A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England – around a third of the network – having no option but to shut their doors to patients in the next few years.
That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering – it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years.
The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions.
The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures – 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government’s approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.
Neglecting pharmacy in this way is a recipe for disaster. The GP network is in decline – 1,700 fewer GPs since 2015; over a third of GPs want to take early retirement – and A&E is already strained beyond its capacity. Pharmacy is the 3rd pillar of access to NHS care alongside GPs and A&E which more than proved its worth during the height of the COVID pandemic.
Pharmacy could alleviate the strain on other parts of the NHS and improve patient care and outcomes, but it is being starved of government funding. Funding was fixed at £2.6bn in 2019 for five years which takes no account of inflation which as we know has reached scary levels. The 2019 contract is no longer relevant to the economic realities of 2022.
Local pharmacies are a national healthcare asset which is used and valued by the communities they serve. We are in danger of losing many of those vital local pharmacies which simply results in yet more pressure on GPs and A&E and more avoidable cost for the NHS.
That makes no sense to me.
I hope the government will rethink pharmacy funding austerity and help prevent closures before it is too late. For too long, the sector has suffered from 'here today, gone tomorrow' health secretaries resulting in no clear sustainable long-term strategy for integrated care and 'start-stop' policy making which is a barrier to sector investment decisions: what they commit to now they know will be someone else’s responsibility to deliver or change in the next few months and years.
Community pharmacy and patients deserve better. And we must not forget that it was government policy to promote extended hour pharmacies which led to thousands of more pharmacies opening which the government says it will not now fund sufficiently, but still wants them to be open to avert a winter NHS crisis.
By Steve Anderson
Steve Anderson is the UK Group Managing Director of Phoenix.
Sukhi Basra