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Anyone who has studied the finances of an independent pharmacy business knows that money is tight. In many cases, they are perilously close to failure. It's easy to assume they are retail businesses, cashing in on the higher public profile the sector has enjoyed during the pandemic years. But those have been mere words. Certainly, the pandemic represented a halcyon period for the profession. We engendered a feeling of normality, dependable and accessible to society. We played a substantive role in keeping people out of hospitals and giving the vulnerable the ability to live independently from their own homes for longer. We mobilised to smash flu vaccination records and deliver covid jabs. But despite the warm words of a new service based future and the incessant expressions of gratitude contractors desperately need the headroom to prepare, plan and invest. Platitudes, press releases and assurances of a bright clinical future are small comfort to what is needed and that's cash on the table. As the adage goes: "Talk is cheap, money buys houses." Cashflow crisis Since 2016, we have witnessed almost 650 pharmacies fall by the wayside. Some may have merged; the majority, however, have perished due to the relentless need for an increasing cashflow. It is cash, or rather the lack of it, which is killing independent pharmacies.

The recent announcement that Royal Mail will be partnering with distance selling pharmacy (DSP) giant pharmacy2U highlights how standards of regulatory enforcement are being ignored to accommodate the DSP model. The brunt of these double standards hinges around the levelling down of temperature enforcement standards by the Medicines and Healthcare products Regulatory Agency (MHRA) which demands mapping must be audited from the point of dispensing to the patient. The MHRA has a well recognised duty to ensure medicines reach patients in a safe condition. The current anomaly appears to turn a blind eye to this step in the supply chain at the point the wholesaler releases goods to the pharmacy hub. Equally the training on delivering medicines safely and effectively direct to patients should apply fully to all hubs including DSPs. Why is it that DSPs are being treated differently to bricks and mortar pharmacies? It's essentially the same patients receiving the same medicines from the same wholesalers. A further regulatory disparity exists around how parcels must be "tracked and signed for" to be reasonably certain medicines are delivered into the hand of the intended recipient, as per existing regulations. Clearly an untracked, unsigned package cannot be guaranteed to finish in the hands of the intended recipient. There is a very real possibility that such omission could lead to community pharmacy closures which will, in turn, lead to unemployment and a reduction in the care services. At a time when integrated care systems have just gone live, the removal of vital support services leading to further inequalities is the wrong message for both providers and patients alike.

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