Pharmacists have warned the sector is “close to the edge” amid reports they may have to step in for striking nurses.
Millions of patients rely on pharmacies every single day as the first port of call to our national health service. They also offer a whole host of additional services, like help on substance abuse, weight loss, and of course – mammoth vaccination roll outs.
But more than 90% of community pharmacies get their income via NHS contractual funding, which has faced real term cuts of 25% since 2015, the December 2022 Pharmaceutical Services Negotiating Committee (PSNC) community pharmacy briefing showed.
“We are very close to the edge,” said Malcolm Harrison, CEO of Company Chemists’ Association at Boots pharmacy.
‘Haemorrhaging money’
Graham Phillips followed in his father’s footsteps when he became a pharmacist, and now he is the Managing Director of the Manor Pharmacy Group.
He had to close one of his establishments in 2020, as it was “haemorrhaging money”, Mr Phillips explains.
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“At that time, I had a reasonable sized group of 10 pharmacies. It nearly took down the whole group of pharmacies. And as a result, I was on the verge of a nervous breakdown.”
Mr Phillips now owns three out of 10 of the pharmacies, but still struggles to make ends meet with limited NHS funding.
He explains that community pharmacies are “losing money on every prescription” they dispense due to the fact they buy drugs and sell them onto the NHS, often at a loss.
“It’s not sustainable,” he adds. “I reckon in the next 12 months, you could lose a third of the local pharmacies from the network.”
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Skyrocketing prices
The pressure is made worse with the current threat of an invasive form of Strep A causing the cost of antibiotics to skyrocket.
Multiple pharmacies have warned they cannot obtain necessary medications, such as Amoxicillin, to treat Strep A as a child in Sussex died with a suspected infection on Friday, bringing the total up to 16.
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Despite the government insisting there are “sufficient” stocks, diminishing concerns about a national shortage, one pharmaceutical industry leader who agreed to speak to Sky News anonymously, said the cost of Amoxicillin has risen from 80p to £18.
Shortages have been driven by “complicated supply chains,” with the Department of Health and Social Care maintaining that it is “normal” for prices to “fluctuate based on demand”.
More and more pressure, with no money to fund it
Both the National Pharmacy Association and the Company Chemists Association, which represent the biggest and smallest pharmacies across the UK, say it has uncovered a community pharmacist shortfall in England of 3,000, partly due to poor NHS recruitment.
There have been 670 permanent closures since 2015, with both Association’s warning there will be many more, unless adequate funding is provided.
Mr Harrison explains that whilst seeing real term cuts in funding, the sector has also seen “a 36% uplift in workload,” meaning staff are having to do more for less.
But many pharmacies are already struggling to make ends meet, and if they are expected to also help plug gaps that may be caused by NHS strikes, they will need help.
Members of the Royal College of Nursing (RCN) will take industrial action on 15 and 20 December across England, Wales, and Northern Ireland.
“Our experience from COVID shows that when other parts of the system shut down, people go to where is still open, and that’s pharmacies,” says Mr Harrison.
“The problem we have got is that more and more people coming in puts more and more pressure on the pharmacy teams, and there is no money there to fund it, or to get more people in to deal with that pressure.”
Responding to concern held by community pharmacies, a Department of Health & Social Care spokesman has said: “We commit almost £2.6bn annually to support their vital work and improve integration in the NHS.
“In September, we announced a further £100m investment in the sector and commissioned services to enable pharmacies to manage routine oral contraception without a GP prescription, take minor illness and urgent medicine supply referrals from A&E and provide extra support for patients newly prescribed anti-depressants.”
