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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.

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."

"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."

With the UK General Election set for 4 July, pharmacy bodies are actively engaging with all political parties to secure support for the community pharmacy sector. They are pressing parties to address urgent issues such as pharmacy closures and medicine shortages. "The upcoming general election is a critical opportunity for us to strengthen supporters of community pharmacy in readiness for the new Parliament," said Janet Morrison, chief executive of Community Pharmacy England (CPE). She stressed the need for unity within the sector in advocating for community pharmacy and raising awareness of the issues with election candidates from all parties. As the general election approaches, CPE has called upon all political parties to support pharmacies by "introducing a long-term sustainable funding model and reviewing the medicines supply chain, including much-needed short-term relief measures."

Health secretary Sajid Javid vouches support for a "pharmacy first" model of care for minor illnesses, to help clear the backlog of NHS care arising due to the Covid-19 pandemic. Speaking at the National Pharmacy Association's (NPA) centenary dinner in central London on Wednesday (November 24), Javid said he wanted to "go further" than existing services like the NHS Community Pharmacist Consultation Service, to make it "quicker and easier" for people to access primary care. He said: "I want to see how much further we can go. That's one of the reasons why we're working up plans for a pharmacy first model in England that will direct more patients directly to pharmacies without having to go to see their GPs. This will help us to beat the backlog and make sure that even more people can benefit from (pharmacists') brilliant advice and care." Expressing his commitment to transform every aspect of health and care in the country he said that community pharmacies should be "at the very heart of primary care - not just treating people but preventing people from becoming patients in the first place."

A new report has suggested that adopting hub and spoke dispensing model could be a realistic and affordable option for many pharmacies across the UK, not just a select few. The report released by Centred Solutions highlighted several evidence-based benefits of this model, including a return on investment (ROI) within two years for an average pharmacy, debunking the skepticism that has long surrounded the model. Analysis by the software and technology company found that the ROI, from setting up a hub and all operational costs (excluding transport), can be achieved through either re-directing time saved into delivering services, improving resource efficiencies, or a combination of both. One of the key findings is the 81 per cent reduction in payroll costs per item-from 99p in a pharmacy to just 19p in a hub. The report also revealed that by shifting to a hub and spoke model, pharmacies could offload 50 per cent of total dispensing volumes (70-80 per cent of repeat dispensing) from their branches, creating much-needed capacity. The report also projected an average stock reduction of 50 per cent in the first year for pharmacy branches moving to this model of dispensing.

As an Alphega pharmacy mentor, Sue Dobson has worked with pharmacists across the country, helping them adapt to the growing responsibilities and challenges they face in their profession. One of the most exciting developments in recent years has been the Pharmacy First initiative, which positions community pharmacists as key players in patient care, especially through GP referrals. However, Sue has seen firsthand that the success of this initiative depends largely on the strength of the relationships we build with GPs and how we integrate these referrals into our day-to-day operations. Some pharmacists have thrived by establishing strong, collaborative relationships, while others have struggled to break down initial barriers of trust. In this conversation, she speaks with Anil Chauhan, a Preston pharmacist who, along with his partner Yasar Hussain, has made GP referrals a seamless part of their practice. Their success story is a great example of how perseverance, trust-building, and a proactive approach can truly make a difference in the Pharmacy First model. Sue Dobson: Anil, you and Yasar have done a great job with the Pharmacy First initiative and GP referrals. Can you start by sharing how you first got involved with GP referrals and what made it successful in your practice?

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.

As the general election campaign heats up, major political parties - including Labour, the Conservatives, the Liberal Democrats - have released their manifestos, detailing their plans and visions for the future of community pharmacy. While the Conservative Party promises to expand Pharmacy First initiative, Labour pledges support for small businesses, with plans to overhaul the business rates system. The Liberal Democrats' election manifesto commits to developing a fairer and more sustainable long-term funding model for pharmacies. Announcing their plans recently, Prime Minister Rishi Sunak stated that they are investing in community care services to secure the future of the NHS and make healthcare more accessible. The Conservatives plan to fund these initiatives by cutting NHS managerial positions back to pre-pandemic levels and halving the government's management consultancy expenditure.

The Company Chemists' Association (CCA) has responded positively to the Labour Party's manifesto, which outlines plans to bolster community pharmacy services and shift the NHS towards a more localized, prevention-focused model. Key proposals include the creation of a Community Pharmacist Prescribing Service and the enhancement of care delivery in local communities. Malcolm Harrison, Chief Executive of the CCA, expressed strong support for these initiatives and said: "We welcome the Labour Party Manifesto's clear focus on moving to a 'Neighbourhood Health Service', prevention, and the return of the 'family doctor'." "Harnessing community pharmacy is crucial to delivering each of these," Harrison added.

Released on Monday morning, the election manifesto shared by the Liberal Democrats pledges to "strengthen patients' rights" by tackling public health inequalities and providing early access to community services. The Liberal Democrats Party's manifesto promises to address the issues at both the "front and back doors" of the National Health Service (NHS), which the party claims has been plunged into crisis by the Conservatives. Pledging to invest in public health and early access to community services, the party aims to "work towards a fairer and more sustainable long-term funding model for pharmacies and build on the Pharmacy First approach to give patients more accessible routine services and ease the pressure on GPs." The pledge also includes making prescriptions for people with chronic mental health conditions free on the NHS, as part of a wider commitment to review the entire schedule of exemptions for prescription charges.

The Department of Health and Social Care (DHSC) has finally published its response to the 2022 consultation on hub and spoke dispensing. Considering the consultation evidence and further discussions, the government has expressed its intention to progress the proposals for enabling hub and spoke models across different legal entities as soon as possible. This will be achieved by using the enabling powers outlined in Part 2 of the Medicines and Medical Devices Act 2021 (MMDA) to amend the Medicines Act 1968 and the HMRs. Furthermore, the DHSC has decided to proceed with the implementation of the two models of hub and spoke dispensing that it consulted on. The government response to the consultation reads: "Having considered the responses, the government intend to proceed to implement the necessary changes to medicines legislation to remove the current restrictions that prevent the hub and spoke dispensing models from operating across different legal entities found in section 10 of the Medicines Act 1968.

According to the National Health Services (NHS)'s new mandate, pharmaceutical companies seeking to participatign its Antimicrobial Product subscription model must certify to the BSI Kitemark for minimised risk of Antimicrobial Resistance (AMR) This move is part of the NHS's strategy to tackle the growing global threat of AMR by ensuring that antibiotic manufacturers adhere to stringent environmental controls. The NHS antibiotic subscription model is the first of its kind globally, offering pharmaceutical companies a fixed annual fee based on the value and availability of their antimicrobials to the NHS, rather than the quantity consumed. The innovative approach aims to stimulate the development of new antibiotics while addressing the environmental impact of their production. The NHS antibiotic subscription model is a ground-breaking incentive program as the first in the world to pay companies a fixed annual fee for antimicrobials based on the value of the drugs to the NHS, and their availability, instead of the volumes used.

The UK government on Thursday (8 May) launched a new plan to tackle antimicrobial resistance (AMR), a global issue that makes infections difficult or impossible to treat. This is the second phase of a series of 5-year national action plans, aimed at supporting the government's 20-year vision to contain and control AMR by 2040. With the launch of this new national action plan, the UK commits to reducing its use of antimicrobials - such as antibiotics, antifungals and antivirals - in humans and animals. Additionally, it aims to strengthen surveillance of drug-resistant infections before they emerge and incentivise industry to develop the next generation of treatments. There are also plans to expand initiatives such as the world-first 'subscription model' for antimicrobials, launched in 2019 as a pilot.