Progress on government commitments to support community pharmacy ‘require improvement’, an expert panel commissioned by the parliamentary Health and Social Care Committee has found.
The panel concluded that the government had not met several of the commitments it made in the 2019 Community Pharmacy Contractual Framework (CPCF), including a commitment to review the sector’s funding model.
This was despite ‘significantly’ increased demand for community pharmacy services, ‘with community pharmacies struggling to deliver services within the existing funding model, or even to remain open’, the panel said in its report.
And the Pharmacy Access Scheme (PhAS), designed to protect patient access to community pharmacies in areas where there are fewer pharmacies, was also found to need improvement.
Government support of independent prescribing training for the existing workforce also required improvement, according to the panel.
And progress on proposing legislative changes to allow for better use of the skill mix in pharmacies and enable the clinical integration of pharmacists was found to be ‘inadequate’ across all criteria.
However, the panel rated the government’s progress on the Community Pharmacist Consultation Service (CPCS) with referrals from NHS 111, GPs and A&E, as ‘good’.
Professor Dame Jane Dacre, who chaired the expert panel, said: ‘Pharmacy plays a key role in the delivery of care so it’s disappointing that progress overall to deliver on the government’s commitments was rated as “requires improvement”.’
She added: ‘We’ve found community pharmacies to be at particular risk with the existing funding model unable to prevent some high street pharmacies facing closure and others struggling to provide services in the face of rising demand and increasing costs.’
And she said that the government pledge to move entirely to digital or e-prescribing across the NHS by the end of 2024 was ‘overly ambitious’.
‘We found inadequate progress in the delivery of this commitment due to the lack of joined-up digital infrastructure in the NHS and social care,’ she added.
And she said that ‘no headway’ had been made on integrating pharmacists within clinical teams, and that ‘when it came to training and education’ – and in particular the government’s commitment to roll out a new three-year education and training programme for community and primary care professionals – ‘there was insufficient funding available to send staff on courses’.
Steve Brine, who chairs the Health and Social Care Committee that commissioned the report, said it made for ‘sobering reading’.
He added: ‘The committee is holding a separate inquiry considering what the future of pharmacy could look like because there’s real potential for innovative work and to truly see community pharmacy at least as part of the primary care model.
‘Success will rest on resolving challenges around funding, the digital infrastructure, and crucially, workforce skills and training.
‘The level of detail about progress by the government so far will feed into our work and, ultimately, help shape the recommendations we make to ministers.’
A Department of Health and Social Care spokesperson commented that since the period covered by the report, it had announced ‘£645m of funding as part of the Primary Care Recovery Plan and thousands more training places as part of the [NHS] Long Term Workforce Plan, on top of the £2.6bn we provide every year to the sector’.
‘This will further bolster the role of community pharmacies to supply prescription-only medicines for seven common conditions without the patient needing need to see a GP, alongside supporting more blood pressure checks and oral contraception consultations,’ they added.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp), commented that the report ‘does not say anything that we have not said before’.
This included that the sector’s ‘sector’s core funding is in desperate need’ of a cash injection and that community pharmacies have ‘for years not had a level playing field around support for our workforce as GP surgeries have had’.
Dr Hannbeck added that in England, community pharmacy ‘continues to be undervalued’.
‘This must change. The public value the services they receive from their local pharmacies and it’s time the government listened,’ she added.
Malcolm Harrison, chief executive of the Company Chemists' Association, said that while the CCA welcomed 'the direction of travel' set out by the government for community pharmacy, there was 'much more to do', as demonstrated by the panel's report.
'Action must be taken to address the historic underfunding of pharmacies and the current funding model must be reviewed without delay,' he said.
And he said that the panel's verdict was 'unsurprising', highlighting the report's comments about the 'ever-increasing workload faced by pharmacy teams' and 'the need to rollout the promised CPCF "efficiencies" as soon as possible' - also emphasised in a CCA report published yesterday.
'Government must be prepared to step up to the plate and implement all pieces of the puzzle together, if patients are to truly benefit from the transformation of community pharmacy,' Mr Harrison added.
National Pharmacy Association (NPA) chair Nick Kaye said that while the report showed that the government had 'taken steps' to meet its policy commitments, 'its chronic failure to properly fund community pharmacies has badly stunted progress' toward a clinical future.
He added: 'The NPA wants to give credit where it’s due, for example the roll-out of training related to independent prescribing and urgent care service developments.
'But the expert panel’s must-do-better ratings are the best the government could realistically hope for given the damaging impact of funding cuts over recent years.”
'Cuts have contaminated the whole scene for nearly a decade, which is one reason why the recent announcement of a fully-funded common conditions service needs to mark a beginning not an end to fresh investment.'
Janet Morrison, chief executive of Community Pharmacy England (CPE) said that CPE was 'not surprised by the panel’s findings that progress on the majority of commitments required improvement', saying that the negotiator had 'been pressing for this on an ongoing basis.'
She added: 'We all know that many of the issues that community pharmacies are struggling with relate to insufficient funding of the sector, which has been cut, in real terms, by 30% over the last seven years. An urgent funding uplift and more support is now required for community pharmacies before the consequences are felt by more and more patients across the country.
'This report paves the way for the Health and Social Care Committee’s full inquiry into pharmacy which will be influential, and we are already fully engaged with.'