NHS spending on community pharmacy and ophthalmic services has been reduced by 19.9% since 2016/17, when real-terms funding is adjusted for need, according to new analysis from the Nuffield Trust.

But in the same time period, GP primary care services saw a 10.3% increase in real-terms needs-adjusted NHS funding, while funding for acute care in NHS trusts increased by 21.4% and ambulance care by NHS trusts received a 27.3% increase.

The analysis, released by the Nuffield Trust today, found that real-terms funding for community pharmacy and ophthalmology fell from £2.5bn in 2016/17 to £2.3bn in 2022/23 - an average annual decrease of 2%.

In the same time period, GP funding grew slightly from £8bn to £9.7bn, although it experienced a £500,000 cut in the last year of the period, which equates to a 7% cut between 2021/22 and 2022/23 when adjusted for population need.

The report highlighted the importance of adjusting real-terms funding for age and sex-related estimates of need, ‘with the numbers of people aged 70 and above growing at over nine times the rate of people aged five to 29 over the period here examined’.

‘Health care cost tends to increase dramatically with rising age, with an 85-year-old male expected to consume on average around 16 times more in acute care cost terms than a 10-year-old male,’ the report added.

The report also noted that ‘despite the often repeated ambition to shift more care and health care resources into services “closer to home”’, spending on NHS primary and community care and local authority public health, ‘grew in real terms by less than half a percent on average a year between 2016/17 and 2022/23’.

‘Perhaps even more strikingly, funding for NHS community health care services was cut in real terms in three out of the six years between 2016/17 and 2022/23,’ the report said.

Dr Nick Thayer, head of policy at the Company Chemists’ Association (CCA) commented: 'Primary care has long been the poor cousin of secondary care and these findings confirm this.'

He added: 'The historic underfunding of the community pharmacy sector has led to the net loss of almost 1,200 pharmacies since 2015. An uplift in funding for community pharmacy is key if the NHS is to take a preventative and longer-term approach to healthcare, and boost efforts to keep people out of secondary care altogether.'

And Paul Rees, chief executive of the National Pharmacy Association (NPA) said the report showed 'how acute, hospital care continues to be a magnet for NHS investment, compared to community-based services like local pharmacies'.

'It is further confirmation that funding for pharmacies has dropped significantly in real terms. In fact, pharmacies are now paid less as a proportion of health service expenditure than at any time since the NHS began,' he added.

'Funding for community pharmacy services has plummeted in recent years, which has meant more than 1,000 have closed and the ones that are still open have been pushed to the brink.

'Not only does community pharmacy play a vital role supporting patients, it also keeps pressure off our overstretched GPs and hospitals, so cutting the sector’s funding is a false economy.'

And he said it was 'imperative' for 'any incoming government' to address 'the crisis in primary care and the looming cliff edge facing pharmacies'.

Jay Badenhorst, director of pharmacy at the Pharmacists' Defence Association, said there were 'significant benefits to be gained from shifting certain healthcare services from hospitals to other settings, when appropriate'.

But he warned: 'For this approach to be truly viable, it must be part of a comprehensive program to restructure primary care. The provision of sustainable funding is a critical component of this, as it enables us to foster collaboration and provide the necessary resources, including staff. Our primary goal is to ensure patient care without fostering competition among organisations delivering different NHS contracts within primary care,' he said.

'With the right level of funding allocation, pharmacists can make a significant difference in healthcare delivery. They can help alleviate the burden on GPs and hospitals by managing minor ailments, offering chronic disease management, and supporting medication adherence. Unfortunately, the current funding situation limits the capacity of pharmacists, regardless of which setting they work in, to expand these services, hindering the realisation of a more integrated and efficient healthcare system,' Mr Badenhorst added.

Brendon Jiang, vice chair of the Royal Pharmaceutical Society (RPS) England Pharmacy Board, told The Pharmacist that medicines were 'an essential part of NHS care', adding: 'With growing demand for pharmacists’ expertise it is vital that pharmacy services across the NHS are backed by long-term sustainable funding.'

And a spokesperson for the Conservative party highlighted the Conservative government's introduction of Pharmacy First in England 'to help unlock 10 million doctors’ appointments across the country', delivering '6.5 million more GP appointments each month than in 2019' and tackling 'the 8am rush to make it easier to get an appointment'.

This week, a parliamentary inquiry into pharmacy recommended that the Additional Roles Reimbursement Scheme (ARRS) should be reviewed to see whether any flexibility on the funding criteria could ‘reduce the drain of community pharmacists into primary care networks’.