Pharmacists have lost thousands in monthly income after having no choice but to pause clinical services during the first wave of Covid-19, a survey by the Pharmacist has revealed.

The survey found a quarter (24%) of 78 pharmacists had missed out on over £2,000 a month between March and June, while a further 26% said they had lost between £1,000 and £2,000. Another 23% had lost between £500 and £1,000 and 27% said they lost less than £500.

One pharmacist commented: ‘We ceased private professional services entirely from 20 March to 1 June, and I estimate a reduction in turnover of around £25,000 from these services alone.

‘Furthermore, the reintroduction of the services has been hit by travel restrictions and lack of confidence in long haul holidays, so turnover is down 70% for June, July and August.’

Another respondent said that the drop in income from services was being felt ‘acutely’, as margins get tighter due to the ‘increased drug costs and extra provision of PPE’.

The survey, to which a total of 104 pharmacists responded, looked at the impact of the pandemic on private, locally commissioned, or advanced services offered by pharmacies.

After a raft of cuts to NHS funding in recent years, pharmacists have sought to diversify their income streams by offering more services – but Covid has caused many to be put on hold.

Of 92 survey respondents who answered a question on how much of their overall annual income comes from services, 27% said clinical services make up 0-5% of their income, while a third (33%) said this revenue stream accounted for 6-10%. Another 24% said services made up 11-20% of their income, while 15 respondents said services account for over 20%.

Between March and June, almost half (41%) of 78 survey respondents said they had ceased operation of clinical services entirely, while others managed to keep some running using social distancing and PPE (35%) or via telephone calls and digital technology (19%).

Resuming services

The survey, which ran from 30 July to 14 September, found almost three-quarters (70%) of 78 respondents had got some services up and running again over the summer, while 8% said all their services were back in operation. The remaining 22% said services were still suspended.

Pharmacists cited social distancing measures and having adequate space in the pharmacy to implement these was the biggest barrier to resuming services, followed by a lack of footfall.

One pharmacist said that the pandemic had reduced their pharmacy’s footfall to ‘zero’. ‘We only have a few walk-in customers and the sale of OTC meds has gone – nothing is selling and many medicines are now coming up to their expiry date, which means a further loss to our pharmacy as no income is being generated,’ they added.

Another respondent said that the cleaning down time required to deliver services safely meant some were ‘no longer financially viable’.

Some pharmacists also commented on fears for their own safety and protection from the virus, with one stating that they felt ‘very uncomfortable’ about the measures proposed to allow pharmacists back into a consultation room. Another respondent said they were less inclined to provide personal advice in a consultation room ‘because of the risks involved’.

‘Cover contractors’ costs’

Commenting on the findings, Mike Dent, PSNC’s director of pharmacy funding, said community pharmacies had faced ‘significant costs’ related to Covid-19, including the loss of income from clinical services, staff costs, infection control measures, and a drop in OTC sales.

He said: ‘It is good to hear that some pharmacies say they have been able to resume some clinical services, but there are challenges and additional costs to making these Covid-safe.

‘Although the scope of ‘clinical services’ can be difficult to define – we know all pharmacies continued to give clinical advice throughout the pandemic even though many of these consultations will have had no direct funding attached to them.’

He added: ‘PSNC is arguing that all Covid-19 related costs for contractors should be covered by the Government and we have written to DHSC and NHSE&I outlining the costs we believe contractors are dealing with. These peaked in March, but now appear to be rising again as we go into the second peak.’

Sandra Gidley, president of the Royal Pharmaceutical Society, said that community pharmacies had remained open and played a ‘vital role’ during the pandemic by providing key healthcare services, dealing with minor ailments and giving health and care advice.

‘It’s vital the Government recognises this extraordinary contribution and ensures that pharmacy businesses do not lose income when they have been working during these difficult circumstances. We are calling on them to back pharmacy with fairer funding that ensures we are able to build on the incredible work that our profession has undertaken,’ she said.

‘As experts in medicines, pharmacists need support to be able to offer more virtual consultations to people who seek advice and need support with their medicines. This will take some burden off other parts of our NHS.’

She added that pharmacists should be given sufficient supplies of PPE and access to mental health services to help them during the second wave.

‘Significant financial hit’

Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), said the pandemic had impacted on the ability of all contractors to provide services in a Covid-secure environment and fair funding was needed for the entire sector, given its vital role.

He added that Covid-19 has presented opportunities to change pharmacy practice, which can benefit all contractors, such as digital technology and providing flu vaccines in car parks.

‘We have also successfully campaigned to remove the need for wet signatures for paperwork relating to advance services. As a result, patients no longer need to physically sign for a flu jab, the New Medicine Service (NMS) or Medicines Use Reviews (MURs),’ he said.

Graham Thoms, chief executive for PGD provider PharmaDoctor, said he was ‘not surprised’ by the survey findings and that data from his company’s eTools tells a ‘similar tale’.

‘With severely reduced activity between March and June, there is no doubt that pharmacies have taken a significant financial hit on their private clinical services for the reasons highlighted in the survey,’ he said.

‘There are also encouraging signs as we have begun to see the appetite for pharmacy services returning to pre-Covid levels. Throughout the pandemic, Pharmadoctor has developed new innovative clinical service packages such as our Allergy Test ‘n Treat and Ear Infection services, which we are providing to all pharmacists free of charge. We hope a combination of our support will help them get back to where they need to be.’