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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.

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.

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.

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."

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."

Pharmacies are valuable healthcare assets, meeting increasing public demand. However, a substantial portion of their capacity is consumed by unfunded work. According to Community Pharmacy England's (CPE) 2024 Pharmacy Advice Audit, community pharmacies conduct over 1.3 million unfunded consultations each week, equating to 69 million annually. The average pharmacy completes around 22 of these consultations daily, each taking approximately 5.6 minutes of staff time -adding up to over two hours daily. This represents nearly 50 per cent more consultations than in 2020 and a 78 per cent increase in time spent on unfunded healthcare advice since the 2020 audit. The audit, which surveyed over a third (3,916) of community pharmacies in England earlier this year, also highlights that pharmacies handle nearly 150,000 informal referrals from GPs and NHS 111 each week. All these referrals could have been routed through the Pharmacy First service, which would have potentially secured over £115 million in funding for the sector, the CPE noted.

Community pharmacy continues to play a crucial role in providing patients with access to essential NHS care through the Pharmacy First service, especially when other parts of the healthcare system are difficult to reach. According to the Company Chemists' Association (CCA), the sector delivered an estimated 65,000 Pharmacy First consultations in the week leading up to Christmas, marking a 10 per cent increase compared to previous weeks. At a Rowland's Pharmacy in Warsop, Mansfield, pharmacist Taseta saw a notable rise in the number of patients seeking consultations for sore throats, particularly among school children and staff. The pharmacy also experienced an increase in urinary tract infection (UTI) consultations, while earache cases remained consistent. Taseta explained the surge, noting, "Lots of people do not want to be ill over Christmas so [they] wanted easy and quick access to care, which we could do in the pharmacy." They also saw more patients engaging with the Pharmacy Contraception Service, which Taseta attributed to time constraints at the local surgery.

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.

The Community Pharmacy Walk-In Consultation Service (WICS), offering treatment for various minor ailments, recorded 19,567 consultations in 2024. This marks a 61 per cent increase compared to the 12,138 consultations recorded in 2023, according to data released by Community Pharmacy Cornwall (CPC) and obtained by The Pharmaceutical Journal. Launched in community pharmacies across Cornwall and the Isles of Scilly in January 2021, the minor ailment scheme is commissioned by the NHS and CPC. It enables locally accredited community pharmacists to supply prescription-only-medicines (POMs) for the treatment of several common conditions utilising patient group directions (PGDs) that Pharmacy First does not currently cover. These include vaginal candidiasis (vaginal thrush), dermatitis, migraine, conjunctivitis, and emergency hormonal contraception. Since its launch, the service has facilitated over 38,000 consultations, with 80 per cent of them resulting in advice or treatment that concluded the consultation in the pharmacy. WICS data also indicates that the service has helped avoid an estimated 30,000 GP appointments and more than 500 inappropriate A&E visits since its inception.

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.

Since its launch on January 31st, the Pharmacy First service by the Company Chemists Association (CCA) has achieved a significant milestone, completing over 200,000 consultations to date. This milestone underscores the service's vital role in providing same-day NHS care through community pharmacies across England. Recent analysis by the CCA has revealed a pressing need to bolster GP referrals, with disparities observed between different Integrated Care System (ICS) areas, resulting in what's described as a 'postcode lottery' for patients. CCA Chief Executive, Malcolm Harrison, emphasised the importance of sustained funding for Pharmacy First beyond 2025, ensuring its availability for patients, community pharmacies, and the wider NHS.

Community Pharmacy England (CPE) has taken an interesting step to increase public awareness and understanding of the Pharmacy First service. The organisation has launched a new video animation that provides clear and concise information about the service, highlighting the seven conditions covered, the eligible age ranges within the clinical pathways consultations, and explaining how patients can access these services. Pharmacy owners and their teams are encouraged to use the new animation with existing resources to communicate the benefits and scope of the service to their  patients. The animation can be linked to pharmacy social media content and downloaded for display on digital screens in pharmacies. General practices are also encouraged to use the animation on digital screens in their practice waiting areas.

In a recent report released by the Company Chemists' Association (CCA), data from the NHS Pharmacy First service indicates a substantial uptake and positive impact on patient care just two months after its launch. The CCA's findings shed light on the service's efficacy in meeting patient needs and its potential to alleviate pressure on General Practices (GPs) within the NHS. According to the report, over 90,000 Pharmacy First consultations were conducted solely by CCA members within the initial two-month period. Impressively, 88 per cent of these consultations, totaling 81,627, were deemed eligible for NHS-funded care indicating a significant demand for the service among patients. In the first month, the data revealed that more than 90 per cent of eligible patients received necessary care directly through Pharmacy First, bypassing the need for further referral.

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."

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.

Staveley Pharmacy, a well-established community pharmacy located in the picturesque village of Kendal within the Lake District, has undergone a change in ownership. The family-run business led by a husband-and-wife team has been acquired by brothers Mohammad Waqas and Khuram Shazad, taking the helm as first-time buyers, according to Hutchings Consultants. Known for its strong counter trade and deep community ties, the pharmacy has been nurtured and managed by the previous owners with a profound dedication to the local community. Over the years, they have developed the business into a trusted local institution. Paul Steet, Associate Director of Hutchings who managed the sale, reflected on the transition, noting the longstanding relationship with the sellers. "Having worked with the previous owners since 2015 when they initially contacted Hutchings Consultants to discuss a valuation of the business, I feel personally connected to this pharmacy. I am delighted that Mohammad and Khuram will be taking over the reins," he said.

The two Gompels pharmacies, located one mile away from one another in Melksham, Wiltshire, have recently achieved significant milestones, underscoring the success of their innovative and patient-centric approach. With a remarkable increase in consultations and a surge in the use of the Pharmacy First service, the pharmacies have become a cornerstone of the community's healthcare. So what is the secret sauce that helps the Gompels achieve success? At the heart of Gompels' success is the dedicated staff and the strong work culture cultivated over decades. Patrick Gompels believes in empowering his team through a strong work culture. "Our culture and empowering the team is the most important thing. We have put a huge amount of work into it," he states. Monthly barbecues, drinks evenings, daily huddles, and five-minute reviews with managers reinforce this culture and keep the team connected and motivated. " I send a bulletin to all the staff at the start of every week, and different people chip in and give their input. This constantly reinforces the strategy and changes, further empowering the staff," Gompels says.

A recent report by the Company Chemists' Association (CCA) has revealed a significant disparity in patient engagement with the Pharmacy First service across the UK. In response, Santosh Sahu, Founder and CEO at Charac, has emphasised the need for technological reform to address "the interoperability gap between pharmacists and GPs". Sahu identified the lack of GP referrals for Pharmacy First consultations as a key issue, attributing it to inadequate IT infrastructure. He urged the sector to "implement technological reforms to enhance interoperability between pharmacists and GPs, enabling them to share patient records, identify care pathways, and address health needs more effectively".

Armstrong's Pharmacy in Sheffield, South Yorkshire has been sold for the first time in 67 years for an undisclosed price. Located on the corner of Gleadless Road, three miles south-west of Sheffield City Centre, the pharmacy dispenses an average of 11,332 items per month, according to Christie and Co, the broker that facilitated the sale. Owned and operated by the Armstrong family since 1957, the business has been acquired by a husband-and-wife team of first-time buyers. The new owners, whose identities were not disclosed, plan to expand the pharmacy by adding more consultation rooms and increasing services offered to the local community. Chris Armstrong, the previous owner, ran the business with his wife Jane before deciding to sell in preparation for their retirement. Commenting on the sale, Chris said: "It was a big decision to sell our multigenerational business but, when it was time to retire, we were glad that Christie and Co were able to quickly market the business successfully."

Marking Pharmacy First's first anniversary in England, the Company Chemists' Association (CCA) has called on policymakers to expand the service, highlighting that there's still "significant room for growth." In a report released today, the association estimates that expanding the service could free up 40 million general practice (GP) appointments every year - more than four times the current potential - and around a tenth of all GP appointments. In its current form, the service is expected to free up more than 9 million GP appointments annually. The CCA has recommended expanding the criteria and treatments available for the existing seven conditions and introducing new conditions. According to the report, community pharmacies provided nearly 1.5 million consultations for the seven covered conditions -earaches, urinary tract infections, sore throats