Pharmacy closures 'could double' without action, contractors warn

Pharmacy closures are a 'worry' for patients and could 'double' if action is not taken to prevent them, community pharmacy representatives have said as they gathered outside the Houses of Parliament yesterday before meeting with MPs.

Complete with a giant map to illustrate the scale of the closures in regions across England, the event marked the launch of the ‘Fight4Pharmacies’ campaign, which is calling for investment in the sector and a re-evaluation of the contract, organised by the Association of Independent Multiple Pharmacies (AIMp).

The NHS Business Services Authority (NHSBSA) reported in October that active dispensing contractors in England were at their lowest level since 2015/16.

And NHSBSA data and AIMp analysis estimates that more than 400 community pharmacies in England have closed since 2019.

Sandeep Dhumi, superintendent of W Phillips Chemist, a pharmacy group based across the West Midlands, told The Pharmacist at the event that the Midlands had seen 56 closures since 2019, adding: ‘It will not be long before that doubles if the rate of decline continues.

‘We've got a 10% drop across the whole Birmingham and Sollihul LPC in the way of pharmacy closures and it's very likely that we're going to have some more if community pharmacy funding is not enough.’

‘Colleagues of mine, other pharmacists, other pharmacy owners... I've seen their accounts… everybody is asking everybody for help, how they can save money, how they can cut costs,’ he said.

‘And it's just getting worse and worse and worse. I'm having contractors approach family members, re-mortgaging their houses, doing all sorts of different things to try and bump up their business,’ he added.

Mr Dhumi suggested that closures were happening in the most deprived areas of the country, where ‘the most in need’ patients were now having to travel further for services; were unable to access flu and Covid jabs; and were impacted by the decline of medicines delivery services, which have previously been offered by many pharmacies for free but are now proving too costly for many to run.

And he suggested that the cause of closures was ‘totally government funding’.

‘They stripped us out from the position from 2015, it's getting worse, and they're not changing,’ Mr Dhumi said.

While medicines pricing, staff costs and workforce issues all played a part in closures, Mr Dhumi said: ‘Ultimately, there's not enough money in pharmacy.’

‘We could talk about medicine shortage. We could talk about minimum wage, but ultimately, all points down to the same thing. It all comes from the same place. There's not enough funding in pharmacy, it's causing closures.’

Sukhy Somal, services lead at Community Pharmacy Walsall and Sandwell - within the Black Country ICB estimated to have had the highest net loss of pharmacies in England last year - told The Pharmacist that pharmacy closures were a ‘worry’ for patients, particularly the elderly and isolated.

‘It’s the impact of the message it sends out to customers about how secure pharmacy is: "Is it okay, if I get my prescriptions from the pharmacy down the road? Are they going to close?"’ she said.

‘They rely on that service,’ she added, highlighting how elderly patients in particular value the face to face interaction with the pharmacy team.

‘We've got to have more funding. I've got friends of mine [contractors] who are putting extra money in out of their own pocket every month, just to make ends meet. And that can't be right. How long do you keep doing it? Something's got to change really quickly.’

As services lead for the local pharmaceutical committee (LPC), Ms Somal supports pharmacies to deliver new services. But she said the new funding for new services like Pharmacy First, hypertension and contraception is ‘not making up the shortfall’.

She added: ‘It shouldn't be there to make up the shortfall, because they’re doing this on top of their day job.’

She described the ‘whole system’ as ‘a bit broken’, highlighting added workload from medicines shortages, ‘dispensing medication that's costing [pharmacies] more than what [the DHSC is] paying for it’, and the impact of ‘clawbacks’ that mean pharmacies can’t plan their cash flow.

And Raj Matharu, chair of Pharmacy London and chief executive of Community Pharmacy South East London, told The Pharmacist that he had come to the event to help create a sustainable profession for his son and the next generation of community pharmacists.

‘My son runs a pharmacy and we were there the other night. It was about half eight, quarter to nine. And he said, "Dad, it’s your generation that got us here. What are you going to do about it?" And that's kind of the driving force of being here,’ he said.

‘He was saying: “What are you going to do to change it?” so that his generation have a profession that's sustainable, stable, and safe for patients,’ Mr Matharu added.

NHSBSA data and AIMp analysis estimates that more than 400 community pharmacies in England have closed since 2019.

New analysis from AIMp shared this week suggests that this could have led to 2.5 million more GP appointments, as patients who would normally visit their community pharmacy may have visited their GP instead.

The AIMp estimate is based on a 2022 audit conducted by Community Pharmacy England of 4,139 pharmacies, which calculated that 48% of the daily average of 19 consultations carried out by community pharmacies would otherwise have been conducted by GP surgeries if patients could not access their local pharmacy.

The total annual figure of community pharmacy appointments that would otherwise have been seen in GP practices was then multiplied by the number of pharmacy closures to arrive at the estimate of 2.5 million GP appointments that could have been saved by local community pharmacies if they had not closed.

The government has said that it ‘does not recognise’ the figures calculated by AIMp.

And it highlighted the £645m of new funding recently introduced for the sector, ‘which comes on top of the £2bn pharmacies already receive per year’.

A government spokesperson added: ‘Pharmacy First will free up an anticipated 10 million GP appointments a year. It has been widely welcomed by the pharmacy sector and so far, 98% of pharmacies have signed up to deliver it.

‘Four in five people live within a 20-minute walk of a pharmacy and there are twice as many pharmacies in deprived areas, making access to care quicker and more convenient.’

In response, Dr Leyla Hannbeck, chief executive of AIMp, told The Pharmacist: ‘The government said they don't recognise those numbers, but the government needs to do the work in terms of trying to understand what's happening.’

Speaking to The Pharmacist at the event, Dr Hannbeck said that the ‘impactful’ Fight4Pharmacies campaign was intended to support ongoing negotiations on the next community pharmacy contract.

‘This is what we should be doing before negotiations. This is what we should be doing when we want to bring the limelight on to community pharmacy.'

She added: ‘I've always said, and I continue saying that there is money in the NHS. Where this money is going is a different story.

‘Our job here is to bring the attention on community pharmacy. This sector could do so much more – look what we're doing with the Pharmacy First Scheme, we are very much behind it… and if you would give us the funding that we need to keep our heads above the water, you will get a solution,’ she said.

MPs including Derek Thomas, Conservative MP for St Ives; Daisy Cooper, Liberal Democrat MP for St Albans and deputy leader and health and social care spokesperson for the party; Sarah Dyke, Liberal Democrat MP for Somerton and Frome; and Sir Robert Buckland, Conservative MP for South Swindon, visited the gathering of pharmacists outside parliament, with a further 30-40 expected to attend a drop-in event held later in the afternoon.

Sir Robert told The Pharmacist that he backed the campaign’s calls for more funding for the community pharmacy sector.

‘We've got to make sure that in pursuing a policy of emphasising health care through pharmacies that we don't lose or see our network degrade,’ he said.

And Ms Dyke, Liberal Democrat MP for Somerton and Frome, told The Pharmacist that community pharmacies were an ‘absolutely vital and essential part of our local services’, particularly in rural areas like her constituency.

And she said that while she ‘wouldn't necessarily agree’ with the campaign’s proposal to re-allocate money from within the NHS, she added: ‘We do need to look at funding’.

She also highlighted other mechanisms proposed by the Liberal Democrats such as cancelling tax cuts for banks to fund health and care services.