As has been reported in The Pharmaceutical Journal, pharmacy trade magazines and national and local media outlets, community pharmacies up and down England are facing the threat of huge cuts to their income, threatening non-contractual services, patient safety and even financial viability. These cuts, for most pharmacies, amount to around £5,000 a year plus 35p per item dispensed. I am not opposed to efficiencies where they can be made safely, effectively and responsibly, but fail to see how the proposals made by health minister David Mowat on 20 October 2016 can do anything but destroy an already hugely efficient part of the NHS.
Mowat’s primary justification for the reduction of payments to community pharmacies is his belief that there are too many pharmacies and they are too close together. However, to “ensure a baseline level of patient access to community pharmacy” certain pharmacies will be protected from being adversely affected by these cuts by the pharmacy access scheme. The only two criteria for inclusion in this scheme is that the pharmacy dispenses less than 109,012 items a year and that the pharmacy is more than one mile by road from the next pharmacy.
The Department of Health in England has had some ten months to devise this scheme and this is what it has come up with: two simple criteria that take no account of the services that the pharmacies provide, the people they serve, the ethnic make-up of their communities, the deprivation in their area or any other socioeconomic factor. If a pharmacy does not meet those two criteria, the government seemingly deems it to be superfluous.
So how many pharmacies does Mowat deem necessary to maintain the pharmaceutical provision currently offered by England’s network of around 11,800 pharmacies, and how would he like them to be distributed? He obviously does not appreciate that pharmacies across England offer more than dispensing of NHS prescriptions. Have the tens or even hundreds of thousands of interactions between pharmacies and patients that result in healthy living or self-care advice and a supply of over-the-counter medicines been factored into the pharmacy access scheme? Mowat needs to realise there is a risk that communities with high levels of ethnic diversity or deprivation stand to be more affected by the proposed funding changes owing to the lack of protection offered to these groups in the pharmacy access scheme.