Month: April 2025

Northern Ireland community pharmacy owners are reeling from a £1m financial hit as April staff salary bills are paid this week.

This is the first month-end when the real financial impact of the new minimum wage and national insurance changes (NIC) are being felt. The £1m bill has landed in spite of urgent pleas to the Department of Health, the Health Minister, the Department of Finance, and UK Treasury, seeking relief for providers of public health services such as community pharmacy.

UK Chancellor Rachel Reeves explained that the increased income from raising Employer NIC would be used to fund “public services”. Community Pharmacy is, in fact, one of those public services, and these latest payroll costs will compound funding difficulties with no sign whatsoever of additional investment in the sector.

Community Pharmacy services are provided by a network of individual pharmacy owners, who each run their pharmacy as a small business. Unlike private sector businesses, as the provider of a heavily utilized and contracted public health service, community pharmacies do not have the opportunity to raise their fees to the Department of Health, or to pass costs on to patients.

With no sign of relief from April’s increased NIC taxes being provided to community pharmacy owners, they either have to fund the higher staff costs out of their own savings or cut staff or opening hours in order to reduce the cost.

At Minister’s Questions in the Assembly on Tuesday 8 April, Health Minister Mike Nesbitt was challenged over the matter, when Kellie Armstrong MLA highlighted that his Department is “effectively asking…pharmacy owners… to absorb the cost, and that they will close the gap through personal finances.”

The Minister replied, saying, “I do not accept that at the moment, because it is just too early… I will work with the new permanent secretary and senior officials in the Department to see what can be done. Certainly, trying to avoid individuals having to put their hands in their own pockets to cover these costs is a motivation for me.”

Representing the contractors for Northern Ireland’s 508 community pharmacies, Gerard Greene, Chief Executive of Community Pharmacy Northern Ireland (CPNI) said,

“We need urgent support now. We have already made representations to the Minister, urging him to either seek relief from the Chancellor and HM Treasury, or to fund full cost recovery for community pharmacy.

“The total annual cost for our sector will be in excess of £12million. As we reach the first month-end after these new taxes came into effect, our sector is feeling the full force of an additional £1million month end cost. By the end of June this will be £3million. To be absolutely clear, this hit is entirely shouldered by individual pharmacy owners as our pleas to the Department of Health appears to be falling on deaf ears.

“At a time when community pharmacy owners are already struggling to balance the books, the Department of Health cannot expect this to be tolerated and patient services to remain unaffected: it will cripple the sector.

“By allowing these new staff costs to slide in, unaddressed, the Minister is essentially allowing individual contractors to prop up vital health services out of their own pockets This is not a fair or reasonable way to run public health services.

“We know the Northern Ireland health budget is under pressure and we would urge the Minister to take this back to Treasury for immediate review and reparation.”

A new campaign has been launched in community pharmacies across Northern Ireland to raise awareness of the signs and symptoms of cancer and help with early diagnosis.

The ‘Be Cancer Aware’ campaign is running in community pharmacies this April and May as part of the Living Well service. It highlights the role of pharmacy teams in providing advice and support, and encourages people who may be experiencing possible cancer symptoms to talk to their GP. It also aims to promote healthy changes to help reduce the risk of developing cancer in the future.

Dr Anna Cullen, Public Health Registrar at the Public Health Agency (PHA), said: “Cancer is a common condition. It is estimated that around half of us will develop some form of cancer in our lifetime.

“Everyone knows what feels ‘normal’ for them and it’s important to be aware of any changes in your body, but there are some common changes and symptoms to look out for and act on. Being aware of the general signs and symptoms of cancer can help in early detection and increase your chance of survival.”

Some signs and symptoms to look out for include:

· coughing up blood;

· blood in urine;

· blood mixed through bowel motion (stools);

· a change in bowel habit that lasts for three weeks or more;

· unexplained, significant weight loss (5kg/10lbs over a couple of months);

· a lump anywhere on your body;

· changes on your skin or to an existing mole (such as itching, bleeding or a change in shape or colour);

· a sore that doesn’t heal;

· symptoms that refuse to clear up, for example a cough or hoarseness that lasts for more than three weeks.

Dr Cullen concluded: “If you notice any of these symptoms and you feel something isn’t right, do not hesitate to contact your GP. In many cases, these symptoms will turn out to be a sign of something far less serious, but it is always best to get them checked out. If it is cancer, an early diagnosis means treatment is more likely to be successful.

“You can also ask your pharmacist for advice and further support. They can help you identify ways you can reduce your risk of developing cancer.”

Clare Conroy, Community Pharmacist from Meigh Pharmacy, Co Down added: “The earlier you find cancer, the easier it is to treat. Community pharmacy is the ideal setting to help encourage people to look after their health, and pharmacy teams play a critical role in supporting early cancer diagnosis.

“As well as advising on how to spot cancer early, pharmacy teams can help support people to make healthy changes that could reduce the risk of cancer. The first step is simple, just ask your pharmacist for advice.”

As part of the Living Well campaign, community pharmacies across Northern Ireland are providing the free information booklet, ‘Be Cancer Aware – Spotting symptoms and reducing your risk’, to members of the public. A copy of this leaflet can be found at www.pha.site/be-cancer-aware-leaflet

For further information on the signs and symptoms of cancer see www.BeCancerAwareNI.info

Health service bodies say increased staff costs will impact patients

From 1 April 2025, Northern Ireland Community Pharmacists, General Practitioners, Dentists and Optometrists have warned that new UK Government National Insurance Contribution (NIC) and Minimum Wage increases will have an immediate impact on patients and the wider health service. 

Their representative bodies (Community Pharmacy NI, the BMA, the British Dental Association and Optometry NI) are calling on the Health Minister Mike Nesbitt and the Northern Ireland Executive for immediate financial support.  They have warned of the imminent risk of vital health services collapsing as operating costs can no longer be covered.

The NIC and Minimum Wage changes, effective from April 2025, add significantly to staff costs.  The four bodies have stated the impact of these additional overheads will be an inevitable reduction in opening hours, cuts to staffing levels and reduced access to patient care.

Although commissioned to deliver primary care health services on behalf of the Department of Health, these practitioners are not shielded from the UK government’s latest revenue-raising measures.  Unlike hospitals or health trusts which fund staff costs through national health service pay agreements, many of these practitioners (dentists, opticians, community pharmacists and GPs) operate as small businesses and are therefore responsible for their own wage bills.

For community pharmacy alone, the estimated additional cost from the new rates of NIC and minimum wages is £12.4million per annum, with the first hit on wages bills being felt this week.

In a letter to the Minister in December the grouping of four healthcare bodies warned that urgent and immediate action is needed, as vital primary health services are at risk.  They said,

“Medical, pharmacy, dental and optometry providers are the front door to the health service for families across Northern Ireland and vital for the transformation of care.

“Yet these services are under extreme financial pressure, resulting in the closure of general practices and community pharmacies, the most rapid shrinkage of NHS Dentistry anywhere in the UK and reduced access to optometry caused by the removal of automatic access to care for patients on universal credit.

“Without adequate protection from UK Government policy changes, the precarious position of Family Practitioner Services in Northern Ireland will deteriorate further.”

The magnitude of the national insurance cost impact to the independent sector, which includes community pharmacists, GP’s, dentists and opticians, is accepted by the Health Minister as £36.5m annually.

From the start of April, the public are being warned to expect a reduction in opening hours and staff levels, together with longer waits for appointments and services, as contractors struggle to meet demand in the face of these unprecedented financial pressures.

Chief Executive of Community Pharmacy NI, Gerard Greene, said,

“In the private sector, businesses can often offset such cost increases by raising the prices of their goods and services. Community pharmacies do not have this option. Unlike the health service, they are not shielded from these increases. 

“The situation is becoming wholly unsustainable and goes entirely against the ethos of delivering public health services – individual pharmacy contractors are personally propping up this service out of their own pockets. We are at the point where, regrettably, this now means difficult decisions on staff numbers and opening hours.” 

Dr Frances O’Hagan, BMA Northern Ireland General Practitioners Committee chair said,

“We cannot overstate the severe financial pressures Family Practitioner Services in Northern Ireland collectively are now under. This will inevitably mean increased patient access issues, further shrinkage of Health Service dentistry in NI, further closure of general practices and community pharmacies, and reduced access to NHS services in optometry practices caused by the removal of automatic access to care for those patients on universal credit. The scope for each of us to raise additional revenue is extremely limited and we would not want patients having to pay more when their own finances will be similarly stretched.

“We call on the Health Minister and the Executive to intervene immediately and provide the mitigation and support needed to offset these latest cost increases we now face.” 

Community pharmacies across Northern Ireland can now sign up to the Daffodil Standards for palliative and end of life care. The Daffodil Standards are a joint initiative between the Royal Pharmaceutical Society and Marie Curie that aim to build on the high standard of care already provided to palliative care patients and their families by community pharmacy teams.

The Standards were launched at Parliament Buildings on Monday 31st March 2025 and are supported by Department of Health NI, Pharmacy Forum, and Community Pharmacy NI, and are led by the regional lead pharmacist for palliative and end of life care. Community pharmacists can sign up to the Daffodil Standards through the Marie Curie website and they are encouraged to use the Standards to build the confidence of pharmacy team members when providing support to palliative care patients.

Once a pharmacy signs up to the Daffodil Standards, a welcome pack containing all necessary resources will be sent out to pharmacy teams. Community pharmacies across Northern Ireland provide support to palliative care patients daily, and the Standards will support pharmacy teams to offer the best end of life care for their patients and their families.

Katherine Kidd Head of Professional Services and Funding at Community Pharmacy NI commented:
“The launch of the Daffodil Standards to support community pharmacies in providing end of life care to patients is welcomed. Pharmacy teams across Northern Ireland can use the Standards at their own pace to help them gradually build on the high standards of care that is already provided to palliative patients, carers, and family members.”

Kevin McDevitt Palliative Care Network Pharmacists added:
“Community pharmacists and their teams across Northern Ireland already provide a high level of care and support to patients and families through a difficult and challenging time. In adopting the Daffodil Standards, there is an opportunity to reflect on the different ways this engagement happens, and how this can be built upon to enable pharmacy teams to further support their patients. I can see the confidence in my team grow through participating in the Standards and I would wholeheartedly encourage community pharmacists to find out more about how their pharmacy could get involved.”

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Peter Armstrong, Regional Lead Pharmacist for Palliative Care said: “We know the huge contribution community pharmacists make towards good end of life care in their local communities, frequently going the extra mile to ensure the very best care for their patients. Implementation of the Daffodil Standards for Palliative Care provides a framework to enable the whole pharmacy team to build on their skills, develop their confidence, elevate their commitment to palliative care and reinforce their key role in supporting patients with a terminal illness and their families.”

Chris Black, Specialist Palliative Care Pharmacist Marie Curie and Belfast Trust concluded that: “Community pharmacies are the most accessible healthcare providers and are ideally placed to support patients and the families of those diagnosed with a terminal illness. The Daffodil Standards build on the amazing work that community pharmacies already provide, creating a clear, structured approach to palliative and end of life care for the whole pharmacy team. The expertise of the community pharmacy team is then on hand to advise and reassure families when they really need support.”