Announcing the autumn budget on Wednesday chancellor Rishi Sunak once again overlooked community pharmacy even as he pledged an extra £5.9bn for the NHS on top of the £12bn a year announced in September.
The chancellor of the exchequer used a stronger forecast for the UK's post-lockdown economic recovery despite a sharp rise in inflation that could approach 5 per cent next year. Community pharmacy insiders say the rising costs will badly hit the sector's precarious finances, leaving many pharmacies on the brink.
Bharat Patel, a community pharmacy contractor and vice-chair of the Pharmaceutical Service Negotiating Committee, said he is worried about "the impact of spiralling business costs" on many businesses which are "already at breaking point".
“The rise in the national minimum wage, as well as significant increase in national insurance, energy costs, rents, other staff salaries, fuel, refit and maintenance will all negatively impact a sector that for so long been starved of adequate funding," said Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, echoing similar concerns.
The Company Chemists' Association (CCA) said it welcomes the announcement to invest in the healthcare system but regrets that there was "no mention of the community pharmacy sector which remains underfunded and underutilised".
It said "unless fair and reasonable funding is agreed", community pharmacies "will not be able to provide access to vital medicines or to deliver the healthcare services that patients have become accustomed to during the Covid-19 pandemic."
Sunak said he would cut business rates for one year for the sectors hardest hit by the pandemic. Business rates are charged on commercial premises such as shops, offices, pubs and warehouses, based on the value of the property. Business owners have complained for years that the system hands an unfair cost advantage to online retailers such as Amazon.
The Treasury has been reviewing the business rate system, which was suspended during the pandemic for the worst-hit sectors, and Sunak told parliament when presenting his budget on October 27 that there would be a new 50 per cent business rates discount for some businesses for one year.
Dr Hannbeck liked that business rates "are being discounted" but pointed out that the measure would be in place "only for one year" and obviously not enough for community pharmacy contractors who have, over the past three years, "exhausted all possible ways of saving costs".
She said: "There is nowhere else left in the operations they can target for savings. Clearly, all businesses will have to deal with these cost increases, but unlike most businesses, pharmacies cannot pass the increased costs to our patients."
Patel praised his fellow contractors for "delivering impressive efficiencies year-on-year" but, like Hannbeck, regretted that "unlike other businesses they are not able to pass costs on to consumers".
He added: "Many pharmacies are already at breaking point, and we are concerned about the impact this will have on the services they offer and on which so many people rely.
"Pharmacies nationwide have made an enormous contribution to the pandemic response efforts, keeping their doors wide open to serve their communities and in doing so saving some 24 million GP appointments a year. The chancellor’s vision for a high wage economy and time of optimism must go hand in hand with support for this critical network of healthcare providers.”
During a buildup to the budget announcement, Sunak had said that the spending for the health service over the next few years would aim to drive down waiting lists and to tackle backlogs built up over the Covid-19 pandemic.
Malcolm Harrison, CEO of the CCA, said: "Community pharmacists have the skills and expertise to support the NHS backlog by alleviating pressures in the primary care system. However, this potential can only be unlocked through long-term and stable investment."
"Community pharmacy has played a key role in the Covid recovery, staying open for patients to access medicines and other essential healthcare services, as well as more recently ensuring people are able to get their Covid and flu vaccinations. With almost 90% of the population living under a 20-minute walk from community pharmacies, the sector is in a prime position to support the Government to fully level up access to healthcare services across the country."
Commenting on the budget announcement, Thorrun Govind, chair of the Royal Pharmaceutical Society in England, said: "Pharmacists across the health service have shown how they will be central to maximizing uptake of flu and Covid-19 vaccinations and, as we head into a challenging winter, the Government and NHS must ensure they get the support they need.
“Making a success of the Government’s planned investment in the NHS will now depend on supporting the whole of the health and care workforce to better manage growing demand across the health service. This must be backed by investment in pharmacy education and training to build on pharmacists’ clinical expertise to support patient care."
Graeme Duncan 
