Written evidence submitted by The National Pharmacy Association (RTR0107)
1.1 The National Pharmacy Association represents the majority of family-owned pharmacies across the UK.
1.2 The NPA is also a founding partner of the Community Pharmacy Workforce Group (CPWG), which brings together the expertise of education; training and professional workforce leads from across the community pharmacy sector.
1.3 The CPWG has submitted written evidence to the Health Select Committee on the current Workforce issues, which the NPA endorses.
1.4 Whilst Health is devolved, much of the healthcare workforce recruitment in the devolved nations is dependent on a strong workforce in England, thus any impact on the English Workforce would reverberate across the four nations of the United Kingdom.
1.5 The NPA will address questions pertaining to the current workforce crisis within the community pharmacy sector across the four nations of the United Kingdom.
2.1 The NPA is a membership body, which represents the vast majority of independent community pharmacies in the UK. We count amongst our members independent regional chains through to single-handed independent pharmacies. This spread of members, our UK-wide geographical coverage, and our remit for NHS and non-NHS affairs means that we are uniquely representative of the independent community pharmacy sector. In addition to being a representative voice, we provide members with a range of professional services to help them maintain and improve the health of the communities they serve.
2.2 The NPA welcomes the opportunity to submit its views to the Health Select Committee call for evidence on the Workforce crisis, and should the committee require any more detailed information from the community pharmacy perspective, the NPA can provide a witness for any sessions of the committee. To do this, please contact Helga Mangion, Policy Manager at independentsvoice@npa.co.uk
2.3 Across the United Kingdom, NPA members continue to highlight significant workforce challenges because of a shortage of pharmacists and other members of staff, particularly as the devolved nations tend to be reliant on England for part of their pharmacy recruitment.
2.4 A problem that was initially felt in rural locations is now beginning to reverberate across cities including London. Hence, the NPA suggests that this issue be addressed as a UK wide issue, if we are to minimise the adverse impact on population health and thus, a further widening of healthcare inequalities.
2.5 What follows are additional thoughts and solutions that affect further the community pharmacy sector across the United Kingdom
3.1 The current workforce crisis within community pharmacy is multifactorial, ranging from lack of funding through to an increase of workload pressures particularly during the pandemic. In England and Northern Ireland, a big factor is the lack of NHS investment in community pharmacy services over the past six years, as highlighted in the independent reports by Ernst and Young (EY) and KPMG respectively. Having taken a detailed economic analysis of the sector’s finances, EY concluded that without intervention many pharmacies will be unable to survive.
3.2 The Covid-19 pandemic has brought about other factors that further affected the workforce pressures within pharmacies. NPA members have worked very hard to insulate patients from the effects of staff shortages, and are confident that this has not generally impacted patient care or the supply of medicines by independent pharmacies. However, the situation is not sustainable.
3.3 Community pharmacies continue to participate in commissioned services and invest in the training and development of pharmacists and pharmacy technicians and the rest of the pharmacy team. However, pharmacy employers across the UK, are unable to compete with the remuneration packages offered under Agenda for Change, which presents a constant challenge in relation to recruitment and retention.
4.1 The NPA welcomes the inclusion of the pharmacist role onto the shortage occupation list, which allows for NPA members across the devolved nations to advertise vacancies internationally, and echoes the CPWG in its request to extend this to pharmacy technicians. This notwithstanding, due to the current restrictions on travel because of the pandemic coupled with the lack of seamless access to EU pharmacists, NPA members have not be able to benefit much for this change currently.
4.2 In England and Scotland, NPA members inform us that they have been adversely impacted by NHS policies such as the Additional Roles Reimbursement Scheme (ARSS) in England, the recruitment to support the pharmacotherapy element of the GP contract in Scotland and the additional 400 plus roles recruited into the Northern Irish Primary Care System. This has continued to encourage the migration of pharmacists and pharmacy technicians from community pharmacy, leading to a number of unfilled vacancies.
4.3 Community pharmacies across the UK inhabit the most deprived areas within the United Kingdom. Their availability ensures that health inequalities including rural locations are minimised by ensuring that a pharmacist is always available during opening hours to provide immediate healthcare advice. Often the opening hours of the community pharmacy extend beyond the traditional opening hours of other healthcare settings.
5.1 The NPA proposes the following recommendations to ensure that healthcare provision continues to be maintained in a seamless manner across the United Kingdom:
5.1.1 The respective NHS Bodies work with the pharmacy employers to ensure a consistent and adequate coverage of community pharmacy. This includes but not limited to:
5.1.1.1 A local impact assessment to be carried out prior to any recruitment into other healthcare settings that may impact community pharmacy.
5.1.1.2 The local healthcare system consider the impact of the creation of new roles on all healthcare providers in the area and their ability to deliver their objectives on behalf of the NHS.
5.1.1.3 A comprehensive workforce plan that includes community pharmacy roles, (pharmacists and pharmacy technicians).
5.1.1.4 Review services and roles within the local systems and commission through community pharmacy where appropriate.
5.1.2 Review the reimbursement and remuneration model for community pharmacy services to ensure that community pharmacy is sufficiently resourced to offer terms that are equivalent to whose within Agenda for Change
5.1.3 England to adopt some of the key learns and successes from the devolved nations that include investment towards the training and development of the community pharmacists such as Independent Prescriber qualification.
Jan 2022