If the sector is stabilized and a fair deal is achieved, community pharmacy could effectively deliver solutions that support the government’s policy goals
Janet Morrison, CEO of Community Pharmacy England (CPE) has emphasised that stabilization of the sector is essential before any solutions can be delivered to fix the “struggling” health service.
Speaking at the recent SIGMA UK Community Pharmacy Conference 2024, Janet described the current contract as “unaffordable” and warned that pharmacies are becoming “unsustainable.”
“Without an urgent funding uplift, the sector is facing a ‘house of cards’ collapse that will seriously impact communities, patients, and the safety of medicine supply.
“So, first of all, we have to secure the stabilization. We have to make sure you can keep the lights on and the doors open, and that's critical,” she stated.
Janet pointed out that if the sector is stabilized and a fair deal is achieved, community pharmacies could effectively deliver solutions for the government that meet their policy goals.
However, she noted that negotiations for the Community Pharmacy Contractual Framework (CPCF) for 2024-2025 cannot resume until the budget is published on October 30.
The CPE had begun negotiations in March with the previous government, but discussions were halted due to the general election.
“The Department of Health has made submissions to the Treasury for this year's funding shortfalls and the Spending Review for 2025-2026. They can't proceed with negotiations with us till those discussions are resolved,” Janet explained.
In the meantime, the CPE committee is reviewing its negotiating strategy, objectives, red lines, and tactics to adopt if the desired outcomes are not achieved.
Janet stated that the new government has committed to responding to the Health and Social Care Select Committee's pharmacy inquiry, which reinforces the need to fix the contract and funding, as well as medicine supply issues.
Reflecting on a recent meeting with Stephen Kinnock, she described the conversation as “productive and positive,” highlighting the pharmacy minister’s seriousness in listening to the concerns raised by pharmacy representatives.
Janet highlighted the ongoing funding crisis within community pharmacy, revealing that the previous government had deliberately cut funding by over 30% in real terms, which has “squeezed the whole sector beyond capability now.”
This has resulted in increased workload intensity, with demand rising every year and the contract continually adding new services. Over this period, service delivery increased by 350%, and dispensing grew by 5-9% each year, Janet stated.
“We were doing a whole lot more for less money in real terms, and that has also been accompanied by, particularly in the last few years, rising operational costs, inflationary pressures, workforce costs,” she added.
These challenges have led to a deteriorating cash flow for many pharmacies, with numerous establishments now battling for survival.
The Darzi review also highlighted the closure of 1,200 pharmacies over the past seven years, impacting both high street services and patient care.
Furthermore, Morrison shared findings from CPE's annual survey, revealing that 64% of businesses were operating at a loss, and 16% of respondents were uncertain whether they would still be open within a year.
In addition, 90% of respondents cited rising costs, especially in staffing and medicine procurement, as a major concern.
Despite these challenges, Janet praised the success of Pharmacy First, noting that 96.5% of pharmacies have signed up to provide this service, resulting in over a million clinical pathway consultations delivered to the public by August.
“The winter months will be challenging, with the added demands of COVID and flu vaccinations alongside winter pressures. However, Pharmacy First will be an incredibly valuable part of the system to offer support to patients as they begin experiencing coughs and colds,” she remarked.
While Pharmacy First has been a great success, there were many implementation challenges, including poor marketing and promotion, inconsistent GP referrals, and higher thresholds.
The government has made two concessions regarding the August and October thresholds, reducing them.
Janet said that talks are ongoing with the government to ensure service growth without placing excessive burdens on pharmacists.
CPE envisions a sustainable and ambitious future for the Community Pharmacy, with the right funding and investment to deliver better health outcomes to patients and the public.
To this end, Janet stressed the importance of establishing a firm base with sustainable funding, recognising the valuable roles of independent prescribers, and ensuring community pharmacies are seen as an integral part of the primary care system and as respected health hubs.
According to Janet, CPE’s objectives include improving the contractual framework, driving the success of Pharmacy First, promoting the role of community pharmacy, building the investment case, and leading future thinking.
Janet also announced plans for CPE to engage with and contribute to the development of the NHS's 10-year plan.
