Pharmacies across England, Wales, and Northern Ireland are taking bold steps to address growing funding pressures, as many owners have voted to cut their opening hours and limit services. This significant move follows the unprecedented ballot conducted by the National Pharmacy Association (NPA), which saw 3,339 community pharmacies participating. An overwhelming 97.8% of those who voted support the proposal to serve notice on opening hours, meaning fewer pharmacies will be available during evenings and weekends.
This historic decision reflects the mounting frustration among pharmacy operators who feel the weight of prolonged underfunding. The NPA has urged for an annual £1.7 billion funding increase to fill the ‘financial hole’ created by budget cuts over the past decade. Pharmacy funding has plummeted by 40% since 2015-16, accounting for inflation, leaving many independent community pharmacies struggling to keep their doors open.
During the ballot, more than 96% of those voting indicated they would stop providing locally commissioned services, such as emergency contraception and smoking cessation programs, which are not directly funded by the National Health Service (NHS). This collective action is set against the backdrop of rising operational costs due to increasing employer National Insurance contributions and National Living Wage adjustments.
Nick Kaye, the NPA chairman, expressed the sentiment of many pharmacy owners, stating, “Pharmacies desperately want to support their local communities with access to medicines and advice but have been forced to the brink by this decade of underfunding.” He added, “Pharmacy owners are not radical but after record closures and persistent funding cuts, something has got to give.”
Looking at the statistics, about 700 independent pharmacies have closed across England over the last two years, which averages out to about seven closures per week. Over the past decade, more than 1,250 have shut down, indicating the severity of the crisis facing local pharmacies.
With the new measures, pharmacies may limit their operations to just the core 40 hours required by contract, significantly reducing patient access to medicines and healthcare guidance. They could also withdraw from providing free home delivery for prescriptions and services such as monitored dosage systems for patients needing assistance with managing their medications.
The future of services offered by pharmacies hangs delicately in the balance. The NPA stresses the need for urgent talks with the government to address these funding issues decisively, or patients could be hurt by the withdrawal of valuable healthcare services.
While the Department of Health acknowledges the important role of community pharmacies, they have expressed the challenges of addressing the issues faced by these independent businesses, which often fall outside the governmental structure. The government remains focused on moving more healthcare services from hospitals to community settings, especially highlighted within their 10-Year Health Plan.
Pharmacies currently serve as the frontline of health services for many communities, helping to dispense medications, administer vaccines, and provide guidance on various health issues. Reducing their hours of service puts additional pressure on patients who may struggle to find alternative healthcare options.
Dr. Leyla Hannbeck, head of the Independent Pharmacies Association, voiced concerns over the situation, noting, “The community pharmacy sector is experiencing a genuine crisis,” citing the £1.7 billion shortfall now worsened by recent budgetary hikes. The NPA and other pharmacy organizations are calling on the government to act before the situation deteriorates.
Pharmacy funding arrangements are complex, with decisions determined at various governance levels. While the devolved governments set baseline funding for pharmacies, decisions about medicines and their remuneration are made at Westminster. This split can complicate discussions surrounding equitable funding and support for community pharmacies.
Many pharmacists report feeling demoralized and uncertain about their futures, worried not just for themselves but for their patients who rely on them for healthcare needs. The ethical dilemma between wanting to serve the community and facing financial hardship is tearing at the fabric of these independent businesses.
Pharmacists warn of the impact on vulnerable populations, including the elderly and those on low incomes, who may be most affected by the potential withdrawal of services. “We are unable to raise our prices like traditional businesses,” lamented pharmacy owner Ashley Cohen, emphasizing the static nature of pharmacy funding governed by contracts with the NHS.
Despite the bleak outlook, there is still hope among pharmacy teams and advocacy groups pushing for government dialogue to modernize and increase funding for pharmacies to cover the clinical services expected of them.
Such proactive measures like the Pharmacy First initiative rolled out earlier this year will enable pharmacies to treat common conditions. Still, significant limitations could arise if funding and staffing concerns are not addressed.
The NPA insists pharmacies truly want to fulfill their roles within the healthcare ecosystem. Still, without necessary support, they will increasingly find themselves unable to do so, risking their place within the health service many have dedicated themselves to for generations. With these proposed changes looming, it’s clear the community pharmacy sector is at a crossroads, needing urgent attention and meaningful reforms from government entities to secure its future.
