Key Summary
- 75% of pharmacies say they are losing money as medicine shortages hit.
- Analysis highlights the impact of a £2 billion funding gap across the sector.
- Rising staffing costs are cited as a key pressure by 95% of respondents.
Community pharmacies across England are facing a severe financial crisis that is directly impacting patient safety and access to care, according to a survey of pharmacy contractors carried out by Community Pharmacy England (CPE).
The survey revealed that about 75% of pharmacies are losing money as medicine shortages hit, with just 14% reporting that they are currently operating profitably.
CPE analysed the views of owners of more than 2,900 pharmacies and 900 team members, highlighting the devastating impact of daily medicine shortages and rising operating pressures on the sector.
Independent economic analysis reveals a £2 billion funding gap across the sector, stemming from funding cuts originally imposed in 2015.
The financial strain on pharmacies is trickling down to the public, with 76% of pharmacy owners reporting that patients are being impacted by the business pressures facing their teams.
Delays and reduced access to care
The ability of community pharmacies to provide accessible healthcare advice, medicines, and clinical services without an appointment is increasingly under strain.
In nearly three-quarters (73%) of pharmacies, patients are waiting longer to receive advice from pharmacy teams. Furthermore, 83% of pharmacies are unable to respond to patient phone calls and emails as promptly as usual, and staff in 39% of pharmacies are unable to spend as much time supporting and advising patients as they would like.
To manage these spiralling costs, business owners are taking drastic measures that threaten the traditional pharmacy model. One-third (33%) of owners are actively looking at ways to further reduce costs, which they believe will likely impact patients.
To manage these costs, the sector is being forced into drastic changes:
- 18% of pharmacies are making staff redundant.
- 30% reduced opening hours during 2025, and 21% expect further cuts in 2026.
- 29% may start charging patients for services that were previously free.
Supply chain crises and medicine shortages
Pharmacies continue to be hit by unprecedented medicines supply issues, resulting in record numbers of price concessions granted month after month.
The procurement crisis means that 72% of pharmacy team members said they deal with medicine shortages that directly affect their patients on a daily basis.
As a result, 88% of pharmacy staff reported that patients are being forced to make repeat visits to multiple different pharmacies to locate and obtain their medication.
Procurement is taking longer than ever before for 30% of pharmacies, while 86% reported spending significantly longer sourcing medicines than they did last year.
Fin McCaul, a community pharmacy owner based in Greater Manchester, highlighted the immense strain this puts on daily operations:
“We regularly spend many extra hours every week dealing with medicines supply issues. It’s frustrating work for staff, and it can be unpleasant where patients are understandably upset and anxious about delays receiving medicines they need and take it out on the team. To make it even worse, some of the medicines we spend so much time sourcing are then so highly priced that we end up dispensing it at a loss to the business, which is totally unsustainable.”
Frontline pharmacy staff noted that supply issues can force some vulnerable individuals to go without medication for days at a time.
One team member highlighted a severe instance where patients with mental health problems went into acute health crises because the price of the antipsychotic quetiapine skyrocketed alongside severe day-to-day unavailability.
Another pharmacist with 21 years of experience said they had never seen so many stock issues or items priced so far above the drug tariff, making it difficult to maintain essential services.
Unprecedented financial distress
The financial baseline for community pharmacies has broken down, according to the survey, with 99.7% of pharmacies reporting higher overall operating costs than last year. A further 99% said that NHS reimbursement does not even cover the basic wholesale cost of the medicines they dispense.
Rising staffing costs are cited as a key pressure by 95% of respondents, with pharmacy owners sharing serious anxieties regarding future cost increases, including upcoming changes to the National Minimum Wage and local business rates.
To keep their doors open, pharmacy owners are increasingly relying on personal sacrifices. One quarter (25%) of pharmacy owners or directors have taken absolutely no salary or income from their business over the past year.
Additionally, 15% have resorted to subsidising their pharmacy business finances using their own personal savings just to keep them afloat.
Dervis Gurol, a community pharmacy owner and superintendent pharmacist based in the South East of England, spoke about the personal toll involved for contractors and the pharmacy team:
“The pressure of being a pharmacy owner now is enormous: on the financial side, many colleagues have had to rely on additional financing and personal savings simply to cover day-to-day costs and bills, and that cannot go on much longer.
“This sort of worry has huge mental health implications, and I know many pharmacy owners are seeing their health worsen as a consequence of long-term stress.
“As well as the impact on patients and local communities, all pharmacy owners worry about what closure of the business would mean for their staff, for the wider health network and of course for local high streets, some of which could not survive another vacant building.”
Calls for urgent systemic reform
There is a clear consensus across the survey findings that the current community pharmacy funding system is completely unfit for purpose and requires urgent, large-scale reform, CCA has said.
Janet Morrison, Chief Executive of Community Pharmacy England, warned that the current crisis runs directly counter to the Government’s ambitions to shift more healthcare out of hospitals and closer to people’s homes.
“Without further investment, pharmacy closures will continue and this will have very worrying consequences for patients and the public,” Morrison said.
“We know that closures often happen in areas where healthcare support is needed most, so this will worsen health inequalities. Further closures will also be devastating for wider local healthcare networks who will struggle to pick up the slack - pressure on GPs and hospitals will increase. And our local high streets, as well as local employment, will suffer.”
CPE said that it is continuing to campaign for sustainable investment alongside a clear, long-term structural plan to protect pharmacies, ensure patient safety, and secure local NHS access across the country.
Responding to the survey findings, Henry Gregg, Chief Executive of the National Pharmacy Association (NPA) said: “Pharmacies are under extraordinary pressure, dealing with record workloads whilst the network is at its smallest in 20 years due to a decade of pharmacy closures because of funding pressures.
“As this survey shows, these challenges coupled with growing medicine shortages are having a detrimental impact on the patients we support.
“It is not fair or sustainable for the personal savings or overdrafts of individual pharmacy owners to be used to subsidise the running of a vital NHS service.
“There is no doubt that May's funding uplift, only the second real terms funding uplift pharmacies have had since 2014, was a positive step forwards by the government.
“However, pharmacies still face a funding gap of over £2 billion and until there is meaningful progress in meeting this, pharmacies will continue to have to cut back services to patients and in some instances close entirely.
“We are desperate to see the role of pharmacy expand and pharmacies stand ready to deliver the government's 10 Year Plan. But this can only be done with long term, sustainable funding.”
