Widespread pharmacy closures impact older people and rural communities, Healthwatch report reveals

A worrying rise in pharmacy closures across England is disproportionately affecting older people and rural communities, according to a new report by Healthwatch England.

Findings obtained through Freedom of Information (FoI) requests have exposed the scale of the issue, with over 436 permanent pharmacy closures recorded in 2023 and more than 13,800 temporary closures resulting in nearly 47,000 hours lost.

The report, published on Thursday, paints a bleak picture of access to vital healthcare services, particularly in rural areas where pharmacy closures have hit hardest. The report found that Integrated Care Boards (ICBs) in rural areas recorded a higher level of temporary pharmacy closures compared to ICBs in predominantly urban areas.

Additionally, ICBs with a higher proportion of people over 60 years of age recorded a higher number of hours lost per pharmacy.

Healthwatch chief executive Louise Ansari expressed concern about the impact on elderly populations, noting that the closures were undermining the government's flagship Pharmacy First programme, designed to relieve pressure on GP practices by allowing patients to seek care for common conditions at local pharmacies.

“This issue is having huge impacts on older people and is particularly acute in rural regions where people already have to travel further to visit their pharmacist,” Ansari said.

“Staff shortages, the key driver of permanent and temporary closures, call into doubt the potential of Pharmacy First, meaning people can’t get the advice, care and medications they need and when they need them.”

The research has provided the first geographical breakdown of pharmacy closures in England.

• North East and North Cumbria ICB recorded the highest number of temporary closures, and hours lost, with 1,438 closures and 4,054 hours lost. When adjusting for the size of the ICB, Norfolk and Waveney ICB, reported the highest number of hours lost per pharmacy, 17.48 hours.
• South East London ICB recorded the lowest number of temporary closures, 70, and North West London ICB the lowest number of hours lost (212).
• Kent and Medway ICB had the highest average closure length, five hours and 38 minutes, per pharmacy.
• The ICB with the lowest average closure length is North East London, with two hours and 22 minutes, per pharmacy.

Industry calls for urgent action

The report has drawn swift reactions from key industry bodies, calling for immediate investment in the pharmacy sector.

Tase Oputu, chair of the RPS England Board, urged the government to prioritise pharmacy funding and workforce planning to prevent further closures.

“Pharmacies play a vital role in our communities, providing essential healthcare services that have become more in demand as pressures on the NHS continue to grow,” she said.

“These findings highlight the urgent need for sustainable funding and workforce planning to ensure patients are not left without access to medicines and support. Warnings of pharmacy closures must be taken seriously to ensure patients can continue to access a resilient pharmacy network.”

Similarly, Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), emphasised the financial strain pharmacies are under, pointing to a real-terms cut in funding of over 30 per cent since 2015.

“Without significant additional funding, further pharmacy closures are inevitable, and patients will find it harder to access the medicines and NHS care they need,” Harrison warned, urging the government to commit to deliver long-term investment in the sector.

Paul Rees, chief executive of the National Pharmacy Association (NPA), warned that the rising number of closures could create “pharmacy deserts” in parts of the country.

“Community pharmacies act as the front door to the NHS,” Rees said. “If people lose access to them, it will force more patients into the 8 o'clock scramble at their GP surgery, putting pressure on the rest of our NHS system.”

“1.6 million people a day visit their pharmacy but they are closing at a record rate, and millions of people are seeing the effect of that in their communities. If the government wants to cut GP waiting times – and free up GPs to see patients with more serious conditions – it needs to invest in community pharmacy.”

In its report, Healthwatch has urged NHS England to commission a national evaluation of the pharmacy sector to address workforce shortages and funding gaps. The report called on ICBs to analyse and publish monthly figures on the number of temporary closures to inform workforce planning, spot trends in postcode variations, and tackle persistent closures using agreed local hours plans.

The organisation is also advocating for better communication with patients about temporary closures through platforms like the NHS App and local pharmacy websites.

“We know that people's frustration often stems from not being informed about pharmacy closures in advance. Better signposting that pharmacies will be closed and setting out alternatives would go some way to improving patient experience,” Ansari said.

“However, in the longer term, action must be taken to address staff shortages and unequal access. A national evaluation of pharmacy funding and the size, role-mix and distribution of the pharmacy workforce is necessary to improve planning of pharmacy services.”