Philip Hunt on the increased risks to the viability of thousands of community pharmacies
With the NHS now preparing for what promises to be one of the most pressurised winters ever, it seems perverse that community pharmacists – well placed as they are to take some of the load off other busy health professionals – face a cut in funding.
These pharmacies are the most accessible of all healthcare services, with many extending their hours and services. Last year, saw an average 137 visitors each day, 281 medical reviews, the dispensation of around 87,000 prescribed products, and the distribution of nearly a million flu vaccines.
According to a Price Waterhouse Coopers (PwC) analysis commissioned by the Pharmaceutical Services Negotiating Committee (PSNC), in 2015, community pharmacies contributed £3bn in value to the NHS and public sector in England. This included £1.1bn for the NHS; £600m in benefits to patients and £242m avoided in treatment costs.
Budget cuts and changes to how funding is distributed are putting all of this at risk, and threatening an increased burden on GPs and A&E departments.
The majority of community pharmacies’ funding comes from the NHS, and pays for premises staff and all other operating costs. Funding reductions however, have seen a 7.5% drop in financial support since 2015-6.
These are not the only changes to funding, as a number of dispensing fees will be combined into one – with established fees being phased out. Pharmacies in isolated areas will receive funding from an access scheme and high performers will receive an extra £75 million in quality payments as a way of promoting greater cooperation with other parts of the NHS. In addition, a pharmacy integration fund will provide an extra £42 million. All of this is welcome but it will not ameliorate the impending crisis, as the overall package risks the viability of many pharmacies.
The government is well aware of the scale of the potential closures. In a meeting last year with the All Party Pharmacy Group, the then Health Minister Alistair Burt said multiple pharmacies are more likely to adapt to the new system than the smaller independents. In fact, he forecast between 1,000 and 3,000 would close. So much for Tory support for the SME sector!
Currently in many parts of the country, such as busy high streets, there is a choice of community pharmacy. For a government supposedly in favour of competition, it’s surprising that a stated aim of its approach is to reduce that choice. But it’s also a real worry that our more deprived areas are the most vulnerable to such closures
Pharmacies have also been hit with unpredictable high wholesale bills. With a squeeze on NHS funding alongside this, many have been left in in difficulty trying to find a source of credit to pay thebills. The PSNC are warning that banks may withdraw credit if income covenants are not met.
There is palpable fear within the sector about the impact of overstretched services in the past few months and a dire situation this coming winter. If predictions are correct, Britain will be hit by a flu epidemic that began in Australia. Community pharmacies will be on the frontline of this.
In the Lords today, I will drawing attention to these problems. For the sake of the millions of peopledependent on nearby and well stocked community pharmacies, ministers must stop the madness.
Lord Philip Hunt of Kings Heath is Shadow Health Minister in the House of Lords. He tweets @LordPhilofBrum
Published 19th October 2017