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‘Critical situation’: PSNC moots reduced opening hours amid NHS strike chaos

PSNC has ramped up discussions with the government to address the “critical situation facing many community pharmacy businesses” as threats of strike action rage across the rest of the health service.

It comes after Pharmaceutical Services Negotiating Committee (PSNC) committee members met last week to discuss what “other steps businesses might need to take in the absence of additional funding”, the negotiator revealed.

However, the negotiator's “ongoing priority” is to make “strong and urgent representations to government to seek an emergency funding injection into the sector as well as relief from business rates”, it added.

PSNC's director for legal, Gordon Hockey, told C+D today (December 5) that the measures it has requested include allowing pharmacies to close for certain hours of the day to help manage workflow, “similar to the provisions that were in place during the pandemic”.

Other options under consideration – which some contractors are already undertaking – involve not answering patient phone calls, or only doing so for a limited amount of time each day; asking patients to book slots for advice, rather than providing this on a walk-in basis; and charging for or stopping provision of some unfunded services such as medicines deliveries.

While discussions remain ongoing, “we are pushing hard for [a] resolution as soon as possible”, he told C+D.

Read more: Government failing pharmacy as it grows ‘weaker and weaker’, APPG chair warns

It comes against a backdrop of NHS strikes, with nursing and ambulance staff set to down tools later this month. However, Mr Hockey explained that community pharmacy contractors will not be taking strike action.

“The actions that some contractors are taking are not strikes – they are measures that reduce provision of some services which they may offer under the Community Pharmacy Contractual Framework, but don’t have to,” he added.

PSNC is seeking the views of contractors over a series of online events this month to discuss these “serious steps” and consider what further measures may be taken.

“Our events will allow for that honest conversation – so that contractors consider, and the government and the NHS appreciate, what remains possible within the current limited funding”, he added.


Pharmacy’s role in NHS strike action


Government ministers are reportedly planning to draft in pharmacists to ease pressure on the NHS over the winter and “help break” NHS strike action.

The proposals, reported by the Sunday Telegraph yesterday (December 4), would see pharmacists given permission to diagnose minor ailments and prescribe antibiotics to reduce the demand for other health services.

Up to 100,000 members of the Royal College of Nursing (RCN) union are set to strike across England, Wales and Northern Ireland on December 15 and 20, with ambulance staff also due to strike before the end of this year.

Meanwhile, several unions – including the Chartered Society of Physiotherapy and Royal College of Midwives – are currently balloting members over industrial action, amid ongoing pay disputes. The British Medical Association will open its ballot for industrial action by junior doctors in England in January.

Read more: ‘Last man standing’: How will NHS strike action affect community pharmacy?

Responding to reports yesterday, PSNC chief executive, Janet Morrison acknowledged that while pharmacy teams have the “skills to help support patients”, they are “exhausted, overworked, and struggling to make ends meet”.

She added: “If the government wants pharmacies to step up again, they must back this with emergency funding and support.”

C+D has approached the DH for comment.


“Industrial action a last step”


Responding to PSNC's proposals, the Pharmacists’ Defence Association (PDA) director Paul Day told C+D today that governments in all four UK nations “should already be talking to representatives of pharmacists and to the representatives of pharmacy-owning businesses” about what is possible.

“To try and do so now just to try and undermine the valid and reasonable request of NHS employees, including thousands of PDA members employed across the hospital system, is a poorly considered suggestion,” he added.

“Health workers only resort to taking industrial action as a last step because the government have failed to listen and act to their earlier requests for fair pay. They do not actually want to be forced to take that action,” he told C+D.

Read more: Could England’s community pharmacists go on strike?

The government should be liaising with “all health unions” to reach an agreement that both allows for the cancellation of industrial action and shapes “a more sustainable workforce situation for the longer term”, Mr Day added.

Community pharmacy employers in England do not “have such short memories that they will have forgotten the UK government’s cuts to their funding” in 2016 and the consequences these cuts had on the sector, he said.

“We expect that community pharmacy operators will resist taking on any unfunded additional services at this time; until there are enough resources and staff in the pharmacy to safely manage the existing workload without burning out professionals so that so many turn their backs on permanent employment within the sector.”

The PDA would like NHS pay disputes “to be resolved as soon as possible”, he also acknowledged.

“The future of community pharmacy and the value pharmacists can bring to the wider health system are separate conversations which each of the national governments should be having with ourselves and with the relevant employer body in each of the countries,” he told C+D.


“No choice other than to say enough is enough”


Meanwhile, National Pharmacy Association (NPA) chair, Andrew Lane, added that “the sad truth is that many pharmacies have already been forced into taking difficult decisions about reducing access to services, to generate operational savings and make ends meet”.

While pharmacy teams have “worked really hard to insulate patients from the effects of staff shortages, medicines shortages and immense financial pressures”, he added, “there comes a point when contractors have no choice other than to say enough is enough”.

A report commissioned by the NPA in September warned that up to 3,000 pharmacies are at risk of closure by 2024, following years of flat NHS funding and mounting inflation.

The sector requires “urgent intervention” from the government and NHS England “to prevent cracks opening up in patient care”, Mr Lane added.

“It stands to reason that if the current financial envelope is too small to sustain current service levels, it cannot support new NHS developments like the much-trailed ‘pharmacy first’ scheme for common ailments,” he said.

In July, when asked by C+D about pharmacist’s rights to take their own strike action, PSNC chief executive Janet Morrison conceded that contractors could “ultimately…decide if they, too, wanted to withhold their labour at any point”.

However, this would constitute a breach of their contract, she warned.


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