Chief Executive’s Blog: March 2022

By Chief Executive Janet Morrison

Since starting at PSNC I have been speaking to as many people in community pharmacy as I can, and my first impression is one of a very varied sector, which is nonetheless united by its focus on patients and its enterprising spirit. I’ve been hugely impressed by contractors’ commitment to their communities during the pandemic and I can see how much everyone relied on pharmacies to stay open, give advice, administer vaccinations and offer a range of services including distributing Lateral Flow Tests and delivering medicines to shielding patients. It is clear that the public have come to rely on community pharmacies as their trusted first port of call for advice and support, and that this has been a lifeline both for patients and for other hard-pressed frontline NHS services such as GPs.

Yet it’s also very clear that community pharmacies are under severe pressure. Every contractor I’ve spoken to has said that the flat funding settlement is really starting to bite. They’ve squeezed every ounce of efficiency out of their operations, whilst still responding to new services and the accompanying requirements for training, assurance and new processes. Contractors are telling me that whilst demand for their services and advice is rising, their costs are too – staff shortages are pushing up salaries and locum costs, and there are inflationary pressures and other rising costs, as well as continuing uncertainty about the resilience of the supply chain. We are now in the uncomfortable position where many contractors feel that they are having to compromise on what they do for patients. PSNC’s Pressures Survey – the results of which will be published soon and are informing our ongoing negotiations with DHSC and the NHS – shows that many pharmacies have had to reduce their opening hours, pause further service expansion or stop providing non-essential services, all with undoubted impact on patients.

Frustratingly this comes at a time when the sector is clearly enthusiastic and ambitious about the role it can play in community health. There is so much potential for community pharmacy to support the prevention and healthy living agendas, to give more support to patients with long-term conditions and to optimise medicines and patient safety. The NHS needs us to be there to continue to provide accessible and trusted first point of contact support to communities and to help address health inequalities.

So it’s clear I have arrived at a critical time for the sector.

There are no obvious easy answers. Public finances are squeezed and many sectors are facing similar challenges – although unlike pharmacies, many other businesses can pass their rising costs on in the prices they charge their customers. Negotiations for Year 4 of the five-year CPCF are unlikely to be easy, despite us strongly making our points on contractors’ capacity and funding.

As we continue those negotiations we will also need to think bigger and start to prepare the ground for Year 5 and beyond. One of my key priorities is to build consensus in our sector on a vision and strategy for community pharmacy and to find common ground with the Department and NHSE&I on shared goals and plans. That vision will need to set out how pharmacies can continue to deliver more services at scale and ensure sustainable business models for the future. To deliver on our ambitions the sector will also need to have confidence in the workforce and digital strategies underpinning the vision that will enable them to offer what customers and patients need. We will also need to strengthen our negotiating and influencing capacity nationally and locally, aligned with the changing healthcare landscape, and we must enhance our engagement with contractors, not just on the challenges and constraints, but also on innovation and future thinking.

When a sector is so pressured it’s hard to find the space and time to think ahead and to think big. We at PSNC need to find the ways to do that. There are going to be many challenges along the way, and I know I still have lots to learn, but I’m looking forward to working with contractors to set that future path.