gather data crucial for showcasing the extent of unfunded care provided by community pharmacies. Scheduled to commence this week, the Pharmacy Advice Audit will entail pharmacy teams documenting informal healthcare advice dispensed over a single day.

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.

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.

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.

'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.

To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the community pharmacists to to establish a robust relationship between community pharmacies and local general practices. The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services. According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to participate at all in the "groundbreaking" Pharmacy First scheme". In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer patients to the Pharmacy First and other community pharmacy services where appropriate. Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy First will likely require sustained effort over several months or longer.

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."

Pharmacy First has demonstrated the enormous value of community pharmacy in providing accessible front-line care. However, pharmacists continue to face several challenges in delivering the service. "Pharmacy First is a success, but it needs proper support to reach its full potential," said Numark chairman Harry McQuillan. In the first year alone, community pharmacies in England delivered an incredible 2 million consultations, highlighting the vital role pharmacists and their teams play in supporting the NHS. "This significant number shows the high demand for accessible healthcare and the trust patients place in their local pharmacy teams. It's clear that when empowered, community pharmacy delivers," McQuillan told Pharmacy Business. Key challenges in providing the service While Numark members have embraced Pharmacy First, McQuillan pointed out several challenges that persist: "Workforce capacity continues to be a concern, with patient demand sometimes outpacing available resources. "The administrative burden, particularly around IT interoperability, data capture, and reimbursement processes, adds complexity." "Additionally, some geographical areas are still struggling with public awareness, meaning more work is needed to ensure patients understand when and how they can access Pharmacy First."

The Company Chemists Association (CCA) has published a report highlighting the key findings of a roundtable it hosted earlier this month. The CCA convened the virtual roundtable to examine the best practice undertaken by a cross-section of LPCs to promote the delivery of the Pharmacy First service. Key recommendations for how LPCs can help support pharmacy contractors to deliver the Pharmacy First service include: Direct engagement with NHS regions who can supply funding to drive Pharmacy First engagement and promotional activity. Engagement with a variety of staff within GP surgeries, ranging from reception staff to GP partners, to drive referrals, as well as build understanding and awareness of the benefits to General Practice. Harnessing data to inform GP surgeries how they are performing locally Using data to ensure pharmacies close any open referrals promptly. Using multiple channels to promote the service, including the sharing of best practice, myth busting, use of data and creating tools which can be readily used by pharmacies and GPs. Encouraging pharmacy staff to highlight the Pharmacy First service to customers - with specific emphasis on the provision of NHS-funded care, timely access and convenience the service provides. The CCA said the report is intended to support all LPCs and pharmacy contractors as they work together to care for patients requiring urgent NHS care in their community.

In response to concerns raised by pharmacy owners, the government has decided to adjust the August threshold for the Pharmacy First service from 20 to 15 clinical pathways. The ability of pharmacy owners to achieve the thresholds for the monthly Pharmacy First payments has been a topic of great concern. Community Pharmacy England (CPE) has been actively discussing this issue over the last few weeks with the Department of Health and Social Care and NHS England. Ministers have now decided to adjust the August threshold for the Pharmacy First service to 15, CPE announced today (July 31). Commenting on this decision, Janet Morrison, CEO of Community Pharmacy England said: "We are pleased that Ministers have listened to our concerns and acted quickly to make an adjustment so soon after coming into office."

In its closing oral statement to the UK Covid Inquiry Module 3 on Wednesday (27 November), the National Pharmacy Association (NPA) urged the government and NHS to "recast community pharmacy in their minds as a valuable partner in the post-pandemic recovery, and not as a cost center." The Inquiry was also asked to recommend sufficient government investment in the network and infrastructure needed to integrate community pharmacy into the broader health system and support effective cooperation across the health service. Additionally, the NPA requested that the significant contribution of community pharmacy to the pandemic response be reflected in the Module 3 findings to "redress the lack of recognition they received throughout the pandemic." The NPA's closing statement addressed four key issues - the role of community pharmacy, the impact on pharmacy teams, the resilience of the pharmacy network, and the lack of recognition given to the sector during the pandemic and since. Lee John-Charles, speaking for the NPA, told the Inquiry that "Community pharmacy became the first port of call for patients seeking health advice during the pandemic." "Many community pharmacies went to great and heroic lengths to ensure that their services were maintained during the pandemic and demonstrated the value of the network of community pharmacies across the country."

Gurinder Singh, a lecturer of Pharmacy at the University of Reading, is set to transition into the role of an independent community pharmacist, along with his wife, Rajdip Purewal, a Clinical Pharmacist in General Practice and clinical lecturer at University of Hertfordshire. In an exclusive with Pharmacy Business, Singh shared his excitement about his acquisition of a Boots pharmacy located in picturesque Malmesbury, Wiltshire. His acquisition reflects broader trends in the pharmacy sector where experienced professionals are stepping in to fill gaps left by corporate closures. According to Singh, driven by a passion for healthcare and a commitment to their community, the new venture promises to bring an innovative and personalised touch to pharmacy services offered in the area. Discussing his motivation for revamping the pharmacy, now Malmesbury Pharmacy, Singh said: "My initial motivation was to ensure the local community didn't have to put up with another closure of a pharmacy after the recent closure of the Lloyds Pharmacy in Malmesbury."

"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."

Ensuring comprehensive healthcare services for the community necessitates collaboration between pharmacies and GP surgeries. However, several pharmacists have voiced concerns about a lack of cooperation from their local GPs in implementing the Pharmacy First (PF) service. In a survey conducted by the National Pharmacy Association (NPA) covering 470 pharmacies across England, three-quarters of pharmacists (77 per cent) indicated that local GP practices are not appropriately referring patients to the new service. The survey highlighted instances of patients either not being referred or being referred but found ineligible for support through Pharmacy First. Additionally, one in five NPA members (19 per cent) felt that their local GP practices were not engaging with the initiative at all. Commenting on the issue, NPA chair Nick Kaye said: "Feedback from across our network suggests that the rollout of Pharmacy First varies considerably from area to area.

O'Briens Pharmacy Group has sold Bispham Pharmacy as part of a strategic review of its nine-site portfolio, now reduced to eight, across the Fylde coast region. Christie and Co, the property adviser, recently announced that the group's popular Blackpool pharmacy business has been acquired by first-time buyer, Arif Bhuriya. Bispham Pharmacy, which dispenses around 4,500 items per month, is situated in the heart of Bispham's commercial centre, opposite a bustling shopping area. The community pharmacy has been in this location since February 2021, following a minor contract relocation. O'Briens Pharmacy Group provides pharmacy services across Fleetwood, Thornton-Cleveleys, Bispham, Burscough, Liverpool, and surrounding areas. Aisling O'Brien, owner of O'Briens Pharmacy, explained the rationale behind selling the Bispham site: "When we had a strategic review of our group, we saw Bispham as an ideal site to dispose of, knowing it would fare much better in the current climate as an owner-operated site.

NHS England announced at the Pharmacy Show this morning that Ministers have decided to amend the Pharmacy First thresholds for the remainder of the year. This decision follows concerns raised by Community Pharmacy England (CPE) regarding difficulties faced by pharmacy owners in meeting the required number of clinical pathway consultations for monthly Pharmacy First payments In response to CPE's representations to the Department of Health and Social Care (DHSC) and NHS England, the threshold was earlier reduced from 20 to 15 in August, and from 30 to 20 in October. At the Pharmacy Show on Monday, Ali Sparke from NHS England announced the revised thresholds, setting them at 20 for November and December 2024. Starting in January and February 2025, the number of clinical pathway consultations needed for the monthly Pharmacy First payment will rise to 25, with a further increase to 30 in March.