Key Summary
- Total community pharmacies in England fell to 9,940 in April 2026, down from 9,944 in March.
- The sector is shifting from corporate to independent.
- Number of small pharmacies increased from 5,050 (March) to 5,067 (April), holding a market share of 51 percent.
The community pharmacy sector continues to face uncertain times with rising overheads like Business Rates, increased national insurance and a hike in minimum wages on one hand and inconclusive community pharmacy contractual framework (CPCF) negotiations on the other.
Pharmacy owners have little clarity regarding their future for a viable operation or investment.
In April 2026, the number of pharmacies has remained under 10,000, while continuing their slide over the preceding months.
While there were 9,944 pharmacies in March, it dipped to 9,940 in April. While the month-on-month decrease is small (four sites), it confirms that the sector has not yet found a "floor" and remains at its lowest level since 2005.
The sector has now shed 2,009 locations from its 2015 peak of 11,949 pharmacies.
However, there has been an addition of 17 small pharmacies within a month. It increased from 5,050 in March to 5,067 in April. Their market share has edged up to 51 percent.
Large Units (100+ outlets) dropped by 12 sites this month - falling from 3,179 to 3,167 - as these large chains try to consolidate or divest.
Edge Health findings
The recent Edge Health report, sponsored by Sandoz, said that while smaller and independent pharmacies operate with lower overheads, they are increasingly constrained by high exit costs (e.g. redundancy, lease commitments, loss of a pension-supporting asset), leading in some cases to the persistence of so-called ‘zombie’ businesses that remain operational despite being economically non-viable.
It noted that pharmacy teams are spending a lot of time comparing prices and splitting orders across wholesalers for marginal gains that are later eroded through discount recovery under the current reimbursement system.
"This cycle sustains downward pressure on generic medicine prices to historically low levels, increasing the risk of shortages, price concessions and cash flow pressures – overall damaging the market."
It pointed out that "with only a minority of pharmacy owners now reporting profitability, the mechanism appears increasingly out of step with economic reality."
The report assessed the financial impact of Pharmacy First, the NHS initiative to shift demand from general practice and urgent care into community pharmacy.
Though the uptake for this scheme has been strong among pharmacies, it delivers only modest profitable income for most contractors.
Chemist Warehouse entry
Amid such a bleak scenario, the entry of Australian pharmacy major Chemist Warehouse into the UK market has surprised many analysts. They have acquired stake in some branches of Greenlight Healthcare Limited.
Chemist Warehouse has over 500 stores in Australia and has a presence in China, Dubai, Ireland and New Zealand.
Distance selling up
The number of distance selling pharmacies (DSPs) is accelerating.
The March report noted 75 units added since 2021; but by April it has reached 85 units (moving from 444 in March 2026 to 454 in April 2026) due to delays in approving what should be the final wave of applications.
Extended-hour pharmacies
The pressure on extended-hour sites continues due to increased overheads. The number of 100-hour pharmacies fell from 788 in March to 786 in April. Many of them have now reduced their hours to 70 per week.
It is 310 less than January 2021, which shows the overall dwindling access to pharmacies.
‘Squeezed middle’
Medium-sized groups (6-99 outlets) continue to struggle with the "squeezed middle" effect mentioned previously. They saw the largest month-on-month decline of any group, dropping from 1,715 to 1,706 units. It was 1,749 units in January demonstrating consolidation, closures or disposals in this sector.
The data analysis was done by Michael Holden, founder of MH Associates, using NHS BSA figures.
Why the crisis?
One of the prime reasons for the crisis is over a decade-long underfunding of pharmacies. It began in 2015, and pharmacies have been struggling ever since.
While there was an uplift in funding during 2025 talks, it was not enough and the NHS’ independent analysis had revealed that there was still a shortfall of £2.6 billion.
It was also offset by rises in national insurance, inflation, and increased workload due to local closures and more services to deliver.
The government had in February confirmed that the current funding in real terms is 26 percent less than what it was a decade ago. Pharmacy minister Stephen Kinnock, in a written reply to Liberal Democrat MP Helen Morgan, said the funding for community pharmacies is £800 million less in real-terms today than it was in 2015/16.
Though the 2025 Community Pharmacy Contractual Framework (CPCF) funding marked the first increase in a decade, the NHS’ independent analysis had revealed that there was still a shortfall of £2.6 billion.
The recent war in the Middle East, medicine shortage, and employment difficulties have added to the struggles of pharmacists.
As manufacturers and importers struggle to source raw materials and medicines the prices have gone way above NHS stipulated reimbursement prices. For the past 2-3 months there have been a record increase in price concession requests.
CPE director of research and insights James Davies said, “We have had a record number of price concessions recently, and while these indicate pricing issues rather than necessarily meaning there are medicines shortages, they show that the medicines supply chain is under increasing pressure, which is only likely to get worse in light of the conflict in the Middle East.
