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Pharmacy advanced services at risk amid rising pressures, LPCs warn

Workforce, capacity, and financial pressures are testing pharmacy contractors’ ability to deliver advanced and locally commissioned services, local pharmaceutical committee (LPC) chiefs have told C+D.

For months, the sector has been debating about whether workforce issues in community pharmacy are down to a shortage of pharmacists or rather a lack of pharmacists willing to work in the sector in its current state.

While the Pharmaceutical Services Negotiating Committee (PSNC) is continuing to raise awareness of the “unreasonable and unsustainable pressures” on pharmacies, the sector still awaits to learn the outcome of the negotiations for the fourth year of the five-year community pharmacy contract.

Read more: PDA fires back after CCA accuses union of 'dismissing' workforce pressures

C+D has spoken with LPC chiefs about the pressures faced in their areas to learn whether they believe these are impacting advanced and locally commissioned services. 


Government must “urgently inject” funding


Rob Severn, chair of Nottinghamshire LPC, told C+D that the current workforce pressures “combined with inflationary pressures, is rapidly squeezing the financial position for many contractors”.

This “is a worry”, he admitted. “I know that the contractors we represent are doing everything they can to ensure their patients are being looked after as best they can be,” he added.

It is vital that teams “try to ensure all income streams can be maintained”, he said. “I would call on the Department of Health and Social Care and the government to urgently inject some extra funding into the sector.”

Read more: Lack of funding and workforce issues to blame for temporary closures, say LPCs

Meanwhile, Suffolk LPC chief officer Tania Farrow agreed that workforce and workload pressures “are acute”, with community pharmacies “doing all they can to ensure the delivery of core contractual requirements”.

Beyond delivering essential services, some pharmacies “are having to decide” which other they have the “capacity to offer”, Ms Farrow added.

“There is a real risk inherent in that where advanced and locally commissioned services are concerned,” she said.


“Somewhat too negative a stance to overstate concern”


However, Somerset LPC CEO Michael Lennox admitted that while there is “some resource-shortage impact and operational pressures on service delivery”, it is “too early and somewhat too negative a stance to overstate concern about a retrograde service delivery shift”.

Pharmacy closures, “especially when poorly handled, along with capacity fluctuations during this peak holiday season and periodic COVID-19 resurgence, will hamper some day-to-day delivery”, he said.

Read more: Temporary closures: C+D reporter discusses scale of problem on BBC

But in Somerset, “many” contractors are “strongly” handling their essential, advanced and locally commissioned services, he told C+D.

Flat funding in the national contract and “business-induced financial pressures” are giving contractors “a torrid time”, he admitted. “But I would not wish to contribute to any growing sense of wider network failure to deliver services.”


Teams encouraged “to focus on areas of greatest return”


Meanwhile Nick Hunter, chief officer at Doncaster, Rotherham and Nottinghamshire LPCs, told C+D that local contractors “are thinking very carefully about what they are prioritising” and “we are encouraging them to do so”.

It is “better they focus on the areas of greatest return than spread what little resource they have too thin and continue to struggle”, he added.

Read more: Pharmacy bodies plea to protect ‘exhausted and starved-of-funding’ sector

Across all three LPCs, contractors are being encouraged to focus on the Community Pharmacist Consultation Service, the new medicine service, the hypertension case finding service and the upcoming flu vaccination service, he told C+D.

“That’s not to say they shouldn’t provide the other advanced services, but for most we are advising they need to get these ones right first.” Essential services should be delivered “as their first priority”, he added.

“Then specific to each area, we are encouraging engagement with key priority local services – like the extended care service across Nottinghamshire,” Mr Hunter added.


PSNC: Cutting back services “paints bleak picture for future”


PSNC CEO Janet Morrison told C+D that the current workforce situation is “part of a wide range of pressures” that are putting community pharmacies’ viability “into question”.

Financial data compiled by the negotiator earlier this year revealed that service provision was affected at 69% of pharmacy business, with 51% admitting they were unable to provide locally commissioned services “because of the current pressure levels”, she added.

“As financial pressures continue to escalate across all parts of the economy, we expect that these worrying statistics are now even worse,” Ms Morrison said.

Read more: Is a five-year contract still working for community pharmacy?

The current five-year pharmacy funding contract – agreed in 2019 – “is really starting to bite and many contractors are having to make tough decisions about what they can do for patients as their income declines in real terms”, she also added.

“Contractors had already squeezed every ounce of efficiency out of their operations but now their costs are rising rapidly,” Ms Morrison said.

Cutting back services “is a last resort measure that paints a bleak picture for the future”, she admitted.

“Many community pharmacy businesses are at crisis point and PSNC is continuing to urge the government and the NHS to take these findings as a clear warning signal that these unreasonable, and unsustainable, pressures on community pharmacies cannot continue.”


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