Almost three quarters of distance-selling pharmacies are breaching NHS contracts, Company Chemists’ Association claims

Around 72% of distance-selling pharmacies (DSPs) are breaching their NHS contracts by dispensing the majority of their prescriptions to local patients, an analysis by the Company Chemists’ Association (CCA) has found.

The CCA says that DSPs that dispense too heavily to patients in their local area are putting local bricks and mortar pharmacies at risk, and it has called on NHS England (NHSE) to audit all DSPs on whether they are meeting their contractual obligations.

DSPs are intended to provide medicines to patients remotely, for example by post or by courier, and they are contractually required to offer their services and deliver prescriptions across the whole of England.

The CCA said that while DSPs can operate with reduced costs through lower staffing levels, rents and other overheads, this should be offset by higher costs of delivering medicines across the country. But DSPs working on a local footprint create an uneven playing field, putting local pharmacies at risk, the CCA claims.

Using NHS Business Services Authority data that showed there were 374 active DSP contracts at the end of 2022, and then analysing which GP practice issued the prescriptions that each of them dispensed, the CCA found that 72% of DSPs dispensed more than 50% of their prescriptions to patients living in a single postcode area located within 10 miles of the pharmacy.

One DSP dispensed 99.9% of items within a single postal area, and another dispensed 0.0004% of items to patients living more than 10 miles away, the CCA found.

The CCA has called on NHSE to audit DSPs in England, investigate DSPs identified as clearly not offering or providing their services to patients nationally, and challenge DSPs to provide evidence of national service provision and ultimately revoke contracts from DSPs failing to meet contractual requirements.

Malcolm Harrison, chief executive of the CCA said: “It is important that patients have a choice in how they access their medicines and can change this according to their needs.

“However, ‘pseudo-DSPs’ are disrupting the market. NHSE must revoke the contracts of DSPs that continue to fail to meet their contractual requirements.

“It is down to NHSE to investigate, audit and challenge them so they no longer cause a threat to face-to-face access to pharmacy advice.”

A superintendent pharmacist from one DSP, who did not want to be identified, told The Pharmaceutical Journal that some independent pharmacy groups had long-standing pharmacy premises that had been operating as a DSP for many years, and had developed good relationships with local GP surgeries, care organisations and local authorities.

“If these premises are big enough they have adapted over time to become a hub for the ‘spokes’ of the other pharmacies in the group, and they’ve retained the DSP side of the business as an internet pharmacy, plus a local delivery option,” they said.

An NHS England spokesperson said: “Local community pharmacies play an important role in delivering a range of NHS-funded services, but it is right that patients should be able to choose where and how to get their prescriptions.

“Distance-selling pharmacies are required to deliver medicines to anyone who requests them anywhere in England, and where there is evidence that a company is failing to do so it will be investigated by local NHS systems and appropriate action taken.”