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Revealed: Community pharmacy's biggest successes and challenges of 2021

With 2021 almost at a close, C+D spoke to community pharmacy funding negotiators from around the UK to discover what they consider the biggest successes and challenges the sector has faced over the past twelve months.

From record breaking flu vaccination figures to concerns of a shortage of pharmacists in the sector, community pharmacy has faced another challenging year in the face of COVID-19.

Bosses at the UK’s four community pharmacy funding negotiators have given C+D their verdicts on the past year.


England:  PSNC “aggrieved” by funding increase rejection


The Pharmaceutical Services Negotiating Committee's (PSNC's) director of communications and public affairs, Zoe Long, told C+D that a key blow in 2021 was the negotiator's bids for increased funding falling on deaf ears during its talks with the government on year three of the five-year community pharmacy contractual framework.

She told C+D: “PSNC, like all contractors, felt aggrieved that HM Treasury flatly rejected any possibility of an increase in the contract sum for this year. The failure of our interlocutors to accept the financial, workforce, capacity and wider costs challenges faced by every part of our sector was unfathomable.”

“The ongoing financial squeeze being applied to the sector has not been relieved, and contractors were rightly disheartened by just how reluctant the government initially seemed to cover contractors’ COVID-19 related-costs from the first year of the pandemic. Costs continue to rise, and unlike many businesses, pharmacies have no option to pass these on to consumers,” she said.

PSNC's work to try and recoup contractors' COVID-19 costs was "both a high and a low" of 2021, Ms Long told C+D.

She explained: “We were pleased that despite the initial resistance from HM Treasury to fully cover these costs, our co-ordinated funding bid and public affairs campaign eventually led to contractors being able to claim more than double the initial offer of £120m from Government in COVID-19 costs.

"However, the initial reluctance of the government to fully cover costs, and the fact that we then had such a protracted battle to secure this deal, was a significant concern and disappointment for us."

There were, however, “some clear positives and hard-won concessions” she added. These included continuing the transitional payment and significantly reducing the workload for the Pharmacy Quality Scheme, while also rejecting regulatory changes and services “that would not work for the sector”, she added.  

Another “phenomenal” achievement for the sector was pharmacies’ “absolutely critical” response to the ongoing COVID-19 pandemic, Ms Long said.

Staying open and available throughout the pandemic, especially when other parts of primary care became less accessible, was a huge achievement, she added. Community pharmacy in England has offered “some 58 million informal healthcare consultations” and delivered 4.6 million flu vaccinations to date, she said.

In addition, “97% of pharmacies signed up to distribute Lateral Flow Devices in the spring,” she said, distributing “almost 12 million testing kits to the public in just six months”.

“But we know that they have come at a cost – both to pharmacy contractors, and to their teams,” Ms Long added.


Scotland: Pharmacy First "biggest success"


Meanwhile, in Scotland, it is NHS Pharmacy First Scotland that “continues…[to be] the biggest success” of 2021, the director of operations at Community Pharmacy Scotland (CPS), Matt Barclay, told C+D.

“Patient engagement continues to increase, and the data supports this,” he added. “This is exactly the type of service that uses the pharmacy network appropriately, making sure people can be seen at the right time in the right place.”

The expansion of the Pharmacy First service, too, is “a natural extension”, Mr Barclay added. “The strategy around independent prescribing and Pharmacy First Plus is the right one, too. Embedding independent prescribing skills in community pharmacy is important to the future of patient services and pharmacy practice in Scotland. We should absolutely aspire to the ultimate goal of a pharmacist prescriber in every pharmacy.”

But as in England, the “biggest challenge has undoubtedly been the continuing pandemic and the impact on the pharmacy network”, Mr Barclay told C+D.

“Community pharmacy by its very model is accessible and while this is undoubtedly a good thing, it does mean that it can be challenging in terms of patient expectations,” he added.

“By and large, the public is very understanding but this can slip when everyone is under pressure and fatigued in life. When I hear instances of abuse towards pharmacy teams, it is disheartening, considering their contribution through these times and frankly unacceptable.”

In August, CPS called for a “temporary stop” to the recruitment of pharmacy professionals to GP and primary care support roles, to prevent a further “workforce drain” in the sector.

“The simple fact is that there is not enough available resource to meet all the basic needs or ambitions of all three main sectors of pharmacy practice in Scotland,” Mr Barclay told C+D.

 “We appreciate this is a complex and multi-faceted issue, with all stakeholders having to consider their impact in this area,” he added. “There is no silver bullet here, but we are considering any and all supportive measures that are within our control and influence.”


Wales: Contractors face “significant workforce challenges”


This is a concern shared by Judy Thomas, director of contractor services for Community Pharmacy Wales (CPW). The “biggest challenge” of 2021, she said, was the “significant workforce challenges being faced by contractors”, alongside the pressures facing community pharmacy from “the ongoing pandemic”.

But Ms Thomas pointed to the new Welsh community pharmacy framework, revealed just last Thursday (December 16), as CPW’s biggest win in 2021.

Under the deal, which will begin from April 2022, funding for the new community pharmacy clinical service will increase from £11.4 million to £20m per year by 2024. The government also pledged to increase funding for independent prescribing services from £1.2m to £20.2m per year by 2024.

Health Education and Improvement Wales (HEIW) has also “committed to providing a minimum of 60 independent prescriber training places with funded HEIW fees and funding towards backfill from 2022/23 onwards, and will also look to extend this”, Ms Thomas told C+D.


Northern Ireland: Community pharmacy administered over 250,000 COVID jabs


Meanwhile, for Community Pharmacy Northern Ireland (CPNI), it is the rollout of the COVID-19 vaccination service that has been the biggest success of 2021, chief executive officer Gerard Greene told C+D.

In just nine months since community pharmacy began administering first doses of the vaccine, the sector is now “the main facilitator of the Northern Ireland-wide programme”, he added.

As of December 16, community pharmacy had administered more than 254,000 COVID-19 vaccinations and surpassed 37,000 flu vaccinations, Mr Greene told C+D.

But it is the shortage of pharmacy staff that Mr Greene highlighted as 2021’s biggest challenge for CPNI.

The demand for core services has “remained consistently above pre-pandemic levels throughout much of 2021. In stepping up to meet these demands, there have been enduring pressures placed upon the workforce, which has led to staffing shortages,” he said.

Despite these challenges, however, “community pharmacists continue to go above and beyond for patient care”, he added. “I would like to thank the network for their unrelenting commitment to the public health of the people across Northern Ireland.”


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