More and more pharmacies are closing as a six-month delay to the community pharmacy contract means core funding has still not been uplifted since 2019.

Contractors told The Pharmacist that they struggle to keep up with increased demand for services and the knock-on impact of pressure elsewhere in the health system, while being unable to pay their staff enough to retain them.

And community pharmacy leaders have described the delay to the contract as 'frustrating' and 'ridiculous'.

On Monday, the community pharmacy negotiator announced that discussions with the government on the already-delayed 2024/25 community pharmacy contract are not expected to resume before September.

Community Pharmacy England (CPE) said that despite recognition from new ministers on the ‘urgent need’ to re-commence negotiations, it believes this will not be possible until the Department of Health and Social Care (DHSC) and the Treasury have discussed the level of funding available for core public services.

It has previously told the sector not to expect ‘revolutionary’ change in the 2024-25 contractual framework, instead saying that the negotiator was trying to create ‘building blocks’ to lay the groundwork for the next contract, which is expected to begin in April 2025.

'It's really concerning, when every penny counts, to not know how many pennies there are'

But contractors have told The Pharmacist that, several months into this financial year, not having a contract in place makes it impossible to plan and develop their businesses in already pressurised circumstances.

'It's really concerning, when every penny counts, to not know how many pennies there are. To not know what we're actually meant to be doing right now - it's really tricky,' said Vikki Furneaux, Clinical Lead Pharmacist at Monkbar Pharmacy in York.

She said current funding levels were already 'insufficient', noting that since the last contract was agreed in 2019, 'the shape of community pharmacy has changed entirely', with 'some of their biggest names in pharmacy collapsing’.

Meanwhile, pressure on other parts of the NHS meant pharmacies were delivering unpaid care for non-commissioned services, she added.

'Everyone is exhausted'

'Everyone is exhausted. We're tired,' she said.

'Part of me wants to remain hopeful that surely they've got to listen? But then the exhausted part of me is wanting to plan the escape. As a contractor, you just think well, how much longer can we can we do this for? Is it worth it?

'There are more and more conversations now about selling up [among contractors], which we hadn’t had previously [...] because the stress is not worth it. And the uncertainty is not worth it.

'We pick ourselves up and we get back. But how many times can we keep doing that?'

'We see other agreements being put on the table for other parts of the NHS.'

While community pharmacy has not had a core funding uplift since 2019, Ms Furneaux noted: 'We see other agreements being put on the table for other parts of the NHS.'

London contractor Beran Patel also highlighted that clawbacks of community pharmacy funding were recently announced the same day that doctors were offered a pay increase.

'That's just not a kick in the teeth. That's a kick in everywhere that you can think of,' he told The Pharmacist.

'I've been here 30 years and I can't make ends meet, I don't know how anybody else is surviving,' he said.

'We cannot hold on to staff'

And while minimum wage has increased by over 30% since 2019, pharmacy funding has not. 'We cannot hold on to staff,' Mr Patel said.

'If we don't have the investment, how are we going to expand our businesses?' he said.

Along with the increased workload of Pharmacy First consultations, the closure of other local pharmacies has caused Mr Patel's prescription volume to increase.

And while uptake of Pharmacy First was 'steady', Mr Patel said he was struggling to meet the minimum monthly thresholds required for the £1,000 monthly payment.

'The gateway criteria is horrendous to get somebody through, I've got to spend 20-25 minutes in the consulting room only to find that they don't fit the criteria,' he said.

'If I'm spending 20 minutes with a patient to deliver a service, half the time I need a second pharmacist to be able to do the work,' he said.

'We literally are begging for stock.'

Other issues, like an IT system 'which is not fit for purpose' and stock issues that required him to 'come in an extra hour early in the morning, just to try and get through to a warehouse' were exacerbating workload and uncertainty, Mr Patel suggested.

'We literally are begging for stock. How can you function like that? I mean, it's just scary. Absolutely scary,' he told The Pharmacist.

'Sadly I have reached a point [where] the energy is gone. I am struggling to be enthused to come into work in the morning.

'In the morning, the first thing we look at is the bank balance, just to see if we are solvent or not,' he said.

And while both Ms Furneux and Mr Patel praised efforts to raise awareness about the plight of community pharmacies, Mr Patel questioned whether the government was listening.

'Almost half a million signed petitions going into the government. What have they done about it? Nothing.'

Current pharmacy contract 'entirely inadequate'

Chair of the National Pharmacy Association (NPA) Nick Kaye, told The Pharmacist that the delay in contract negotiations until September was 'frustrating'.

'Current arrangements, including the overall level of funding, are entirely inadequate to sustain the pharmacy services millions of people rely on.

'We urgently need a new deal that respects the vital role of pharmacies, guarantees inflation-linked funding increases as a minimum and ends pharmacy closures.'

And a spokesperson for the Independent Pharmacies Association (IPA) said the wait until September was 'ridiculous' and raised concerns over the role of the negotiator.

'We have been in a long-term contract for many years so there was ample time to prepare for the end of it,' they said.

The spokesperson added that the effects to pharmacists are 'calamitous'.

CPE 'could not be more aware' of sector's 'desperate need'

Janet Morrison, chief executive of Community Pharmacy England, that the negotiator would 'of course' have welcomed the agreement of the contract before the start of the financial year.

'Nevertheless, as is well known, we are dependent on ministers approving the initiation of negotiations and this was delayed this year by the Pharmacy First negotiations and implementation process and a change in Minister in November 2023. The timing of negotiations is entirely a matter for government, not Community Pharmacy England,' she said.

She said the delay of negotiations until the autumn was 'unsurprising', given the snap election, new government and ongoing review of public finances ongoing.

But she added that the negotiator 'could not be more aware of the desperate need for an improved funding contract and the dire financial straits in the sector'.

Government praises 'vital role' of pharmacies

Meanwhile, a government spokesperson confirmed that given the early stages of the new government, more detail on specific policies would be provided in due course.

And they said: 'Community pharmacies play a vital role in our healthcare system and are key to our plans to make healthcare fit for the future.

'This government is committed to working with the sector to expand the role of pharmacies, including making prescribing part of the services delivered by community pharmacists.'