Patient safety could be compromised if the current level of pharmacy closures and workload pressures continue – warn community pharmacists
The National Pharmacy Association (NPA) will ask its members to vote on taking industrial action in order to bring to the public’s attention the “slow death of community pharmacy”, the organisation’s chief executive has told Pharmacy Business.
The NPA, which represents 6,000 community pharmacies across the UK, announced today that it will be sending a formal ballot to its members to vote on work to rule plans to protest against a decade of cuts to pharmacy funding.
The ballot will ask pharmacies to consider a range of actions if the financial situation for pharmacies does not improve.
This includes, reduction in services; cut hours to contract minimums; withdraw free deliveries or end the provision of free blister packs; cease to share data with the NHS unless it’s a legal requirement; and consider serving notice on a range of locally contracted services, negotiated directly with local authorities.
The ballot will be open for responses for six weeks and any action supported by a majority of pharmacies could take place before Christmas.
Paul Rees, chief executive officer at the NPA, refuted suggestions that the action by pharmacists would have a negative impact on patient care.
“This is all about the movement to save our pharmacies because 1500 have closed in the last ten years, seven are closing each week, and three quarters are in the red,” Rees told Pharmacy Business.
“In the last decade, there’s been a massive increase in dispensing, in volume – community pharmacy has to do something to safeguard patient care in the long term.
“If things carried on, on the same trajectory, with fewer and fewer pharmacy and more and more dispensing, patient care in the future would be compromised.
“We’re asking our members, do they want to consider these work to rule options as a way of safeguarding patient care in the long term and safeguarding financial sustainability.”
Rees accepted that there may be some inconvenience for patients but stressed that it’s “far better for pharmacies to still exist than to not exist at all”.
“The biggest impact on patient care is the continuing collapse of the community pharmacy network, there is now the risk of pharmacy deserts in some rural parts of the country,” he said.
“This is a profession that has been taken for granted for too long, and so many pharmacy owners have had to borrow money and re-mortgage their homes just to keep going.”
The ballot warns that patient safety could be compromised if the current level of pharmacy closures and workload pressures continue. The NPA estimates that pharmacy funding has fallen by 40 per cent of real terms over the past ten years.
In June, the NPA revealed that around two-thirds of pharmacies in England have had to cut their opening hours since 2015 to reduce costs.
The analysis of opening hours of a sample of 110 pharmacies in England between 2015 and 2024 showed that 63 per cent have reduced their opening hours by an average of 6.1 hours per week.
As of January 2023, due to increases in inflation, community pharmacies in England have lost £1.6bn in funding since 2015/2016.
On Monday, Baroness Merron, Parliamentary Under-Secretary of State at the Department of Health and Social Care, said the government would start negotiations for the 2024/2025 pharmacy funding contract “as a matter of urgency”.
The most recent five-year contract for pharmacies in England expired in April.
The NPA are calling for a £1.3 billion funding increase in England to plug the financial blockhole facing community pharmacies.
Janet Morrison, Chief Executive of Community Pharmacy England (CPE), which negotiates on behalf of the profession told Pharmacy Business that she will take on board the responses from the ballot when she meets with the DHSC.
“Relentless funding constraints and rising costs have put community pharmacies in a desperate and impossible position. Like everyone in the sector, we are in favour of anything that helps to make this case, and we have been clear about the situation in all our meetings with and submissions to the new Government and the NHS,” said Morrison.
“We recognise that many business owners and their teams and other national organisations want to do their bit to make the case for community pharmacy. The more voices we have making the same case for pharmacy the better, and where we can, we and LPCs will continue to work collaboratively with all of them: our doors are always open.
“Pharmacy owners can choose which campaigns and activities they wish to actively support: Community Pharmacy England and LPCs will continue to work with everyone for the greater good of community pharmacy.
“Community Pharmacy England discusses tactics and positioning on an ongoing basis with regard to what will best support negotiations: we will be interested to hear about the outcomes of this ballot to inform those considerations.”
Morrison will be part of a cross-sector delegation, led by the NPA, that will deliver a petition of more than 350,000 signatures to Downing Street today calling for action to support community pharmacies.
“Our target was to get 300,000 signatures, because that’s what the Royal College of GPs amassed ten years ago when they ran a similar campaign for more resources for general practice. We’ve got 350,000 signatures, and that shows that the public care as much about community pharmacy as it does about general practice,” said Rees.
Company Chemists’ Association (CCA) CEO Malcolm Harrison, and Community Pharmacy NI Chief Executive Gerard Greene, will also be part of the delegation.
Harrison said: “The CCA shares the concerns expressed by the National Pharmacy Association. Community pharmacy cannot be expected to deliver more and more workload within an ever-shrinking funding pot.
“It’s clear that community pharmacies can help to solve so many of the issues identified in Lord Darzi’s investigation into the NHS but can only do so with urgent investment. Without additional funding we are concerned that patient’s access to vital medicines and the NHS services they have come to rely on will deteriorate and further pharmacy closures will be inevitable”.
Lord Darzi’s review of the NHS in England, commissioned by the government, concluded that the system is in “critical condition”.
Darzi said there was “huge potential” of pharmacy within healthcare and felt community pharmacy had “traditionally been one of the great strengths of the health service in England”.
However, Darzi’s report also outlined concerns around pharmacy closures in recent years and he expressed a “very real risk” that community pharmacy could soon find itself with “too few resources in the places where it is needed the most”.
“What we need now is for the government to take a lead from the Darzi report and to step up to the plate and deliver a fair deal to pharmacy in England, and for the devolved administrations, which will then safeguard the continuation of excellent patient care,” said Rees.
“We desperately want to work with Wes Streeting, (Secretary of State for Health and Social Care) and the new government to unleash the vast potential of pharmacies to deliver the better health in the community that we all want.
“But despite big settlements for junior doctors and train drivers since the election there is no sign – as yet – of an end to the chronic real terms cuts that is literally driving dedicated healthcare professionals in pharmacies out of business.”
Rees explained that the impact of the Pharmacy First scheme which was launched in January and has led to over a million patient consultations, shows the greater role pharmacists can play in the health service.
“Given that this is a service that is new, a service that was rushed through, it’s an incredible outcome – that’s 1.1 million people who didn’t need to see their GP,” said Rees.
“Pharmacy can help take the pressure from general practice and help cut waiting times for A&E, but only if it is resourced.”
Rees said the next step in the NPA’s campaign will see them have a stand at the Labour Party conference.
A Department of Health and Social Care spokesperson told Pharmacy Business: “This government inherited a broken NHS where pharmacies have been neglected for years.
“Pharmacies are key to making healthcare fit for the future as we shift the focus of the NHS out of hospitals and into the community. We will make better use of pharmacists’ skills, including accelerating the rollout of independent prescribing to improve access to care.”
By Sarwar Alam
