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Community pharmacy

England has lowest number of community pharmacies in five years, figures show

A net loss of 166 pharmacies in England during the financial year 2019/2020 resulted in the lowest number of contractors since 2015/2016.

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There were 11,826 active community pharmacies and 112 active appliance contractors during 2019/2020

Closures in 2019/2020 have resulted in the lowest number of community pharmacies in England since 2015/2016, figures from the NHS Business Services Authority (BSA) have revealed.

According to the report, published on 19 November 2020, there were 11,826 active community pharmacies and 112 active appliance contractors during 2019/2020. Overall, 239 new pharmacies opened, while 405 closed; a net loss of 166 pharmacies during the financial year.

The report, which covers the financial years between April 2015 and March 2020, does not take into account the effects of the COVID-19 pandemic.

The figures follow data revealed by The Pharmaceutical Journal  in September 2020 that showed a net loss of 136 community pharmacies in England in the first eight months of 2020, which contractors attributed to the impact of the pandemic.

Simon Dukes, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC), previously warned in March 2020 that many community pharmacies were on the “brink of collapse” as workload increased.

“Despite contractors’ best efforts (including dipping into their own money), many have had to make difficult decisions in recent years, with sometimes disastrous impacts on staff and local communities,” said Dukes, commenting on the figures from NHS BSA. He told The Pharmaceutical Journal that COVID-19 had only “worsened the situation”.

”The PSNC is still waiting for responses on its bids for a CPCF [community pharmacy contractual framework] funding uplift and for the £370m in advance payments to be written off,” he added.

“HM Government must act: without this additional support we could see mass closures and redundancies in the next 18 months. This would have a catastrophic impact on patients and is utterly counterintuitive in a global health crisis.”

The DHSC announced in March 2020 that it would be providing £300m in advance funding to community pharmacies, but it insisted that this would have to be repaid. Since then, the government has announced an extra £70m in advance funding.

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, said she was “surpised” that there had not been more closures than those recorded.

“Pharmacy has streamlined its cost-base as far as it can [to] mitigate the reduced funding,” she said.

“It is worth noting that, unlike other healthcare providers, pharmacies have a raft of obligations such as premises lease, [and] staff redundancy costs involved in closing pharmacies.

“It is always difficult to understand whether some of the openings and closures are connected, and the process of consolidation is quite an unwieldy one, but we believe the continuing direction will be a reduction on total numbers.”

The report also highlights that the cost of drugs and appliances reimbursed to community pharmacies and appliance contractors totalled £8,649m in 2019/2020; an increase of 5.1% from £8,229m in 2018/2019, following four consecutive years of decreases from the five-year high of £8,664m in 2015/2016.

The NHS BSA said the rise was “in line” with the number of flu vaccines administered, the costs of which increased by 4.29 times between 2015/2016 and 2019/2020 from £3.75m to £16.1m.

In addition, the figures show that the number of items dispensed by community pharmacies in England had increased by 4.07% since 2015/2016; and the number of items dispensed by appliance contractors had increased each year since 2015/2016, from 7.91 million to 9.79 million items — an increase of 23.7%.

Owing to the lowest number of community pharmacies and highest number of items dispensed since 2015/2016, the average number of items dispensed per pharmacy for 2019/2020 was the highest of the previous five years at 87,584.

Andrew Lane, chair of the National Pharmacy Association, said that, in recent years, pharmacies have done more and more but for less return.

“Costs are rising and funding has declined, a painful and unsustainable combination. Too many pharmacies have been running on empty and closures are inevitable in these circumstances.

“Given the right support, community pharmacists can do so much more to improve people’s health and relieve pressure on GPs and hospitals. Without a change to the current underfunding, we will witness the irreversible decline of the community pharmacy network in England.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208569

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