What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)’s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies.
Pharmacists are not all shocked by the PSNC’s survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions.
“We are bullied into a corner,” said Salim Jetha Chairman, Avicenna.
“Unlike other industries, we can’t increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required.”
Bristol pharmacist Ade Williams said: “The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies.”
“If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?” he questioned.
The survey results don’t surprise Kent-based community pharmacist Amish Patel. He said, “I have been feeling exactly what has been reported for far too long. I’m burnt out and would say beginning to suffer with my own health because of it. Now it’s for PSNC to talk to government, and government to listen and work with us to find resolutions.”
Shedding some light on what pharmacists expect from the government, Olivier Picard owner of Newdays Pharmacy said: “The government will need to do several things. The first one is they need to address the existing funding of community pharmacy immediately so that the hundreds of pharmacies closures that we've seen in the last few years, don't run into the 1000s. Because that puts extra pressure on the neighbouring pharmacies. And we need this investment in the sector to be now, not in a year's time or two years time when a new contract is negotiated.
“The second thing that we need is extra funding for community pharmacy for new services. So any new services that is launched in community pharmacy. If we expect the pharmacist to do more, for the same amount of money, then I'm afraid we are setting ourselves to fail.”
“We need the government to think long and hard about the future of community pharmacy. Do they want a reduced network of pharmacies to just dish out pills from mail order? Or do they want a pharmacy network that is supporting their community supporting doctors, nurses, any department but taking the pressure of those other services so that everyone can work together. And the only way we're going to have this is if the government is reasonable about the next contract that is negotiated and issued and whether there is inflationary rise built up in that contract, whether there is extra services that are worth the pharmacy doing in that next contract.”
Government must adequately fund the pharmacies
The National Pharmacy Association (NPA) vice chair Nick Kaye commented: “This data is further confirmation that cuts have consequences, not only for pharmacy contractors and staff but also for patients. It’s tragic that pharmacists are now less able to provide the prompt service people have become used to over the years. It should also ring alarm bells in government and at NHS England that pharmacists are spending less time with each individual patient, as a result of funding cuts. Doing more and more for less and less is clearly unsustainable, as these results clearly show.”
The survey reflects the results of RPS Workforce Wellbeing survey which demonstrated that 70% of respondents identified inadequate staffing as one of the major issues affecting mental health and wellbeing in the workplace, and 88% rated as being at high risk of burnout.
The Royal Pharmaceutical Society (RPS) Director for England James Davies said: “We know pharmacists and their teams are experiencing burnout due to workforce and workload pressures, exacerbated by perpetual underfunding of the system.
“We hope that the upcoming NHS England workforce plan addresses some of the issues around retention and recruitment into the pharmacy workforce to help ease some of these pressures.
“Patients may need to wait a longer than usual due to increased pressures on the service. We ask patients to respect our pharmacy colleagues who are working incredibly hard to support patients with the advice and medicines they need.”
Dr Leyla Hannbeck CEO of AIMp said: “The government’s machinery are turning a blind eye to the plight of our sector and its impact on patient care and health inequalities. One example of serious pressures reported is the medicines supply issues.”
“For months AIM has been raising concerns about medicines supply challenges to DHSC, Ministers and in the national media — the DHSC have consistently denied that there are issues and they have failed to take action. Every year pharmacies fill in the pressure survey in the hope that their plight is heard and that decision makers take action. Our sector is currently fighting for its survival and we hope PSNC can use this data to effectively negotiate with the DHSC.”
“Patients need all of the health service, including community pharmacies, to be properly resourced and the PDA support pharmacy businesses in their efforts to secure fair funding for England’s pharmacies from the Westminster government,” said Paul Day Director, Pharmacists Defence Association (PDA) Union.
This is a serious concern and regardless of their own funding challenges employers must still meet their duty to ensuring the health and safety of those that they employ.
Such poor working conditions are also a contributor to many pharmacists reducing their hours, becoming locums or leaving practise altogether, which only adds to the pressures on community pharmacy operators and has other longer term impacts for the profession.
If England is to have the pharmacist workforce necessary to care for patients, employers must make their working environments safe for staff, as well as for patients, and government must adequately fund the pharmacy contract.”
A CCA spokesperson said: “The results of PSNC’s Pharmacy Pressures Survey come as no surprise. This is further confirmation that the pharmacy sector is on the brink of collapse. It is a sad reality that 81% of pharmacy owners are experiencing workload pressures, which is affecting their ability to help patients.
Earlier this year, the CCA uncovered that since 2015, there has been a net loss of 720 pharmacies – a worsening trend that shows no sign of abating. Coupled with underfunding of more than £67,000 per pharmacy annually, it is clear that the sector is fighting to survive.
It would be wholly irresponsible for Government to disregard the Pressures Survey’s findings. Community pharmacy funding is broken and needs a complete re-think – otherwise, we will continue to see a deterioration of the network, impacting patient care across the country particularly in the most deprived communities.
One step the Government must take is to commission a fully-funded Pharmacy First service in England. Recognising and rewarding the work coming into pharmacy from stretched GP services, is a crucial step in stabilising the network. This service would utilise the potential of community pharmacy to make a huge impact on patient access in primary care at a critical time for the NHS. We call on the NHS to use the upcoming Primary Care Recovery Plan to announce such a service.”
The survey of over 6,200 pharmacy premises and 2,000 pharmacy team members indicated that the majority (96%) of pharmacy owners are facing significantly higher costs than last year – up from 80% in the 2022 pressures survey – and many are operating understaffed due to both insufficient funding (48%) and staff unavailability (34%). But at the same time, 92% of pharmacy teams cited a significant increase in requests from patients unable to access General Practice and 71% reported problems sourcing medicines.
Many pharmacy staff (81%) say they are struggling to cope due to a significant rise in workload and 78% report that their work is having a negative impact on their mental health and wellbeing. And, unsurprisingly, 78% of pharmacy owners are extremely concerned about their business finances with 41% now extremely worried about their ability to help patients.
Graeme Duncan 
