Community pharmacies in England are dispensing more prescription items and delivering more clinical services despite a fall in the number of contractors, figures have shown.

The NHS Business Services Authority’s General Pharmaceutical Services Report published today found 418 pharmacies in England closed during 2021/22, while just 308 new pharmacies opened – a net decline of 110 pharmacies and the lowest number of active contractors since 2015/16.

Despite this, the number of prescription items dispensed went up, as did activity across clinical services including flu vaccines, the New Medicines Service and appliance use reviews.

Over a billion items dispensed

The report also found that 1.05bn prescription items were dispensed by community pharmacies and appliance contractors in England in 2021/22 – a 2.65% rise from last year.

In addition, as a mean average, 90,500 items were dispensed per pharmacy contractor in 2021/22 – an increase of 3.6% from the previous year and 8.86% from 2015/16.

Appliance contractors dispense more items than community pharmacies, according to the yearly average calculated by the report, with 98,300 items being dispensed by appliance contractors in 2021/22 – a 44.1% increase from 2015/16.

Meanwhile, the total cost of drugs and appliances reimbursed to community pharmacies and appliance contractors rose by 0.83% to a total of £9.05 billion in 2021/22.

The report did not say how reimbursement figures compared to the original cost paid by contractors for prescription items, but pharmacists have previously raised concerns that they are being asked to ‘dispense at a loss’ amid calls for reforms to the price concession system.

Flu vaccines up by 75%

The data also revealed that a  4.85m seasonal influenza vaccines were administered by community pharmacies in 2021/22, which was a 75.1% increase 2020/21.

It suggested that, as an average, community pharmacy delivered of 492 vaccines in 2021/22 – almost twice as many as the previous year and nearly five times as many as in 2015/16.

The reimbursement cost for flu vaccines paid to community pharmacy as a whole was £49.8m in 2021/22, 13.3 times more than the £3.75m paid in 2015/16. Meanwhile, the sector was paid £46.5m in flu vaccination fees, 8.54 times more than the £5.44m paid in 2015/16.

The number of New Medicine Services (NMSs) undertaken by community pharmacies has also increased.

In 2021/22, 2.1m NMSs were delivered by community pharmacies rose – which is an increase of  125% compared to 2020/21, when the number of NMSs delivered declined slightly during the Covid-19 pandemic, and 114% compared to 2019/20.

This rate of increase is significantly higher than the year-on-year average percentage change of 0.04% between 2015/16 and 2019/20, with the report noting that 2021/22 also included a catch-up service for patients who were prescribed a new medicine but did not receive an NMS or any additional support during the COVID-19 pandemic.

Fees for the NMS paid to community pharmacies increased by 130% from £23.4 million in 2020/21 to £53.9 million in 2021/22.

Community pharmacies also carried out higher volumes of appliance use reviews (AURs), which increased by 61.9% from 2020/21 and 92.2% compared to 2015/16. However, community pharmacies overall were paid just 30.9% more than in 2021/22 and 47.9% more than in 2015/16.

Other findings

The report also found that:

Following the release of the Community Pharmacy Contractual Framework (CPCF) last month, leading pharmacists said that community pharmacy was being asked to ‘do more for less’, and criticised the increased demand for clinical services under a flat funding deal.