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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.

A new report from Community Pharmacy England (CPE) has raised alarms about the severe financial challenges plaguing pharmacies across the sector, threatening their ability to provide even the core services for their patients. The findings are based on responses from over 6,100 pharmacy owners and 2,000 pharmacy staff who participated in the recent Pharmacy Pressures Survey 2024. The report reveals that spiralling costs and increased workloads, coupled with a 30 per cent funding cut in real terms since 2015, are putting countless pharmacies at risk of closure. "Nearly 1 in 6 may close within the next year," the report revealed. A vast majority (94 per cent) of pharmacy owners reported that they have seen significant increases in costs, with almost two-thirds (64 per cent) saying they are operating at a loss. Concerningly, these financial pressures are now affecting patient care, as 18 per cent of pharmacy staff reported severe impacts. The survey revealed that most pharmacies are experiencing longer prescription dispensing times (86 per cent), delays in responding to patient inquiries (80 per cent), and less time to spend with patients (79 per cent).

Lloyds Pharmacy's closure of all its 1,300 branches will wake-up the ministers and NHS officials to the reality of community pharmacy sector in England has reached crisis point, expressed Nigel Swift Managing Director of Rowlands pharmacy and Deputy Managing Director of PHOENIX UK. On Friday, The SUN reported that the UK's second largest pharmacy provider - is allegedly in the process of selling its entire estate of 1300 branches. Lloyds Pharmacy will no longer be a High Street presence following its decision to put all its pharmacy branches at the risk of closure. In January it has announced to close its 237 Sainsbury-based pharmacies. Nigel highlighted the fact that community pharmacy is struggling due to insufficient government funding and immense pressures on GPs and A&E departments - an ongoing issue which poses a very real threat to the sector. Commenting on the announcement, he said: "It's not just Lloyds - an independent analysis by Ernst & Young estimated that 75% of community pharmacies will be in financial distress in the coming years. £750 million has been taken out of the English contract due to inflation since it began."

"I dread the day, the accountant turns to me and says 'this isn't working' - as an owner, we shelter our patients and teams from the financial pressures we feel on a daily basis," shares S.G Barai Pharmacy owner, Reena Barai. Today, S.G Barai Pharmacy in Sutton, Surrey joined pharmacies nationwide in the #SaveOurPharmacies day of action, organised by the National Pharmacy Association (NPA) to spotlight the critical funding crisis facing community pharmacies across the UK. Recent figures reveal that over the past decade, more than 1,400 pharmacies have closed in England, Wales, and Northern Ireland, with additional closures looming in Scotland due to financial pressures. The NPA reports that three-quarters of pharmacies are operating at a loss, exacerbated by real-terms cuts to funding. "We turned our lights off and wore black today to symbolize the precarious situation pharmacies like ours are facing," said Reena Barai who owns the pharmacy.

The National Pharmacy Association (NPA) has called on the NHS and the Department of Health to immediately publish the government-commissioned analysis of pharmacy underfunding and reveal the true scale of the crisis. Commissioned by NHS England, the long-awaited independent review is expected to "lay bare the perilous financial state" of community pharmacies, which is a vital part of the nation's health infrastructure. However, the NPA is concerned that the government may delay its release until after current funding consultations are concluded. The NPA argued that the public needs to understand the fragile nature of the pharmacy network before any new deal can be agreed. It has also warned health officials not to hide "the true scale of funding needed to reverse a decade of swingeing cuts", which has forced record numbers of pharmacy closures. NPA chair Nick Kaye said: "It would be a scandal to keep that evidence buried secret and leave MPs, pharmacies and the public in the dark." He acknowledged that the new government has inherited a crisis in pharmacy funding and emphasised that it will need to take "strong action" to maintain access to medicines.

The National Pharmacy Association (NPA) has warned of multi-million financial hit for community pharmacies, while the Pharmaceutical Services Negotiating Committee (PSNC) has renewed its calls for urgent financial support amid a looming energy bill crisis. NPA board member, Olivier Picard, this week shared a screenshot of his estimated electricity bill on WhatsApp groups. Upon expiration of his current arrangements, in October, his electricity bill could rise from its current £1,821 for one pharmacy to an estimated £6,914 - a near fourfold increase. Piccard said: "This is an eye-watering rise in costs for my own pharmacies and adds to the intense financial pressure we're already under. My standing charges will multiply by 10 and the overall cost to each pharmacy amounts to about £5,000." His comments come just ahead of an NPA-commissioned report into pharmacy inflation which will provide an analysis of inflationary costs pressing on the community pharmacy sector, from utilities and workforce to medicines purchasing.

Digital pharmacy app Charac has raised over £1 million in debt and equity, bringing total funding to date for the London-based startup to £2.5m. Pharmacy Business understands while the majority of the new finance, worth about £1.2 million, comes from the National Pharmacy Association (NPA) coffer, the remainder is put forward by a number of individual pharmacy businesses. The pharmacy sector is in a state of crisis, experiencing nearly two closures per week over the past two years, Charac said in a statement. According to data from the NHS Business Services Authority, there are now only 11,026 community pharmacies in England, the lowest number since 2015. The current crisis is attributed to escalating operational costs, a shortage of staff, and diminished government financial support.

A group of 20 parliamentarians has written to health secretary Wes Streeting MP, calling for urgent government action to address the growing financial crisis facing community pharmacies. In the cross-party letter, supported by Community Pharmacy England (CPE), the MPs warned of a real risk of more pharmacy closures, with one in six pharmacy owners saying that they are unsure if their pharmacy will survive the year. They have urged the Department of Health and Social Care (DHSC) and NHS England (NHSE) to prioritise long-term planning for pharmacies, including the implementation of the Community Pharmacist Prescribing Service. The MPs have also highlighted the need for more effective marketing for Pharmacy First to increase both walk-ins and referrals to this critical service. CPE chief executive Janet Morrison welcomed the support of 20 cross-party parliamentarians and recognising the vital role pharmacies play in the local community. She stressed the urgent need for immediate government intervention to ensure the survival of the sector and to maximise its potential in providing accessible care.

The National Pharmacy Association (NPA) is distributing new campaign materials to pharmacies across England this week to empower them to advocate for fair funding in the forthcoming general election. These include campaign posters, stickers, postcards for patients to send to MPs and petition materials. By supplying these resources, the NPA aims to boost its cross-sector #SaveOurPharmacies campaign and help pharmacies raise local and national awareness of the funding crisis that is forcing pharmacies to close at the rate of 10 a week. NPA chief executive Paul Rees said: "Pharmacies are under crushing financial pressure. We want to help them join our efforts to raise the profile of the funding crisis and make the public and politicians fully aware of the threat to our much-loved pharmacy network.

Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government addresses supply problems and resolves the critical financial state of community pharmacies. CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients. Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy businesses fighting for survival. "As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said. Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also face the consequences.

Many community pharmacies are under severe financial strain due to chronic underfunding and a mismatch between medicine costs and reimbursement rates. A report by the National Pharmacy Association (NPA) revealed that NHS underpays pharmacies by up to £75 a pack for common medicines, resulting in losses of thousands of pounds each month. The NPA analysis found that, in many instances, NHS funding covers only one-fifth of their purchase costs for medicines. Nemesh Patel, Managing Director of the Southdowns Pharmacy Group, said the current pharmacy funding contract is "completely broken and beyond farcical." Sharing their struggles, he tells Pharmacy Business: "Our teams are wasting hours and hours trying to just source medication for patients when they could be better using that time to clinically support our patients, and then when it comes to reimbursement, the drug tariff prices or concessionary prices are structured such that on hundreds of medications we dispense per month, we will be making a significant financial loss, each and every single time our pharmacies dispense that medication."

Sector leaders have welcomed the NPA ballot results, which demonstrate that community pharmacies are prepared to take collective action if a funding increase is not achieved. Nearly all pharmacy owners, who participated in the NPA ballot, said they were willing to limit their services to protest funding cuts. Commenting on the poll results, Malcolm Harrison, CEO of the Company Chemists' Association (CCA) said: "The results of the NPA ballot serves to underline the huge pressure that pharmacy contractors face, following a decade of underfunding. He emphasised the need to start the Community Pharmacy Contractual Framework (CPCF) renegotiations for 2024/25 without delay. "The government and NHS must uplift all elements of the contractual framework, to stop further reductions in pharmacy opening hours and permanent pharmacy closures, and to ensure that patients can continue to receive the medicines and clinical care and advice they need," he added. Harry McQuillan, Chairman of Numark, stated that while the NPA ballot outcome has once again brought the financial crisis facing the sector into focus, this is "an everyday reality" for many independent pharmacies and that it has reached "breaking point." He warned that rising operational costs including the increase in national insurance and minimum wage will push many more to the brink.

After the government announced to award pay rise to pubic sector workers, pharmacy trade bodies have expressed their disappointment at the neglect shown towards funding crisis in community pharmacy. The National Pharmacy Association (NPA) chair, Andrew Lane, said: "Our sector can't help but feel utterly neglected after seven years of crushing real terms cuts to pharmacy funding, amounting to half a billion pounds, and no hint of any relief to come. "This week's public sector pay awards, which include a large number of our health service colleagues, highlight that there's an unresolved funding crisis in community pharmacy which needs urgent attention." "Four months into this financial year, there is as yet no clarity even on current arrangements." "After stepping up to tackle Covid and keep the wheels on the NHS, the sector deserves better than to be neglected in this way," Andrew opines.

The English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of community pharmacy as the third pillar of patient access to essential healthcare. Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC announces no new long-term investment to sustain the sector. Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners. Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated. Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances need open heart surgery not a couple of paracetamol tablets.

Trade bodies have reiterated the call for more funding in response to the reports that ministers are considering a Pharmacy First scheme amid the NHS strike. The Sunday Telegraph reported that pharmacies could be drafted in to help the NHS to cope when other healthcare workers take industrial action. But, a PSNC committee member has warned on Monday that the government suggestions are "categorically impossible" without extra funding. The Company Chemists' Association (CCA) has echoed the sentiment, saying pharmacy network is on the brink of collapse. "We welcome plans for a Pharmacy First scheme in England. However, after eight years of funding cuts, the pressures on community pharmacies are simply untenable," Malcolm Harrison, chief executive of the CCA, said.

Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health and Social Care Committee Steve Brine has said. Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a parliamentary debate focused on the future of community pharmacies on September 14. From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible solutions for a sustainable future in the sector. Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs Taiwo Owatemi and George Howarth among others.

In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.

Pharmacies across Northern Ireland are in financial turmoil, reporting that they are dispensing prescription medicines at a loss due to inadequate reimbursement from the Department of Health (DoH). This crisis has led to the closure of almost a dozen pharmacies over the past 18 months, with many others struggling to stay open. Siobhan McNulty, who runs Melvin Pharmacy in Garrison, County Fermanagh, described the dire situation. "We're dispensing medicines at a loss," she said. "The reimbursement rates don't match the cost of the drugs, and we're left to cover the gap." McNulty relies on sales of non-pharmaceutical products to keep her business running.

The National Pharmacy Association (NPA) survey revealed that 93 per cent of respondents experienced 'at least one month' of negative cash flow across their pharmacy business in 2022. Nine out of 10 pharmacy owners responding to NPA survey said they made a net loss dispensing medicines for the NHS during 2022, for at least one month of the year. According to the poll, 48 per cent of them lost money on this core NHS service for six months or more. 45 per cent said their overall outgoings had exceeded overall income in at least six months of the year. NPA Chair Andrew Lane said: "This survey shows the bleak financial reality facing many independent pharmacies after years of underfunding. Dispensing at a loss and negative cashflow is clearly unsustainable." "This funding crisis must be addressed urgently or pharmacies will fall into a spiral of declining services and ultimately widespread closures, he added. "Tragically, the story is playing out very much in line with independent research commissioned by the NPA last year, which warned of a nationwide financial emergency in our sector."

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."