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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.

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.

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.

"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 a stirring address at the recent conference on Pharmacy at the Westminster Health Forum, Director of NHS Services at Community Pharmacy England (CPE), Alastair Buxton presented a stark assessment of the community pharmacy sector's challenges. Highlighting years of financial constraints imposed by the NHS and government, Buxton warned of a sector teetering on the edge of survival. "There have been no years of financial and operational squeezes applied by the NHS and government to the community pharmacy sector, so as a consequence, there are a lot of pharmacies that are on the on the brink of survival -battling for survival," he said. Buxton underscored the critical and indispensable role of community pharmacies in delivering essential NHS services, from dispensing medications to innovative initiatives like the Discharge Medicine Service and Contraception Service.

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.

'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.

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.

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."

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 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."

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.

The National Pharmacy Association (NPA) has called for immediate intervention by Health Secretary Neil Gray to compensate pharmacies left in financial chaos due to flaws in Scotland's new pharmacy payment system. Introduced last year, the system was designed to streamline payments to pharmacies, dispensing doctors, and medical appliance suppliers. However, the NPA, which represents independent pharmacies across the UK, reported that many pharmacies were facing repeated shortfalls in expected funding under the system. Some pharmacies have encountered discrepancies of tens of thousands pounds due to errors in the Data Capture Validation & Pricing process introduced by NHS National Services Scotland. In other cases, NHS Boards have clawed back money from pharmacies at short notice, following processing errors that had initially resulted in an overpayment.

Nestled in the heart of a bustling high street and a housing estate, at Lincoln Pharmacy, part of Mildcare Ltd Group, in Tower Hamlets in London, the scene is a testament to resilience and innovation, where queues of people seek aid from a pharmacy technician stationed behind a glass window-a symbol of the enduring impact of the pandemic. Amidst the array of modern amenities at the pharmacy stands Atulkumar Patel, the proprietor and Independent Prescriber (IP) at Lincoln Pharmacy, whose vision has propelled the establishment into a beacon of progressive healthcare. Owner of two Pharmacies, Patel's team of 20 dispenses an average of 20,000 prescriptions monthly, maintaining an NHS/OTC split of 80/20. Recipient of the prestigious Independent Prescriber of the Year award at the Pharmacy Business Awards 2023, Patel reflects on the pivotal moment when his pharmacy pioneered the rollout of COVID-19 vaccine jabs within the community. "When doctors' doors closed, pharmacy was the only place where people could get help and care," Patel recounts, emphasising the pivotal role pharmacies played during the crisis. Patel's dedication during the pandemic extended beyond mere service provision; it was about showcasing the untapped potential of pharmacies.

The latest GP Patient Survey 2024 by the National Health Services (NHS) involving 2.56 million patients has revealed encouraging insights into patient experiences with pharmacy services across England. Along with pharmacies, GPs, and dentistry services were also surveyed highlighting the vital role these services provide in healthcare delivery. Among the key findings, 89.3 per cent of respondents reported utilising at least one pharmacy service in the past year, highlighting the widespread reliance on these facilities. Of those who used pharmacy services, an overwhelming majority of 86.8 per cent expressed satisfaction with their experience. The survey identified 'picking up prescriptions' as the most commonly accessed service, with 75.8 per cent of patients utilising this facility.

In response to a recent Parliamentary question regarding pharmacy reimbursement, pharmacy minister Stephen Kinnock stated that pharmacies were permitted to retain £850 million from the medicine margin for 2023/24. The medicine margin represents the difference between the product price reimbursed by the National Health Service (NHS) and the price at which pharmacies buy them. Rebecca Smith, the Conservative MP for South West Devon, inquired about the number and proportion of community pharmacies that had dispensed medications at a loss over the past three years. Kinnock replied that they do not hold this information, and explained that community pharmacy reimbursement arrangements "do not aim to ensure that every pharmacy is paid as much or more than it paid for every product, but aims overall to reimburse as much as they were bought for, plus the allowed medicine margin." Additionally, the minister highlighted that as part of the Community Pharmacy Contractual Framework (CPCF) for 2023/24, pharmacies are allowed to retain "£850 million from the medicine margin, on top of what they are paid for the medicines they purchase as part of providing NHS services."

The government has received thousands of ideas to fix the NHS as the biggest ever conversation about the future of the health service reached the Midlands last week. More than 100 people from across the Midlands participated in the public debate in Wigston in Leicestershire on Saturday (23 November), sharing their experiences, views and suggestions for delivering an NHS fit for the future. Public health minister Andrew Gwynne and NHS England's national director for urgent and emergency care Sarah-Jane Marsh attended the debate, inviting attendees' opinions on NHS reform and how the government's 10 Year Health Plan can help tackle disparities in the region. Addressing the event, Gwynne said: "We can't change the NHS and make it better without you." "When we say that the NHS is broken but not beaten, it's not beaten because the staff are incredible, it is because the NHS is not where we need it to be."

In a delightful announcement, the University of Brighton has honoured NHS England's Chief Pharmaceutical Officer, David Webb with its prestigious Doctor of Science honorary degree Webb's award is a highlight of the university's graduation ceremony which celebrated the graduation of over 3,400 undergraduate and postgraduate students from 92 countries at the Brighton Centre this week. The accolade recognises Webb's transformative work in the pharmacy services within the NHS, highlighting the profound impact his contributions have had on delivery of healthcare across the UK. Under Webb's leadership, significant advancements have been made in integrating pharmacy into NHS care pathways, improving patient outcomes, and enhancing the role of pharmacists and pharmacy technicians in the healthcare system. Webb expressed his honour stating, "I am delighted to receive the honorary award of Doctor of Science from the University of Brighton in recognition of both my contribution to pharmacy in the NHS"

Scotland's first minister, John Swinney, has announced the expansion of the NHS Pharmacy First Service as part of the government's strategy to shift more care into communities. However, Numark chairman Harry McQuillan has stressed the need for additional funding to support this expansion effectively. Speaking at the National Robotarium in Edinburgh on 27 January 2025, Swinney outlined the government's plans for enhancing public services and renewing the NHS, promising a significant boost in NHS Scotland's capacity to reduce waiting times. Recognising the importance of identifying new approaches, Swinney underscored the critical role of community pharmacies in easing pressure on GP services. He said: "I want to see the NHS Scotland Pharmacy First Service expand so that community pharmacies can treat a greater number of clinical conditions and prevent the need for a GP visit in the first place." McQuillan welcomed the announcement, stating that this advancement will "empower pharmacists to provide even greater value, leveraging their clinical expertise to deliver comprehensive care directly to patients." However, he noted that the sector should be provided with extra funding to support this expansion.

A new report from the Company Chemists' Association (CCA) is calling on NHS England to commission a community pharmacy-based national Type 2 diabetes screening service, which could save the NHS £50m each year. The CCA report, titled 'Increasing Access to Diabetes Screening and Prevention Through Community Pharmacy', highlights the urgent need for a national patient pathway for diabetes detection and management. It outlines how NHS-commissioned diabetes screening in community pharmacies across England could deliver numerous health benefits each year, including: Screening 1.5 million adults and identifying 180,000 prediabetics; Detecting 45,000 undiagnosed cases of diabetes and preventing them from developing serious complications Preventing nearly 7,000 heart attacks and strokes, and thus improving patients' quality of life Avoiding severe sight loss in around 15,000 people over their lifetime Saving the NHS £50 million annually by reducing diabetes-related costs. Type 2 diabetes and its complications are currently estimated to account for 10 per cent of the NHS annual budget, and this figure is projected to rise to 17 per cent by 2035/36.