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The year in review: The 10 biggest issues affecting community pharmacy in 2021

While 2021 sometimes felt eerily similar to 2020 thanks to the ongoing COVID-19 pandemic, there have been some unique developments in community pharmacy. C+D looks at the hot topics that made headlines over the past year

2021 was certainly dominated by COVID-19-related news stories, but to a lesser extent than the previous year. The introduction of vaccines gave a more positive spin to C+D's pandemic-related stories, starting in January with the announcement of the first six pharmacy-led COVID-19 vaccination sites.

However, leaving COVID-19 aside for a moment, some dormant topics resurfaced in 2021. For instance, debates on temporary pharmacy closures and pharmacy supervision made a comeback.

Meanwhile, following the addition of pharmacists onto the government’s “shortage occupation list” earlier this year, the sector started to debate whether pharmacists are indeed in short supply.

How much do you remember of the topics that most impacted the sector in 2021?

 

COVID-19 vaccination efforts

 

After much anticipation, January saw the first pharmacy-led sites being approved to join the national COVID-19 vaccination programme in England. In February, the first pharmacy in Wales also started helping with the national vaccination efforts, while around 350 pharmacies in Northern Ireland began giving jabs from March.

But after pharmacies’ service in phase 1 and 2 of the vaccination programme, NHS England and NHS Improvement (NHSE&I) told those interested in joining phase 3 – the booster phase – that the state indemnity scheme would no longer cover them.

Despite this blow, the number of pharmacies participating in the vaccination programme in England continued to grow, reaching 1,464 as of November 17.

As of November 16, pharmacies in England had administered a joint 15 million COVID-19 vaccine doses.

But this number could have been even higher, as it was recently revealed that less than one third of community pharmacies in England that expressed interest in delivering COVID-19 booster vaccinations this summer have been accepted onto the programme.

 

The battle for COVID-19 cost reimbursements

 

Following Scotland’s lead in granting all NHS workers a bonus for their efforts during the pandemic, the government in Northern Ireland confirmed in February that all pharmacists in the country would be recognised for their work during the pandemic with a one-off £500 payment.

But despite the Welsh government also confirming in March that pharmacy team members would be eligible for a COVID-19 bonus payment, pharmacy colleagues in England never received the same gift.

The Pharmaceutical Services Negotiating Committee (PSNC) long battled for the HM Treasury and the Department of Health and Social Care (DH) to write off the £370 million advance payments that the sector received in 2020 to help with cashflow pressures during the pandemic.

But not only did the Treasury “insist” the sector paid back the advance payments, it also rejected PSNC’s demand for a funding uplift to the total budget for the community pharmacy sector.

 

The future is clinical

 

It wasn’t just doom and gloom in 2021, for the NHS across the UK started acknowledging and appreciating pharmacists’ clinical skills, beginning with the COVID-19 vaccination programme.

In November, the English government pledged to invest up to £15.9m over the next four years into a programme to “enhance” pharmacists’ and pharmacy technicians’ skills – including independent prescribing training for some pharmacists. Meanwhile, earlier this month, the Welsh government pledged to increase funding for independent prescribing services from £1.2m to £20.2m per year by 2024.

In Scotland, the NHS Pharmacy First service will further expand to include other conditions, after it was revealed in November that pharmacists had completed two million consultations under the scheme since its launch last year.

 

Lloydspharmacy in the spotlight

 

Lloydspharmacy hit the headlines several times this year. The sector had its eyes peeled on the multiple, after persistent rumours that its parent company McKesson was considering selling off its UK arm.

This was confirmed on November 1, when McKesson announced it had sold off its UK businesses to the private equity firm Aurelius Group for a cool £477 million.

But the multiple was under the spotlight for other reasons, too. In March, several people shared claims on Twitter that Lloydspharmacy was opting to provisionally close some of its branches rather than increase its locum pay rate to find pharmacist cover.

However, Lloydspharmacy looked into these claims and told C+D it was “satisfied with the findings” of its internal investigation.

 

Pharmacist shortages?

 

In August, Lloydspharmacy superintendent Victoria Steele wrote in a blog for C+D that a “shortage of pharmacists is a sector-wide problem”. This issue, combined with other parts of the primary care sector luring pharmacists away from community and the requirement to self-isolate during the pandemic meant that the multiple sometimes struggled to open “all of our pharmacies, all of the time”, Ms Steele suggested.

At the end of the same month, Community Pharmacy Scotland argued that the “uncoordinated recruitment” of pharmacy professionals to GP and primary care support roles was causing workforce pressures and called for a “temporary stop” to GP practice recruitment efforts to prevent a further “workforce drain” in the sector.

The Company Chemists’ Association’s complained that temporary and permanent closures of community pharmacies will “be unavoidable” if the government does not take action to resolve the pharmacist workforce crisis in primary care. However, this was challenged on social media by several locum pharmacists, who argued that the number of registered pharmacists has never been higher.

The sector is divided on whether there actually is a shortage of community pharmacists or if the issue lies instead with a need for better working conditions, it emerged during C+D’s latest Big Debate.

 

The “poisoned chalice” of pharmacy supervision

 

Another hot topic that raised a few eyebrows this year is, of course, pharmacy supervision.

Pharmacy professionals passionately defended their views on how pharmacy supervision could be modernised without compromising patient safety during C+D’s fifth Big Debate in November.

In an analysis on the views shared during the debate, C+D deputy editor Grace Lewis wrote that one of the reasons that discussions around pharmacy supervision have always become heated is because of the perceived threat of removing pharmacists from the premises altogether – which is otherwise known as the practice of remote supervision.

But Association of Independent Multiple pharmacies CEO Leyla Hannbeck has stressed more than once that the current discussions on pharmacy supervision, overseen by a cross-sector group, will not cover remote supervision.

 

A new model for Boots?

 

Last month, Boots announced it is trailling a new model. While the high street pharmacy giant has been known to be first and foremost a pharmacy services provider, it announced that will cease the provision of pharmacy services in 22 of its stores, which will remain open as retail premises.

While it is not yet clear where each those 22 stores are located, C+D is on the case to find out where they are, so watch this space…

This might not be the only change affecting Boots UK, as Boots’ parent company is rumoured to be “exploring” the sale of its UK business.

 

Universal hub-and-spoke model on the way?

 

The Medicines and Medical Devices bill was given royal assent in early February, giving way to the Medicines and Medical Devices Act 2021. With this, the government can begin to make changes to UK medicines law through “secondary legislation”, potentially enabling all community pharmacies to operate a hub-and-spoke dispensing model.

Currently, only pharmacies operating under the same company can operate a hub-and-spoke model.

The changes are subject to a public consultation, the DH specified. The timing of this haven’t yet been confirmed - although the DH has said it will provide an update “in due course”.

There will doubtlessly be plenty to unwrap in 2022, so make sure you check the C+D’s website to stay abreast of future developments.

 

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