Unnecessary closures: PDA wants 'failing pharmacies' to be taken into 'special measures control'

The Pharmaceutical Defence Association (PDA) has urged health ministers of the UK to take a strict and necessary action against the unnecessary closures of pharmacy.

Concerned over the rising number of pharmacy closures, PDA has written an open letter to health secretary Steve Barclay; Robin Swann, health minister for Northern Ireland; Eluned Morgan, minister of health and social services for Wales; and Humza Yousaf, the Scottish health secretary.

In its letter, PDA said: “The minister of health must now ensure the regulation of poor business behaviours and be prepared to take over rogue pharmacies, however large their corporate owner may be. If patients’ access to NHS services is to be protected from the consequences of avoidable full or part-day pharmacy closures.”

The association believes it is only a matter of time before serious harm to patients’ health will be caused by the decisions of mainly large chains of pharmacies to close some of their branches for all or part of a day, instead of engaging an available pharmacist to cover their agreed opening hours.

“While a small number of unforeseen closures have always occurred from time to time in pharmacies for genuine reasons, the indiscriminate scale at which closures have now become commonplace seems to have evolved over the last 20 months.”

The PDA has also noted a rapid evolution of closures as some pharmacy owners have seemingly become emboldened as no effective action or penalties to stop the closures has been taken by government, regulators, or the NHS (the main customer that commissions and funds the community pharmacy contracts).

The PDA has concluded that to protect patients, and ensure their ongoing access to pharmaceutical care, regulators in the UK should empower the Regulation and Quality Improvement Authority (RQIA) to regulate the business behaviours of companies that operate community pharmacies, including their premises, staffing levels, safety, and treatment of patients.

It's suggested an introduction a regime of financial sanctions on any businesses that breach standards and asked to provide the NHS the ultimate option to take failing pharmacies into special measures control, where the operation of that pharmacy is taken over by NHS.

Based on the actions of those who have taken commercial decisions, regardless of the potential patient impact, to unnecessarily close their branches, the PDA believes these measures are now what is required to adequately protect patients and provide communities with access to the pharmacies they rely upon.

Pharmacy closure in Scotland

Data provided to PDA in response to Freedom of Information requests in Scotland shows that the largest pharmacy businesses closed branches for full or part of days at more than 15 times the rate of other community pharmacies.

Data from NHS health boards in Scotland show that during the first five months of 2022 (1 January – 31 May) non-CCA member pharmacies reported 114 occasions across Scotland that they had to close due to unforeseen events.

“Based on the number of pharmacies owned (53 per cent non-CCA/47 per cent CCA) it would therefore be proportionate if the CCA members had reported closures due to genuine reasons on 102 full or part-day occasions during that same five-month period,” said PDA.

It added: “However, the data evidences that there were actually 1,625 reported closures of CCA member pharmacies in Scotland over that period. That means if a patients’ local pharmacy was operated by a CCA member it was more than 15 times as likely to be closed to patients for at least part of the day, than if their local pharmacy owner was a non-CCA member.”

“It is important to note that while all CCA members are headquartered in England, this data relates to Scotland only and so cannot be blamed on poor funding or previous bad policy decisions provided by NHS England. This information relates only to Scotland’s communities which are covered by the separate contract funded by Scotland’s taxpayers,” it stressed.

PDA asks information commissioner to investigate

PDA has referred NHS England to Information Commissioner over failure to share data on community pharmacy closures.

It said: “NHS England and Improvement has not been forthcoming with information requested under Freedom of Information (FOI) laws about Community Pharmacy closures, resulting in the PDA asking the Information Commissioner’s Office (ICO) to investigate.”

The PDA believe that not only does the practice of closure represent significant risk of patient harm, but it damages the reputation of pharmacy, undermines the chances of higher priority funding from governments, and discourages new entrants to the profession/existing practitioners from choosing to work in the sector.

As part of campaigning work undertaken by the PDA against unnecessary full or part-day pharmacy closure, data was requested from the NHS under the powers within the FOI Act about a range of issues including reported pharmacy closures. The association received data from each of the NHS health boards in Scotland.

“This level of information can only be identified by having the official data, and when one health board initially refused to release the information, an appeal by the PDA to the Scottish data commissioner resulted in an instruction to the health board that they must make a full disclosure as requested. Similarly, the PDA asks NHS England to share their data of reported closures as a matter of public interest,” said PDA.

It continued: “Across the UK, it is the NHS which funds the community pharmacy contracts and as it is a requirement of the NHS terms of service for community pharmacies to report each time that closures occur. Therefore many may have the reasonable expectation that the NHS would be monitoring this critical data already, as a key indicator of how their contract was being delivered.”

PDA added: "Despite multiple requests, NHS England has failed to provide the data, and therefore the PDA has been unable to carry out detailed analysis of this concerning situation to the level which has been possible for Scotland. As is appropriate when a public body fails to adequately respond to a Freedom of Information request, the PDA has escalated the matter to the Information Commissioner to investigate."

The association still hopes that NHSE will provide the data as soon as possible, hopefully before the ICO has to investigate, however if that fails to happen it will be for the ICO to determine what happens next.