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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 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 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.

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 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."

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."

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.

This year has been another turbulent year for the UK pharmacy sector. The sector continues to undergo significant transformations, driven by evolving healthcare needs, regulatory shifts, and economic pressures. For pharmacy owners, staying abreast of these trends is crucial to navigating the challenges and seizing opportunities. IQVIA, a leading global provider of clinical research services, commercial insights and healthcare intelligence, delves into the key issues, challenges, and developments shaping the sector, drawing insights from the latest industry data and reports, supported with data released by NHS England (NHSE). The community pharmacy landscape remains unsettled, with disruptive market dynamics at play. The decline in the number of pharmacies, particularly within the Managed Chains channel, underscores the volatility of the market. The number of active pharmacy contractors in England has dropped significantly, with more closures than openings each month, exacerbated by the exit of Lloyds Pharmacy from the UK market which completed at the end of 2023. In the year ending June 2024, there was a net closure of 440 sites within NHSE which equates to a 4% decline in available pharmacies1. The increase in closures from June 2023 was driven by the closures of Lloyds in Sainsburys and the ongoing divestment of the Boots estate.

People in the UK have a high level of trust in pharmacies and many are keen on seeing the Pharmacy First initiative expanded, according to the 2024 STADA Health Report published today (24 June). The 10th annual health report by global healthcare leader STADA Arzneimittel AG, the parent company of Thornton & Ross, involved a survey of over 46,000 respondents across 23 countries, including 2,000 participants from the UK. The UK data showed an overwhelming trust in UK pharmacies, with 94 per cent of those surveyed (more than nine out of 10 Brits) saying they have only ever had good advice from a pharmacist. The report also indicated a strong desire for the Pharmacy First scheme to be expanded, with 44 per cent of respondents advocating for an increase in pharmacists' scope of responsibilities to support doctors.

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."

A group of 20 parliamentarians has written to health secretary Wes Streeting MP, calling for urgent government action to address the growing financial crisis facing community pharmacies. In the cross-party letter, supported by Community Pharmacy England (CPE), the MPs warned of a real risk of more pharmacy closures, with one in six pharmacy owners saying that they are unsure if their pharmacy will survive the year. They have urged the Department of Health and Social Care (DHSC) and NHS England (NHSE) to prioritise long-term planning for pharmacies, including the implementation of the Community Pharmacist Prescribing Service. The MPs have also highlighted the need for more effective marketing for Pharmacy First to increase both walk-ins and referrals to this critical service. CPE chief executive Janet Morrison welcomed the support of 20 cross-party parliamentarians and recognising the vital role pharmacies play in the local community. She stressed the urgent need for immediate government intervention to ensure the survival of the sector and to maximise its potential in providing accessible care.

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."

A recent analysis conducted by the Company Chemists' Association (CCA) has revealed stark disparities in patient engagement with the Pharmacy First service across the country, likening the pattern to a 'patchwork quilt'. It indicated that patients in the highest-performing Integrated Care System (ICS) received seven times more Pharmacy First consultations than those in the lowest-performing regions. As of April 21, more than 3,000 CCA member pharmacies had delivered 126,484 Pharmacy First consultations since the programme's launch. However, the analysis found significant regional variations, with nearly 13,000 consultations completed in the North East and North Cumbria ICS, while only 948 were completed in Gloucestershire ICS. The CCA calculated that if every ICS had as many consultations as the highest-performing ICS, there would have been an additional 600,000 Pharmacy First consultations nationwide.

Stephen Kinnock, Minister of State at the Department of Health and Social Care (DHSC), discussed all primary care contracts, including those related to community pharmacy, during his meeting with Community Pharmacy England (CPE) Chief Executive and two members from the Negotiating Team. The pharmacy minister reiterated that community pharmacies will be central to the new government's health and wider missions. CPE Chief Executive Janet Morrison and her team updated Kinnock on the community pharmacy sector, highlighting the pressures throughout the summer. They underscored the critical challenges facing the sector and the urgent need for a funding lift. They also discussed Pharmacy First and emphasised the broader potential for pharmacies to further support the health of their local communities.

Pharmacy minister Stephen Kinnock has pledged to enhance the role of community pharmacies, particularly in deprived areas, by making better use of the skills of pharmacy teams. In a video message at the SIGMA UK Community Pharmacy Conference 2024 on Sunday, Kinnock also announced plans to expand the Pharmacy First initiative and introduce an independent prescribing service, making prescribing an integral part of the service delivered by community pharmacies. He said: "Since taking on the role of minister of state for care in government, my message has been very clear: we must get our fantastic primary care sector back on its feet to be able to deliver for our patients. "This government is committed to shifting care from hospital to community, from analogue to digital, and from sickness to prevention, and pharmacies will play a vital role in that." Kinnock acknowledged the pressures faced by the sector and expressed concerns that so many community pharmacies have exited the market over the past decade.