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With “too few resources in the places where it is needed most”, community pharmacy is on a “current trajectory” that will mean the sector may face similar access problems to general practice, a government-commissioned review of the NHS has found.
The ‘Independent Investigation of the NHS in England‘ — published on 12 September 2024 — was commissioned by Wes Streeting, the secretary of state for health and social care, in July 2024 to understand the current performance of the NHS across England and the challenges of the healthcare system.
The report was conducted by Lord Darzi, who had previously conducted a review of the NHS in 2008 with the aim of improving the quality of care.
His latest report highlighted that while “one of the great strengths of the health service in England has been the accessibility of community pharmacy” — particularly in areas of highest deprivation — access has deteriorated in recent years, with around 1,200 pharmacies closing since 2017.
With community pharmacies closing in “significant numbers”, the report said there is “a very real risk that on current trajectory, community pharmacy will face similar access problems to general practice, with too few resources in the places where it is needed most”.
The report noted that GPs are struggling to meet patient demand “as the percentage of respondents to the GP patient survey who said they had to wait a week or more for a GP appointment increased from 16% in 2021 to 33% in 2024″.
In January 2021, The Pharmaceutical Journal revealed for the first time that three times as many pharmacy closures occurred in the most deprived areas of England in 2020, compared with the number of closures in the least deprived areas.
Commenting on the report, Paul Rees, chief executive of the National Pharmacy Association, said: “The very real risks to patients from chronic pharmacy underfunding and closures highlighted by Lord Darzi’s report need immediate action to guarantee people’s access to medication and care.
“Lord Darzi is right to point to the huge opportunities for pharmacies, which can be a big part of the solution to GP waiting times, reducing demand for hospitals, prevent illness and help the huge numbers of people off work with long-term conditions, but it needs urgent attention.
“We desperately need to invest in grassroots community healthcare like our pharmacy network, otherwise the government’s ambitions to reform the NHS simply won’t work,” he said.
Darzi’s report also noted that community pharmacy has the potential to provide “even more value-added services for the NHS”, as seen by notable successes such as the Pharmacy First Programme, along with changes in the clinical role of pharmacists where all newly qualified pharmacists will be independent prescribers from 2026.
However, Malcolm Harrison, chief executive of the Company Chemists’ Association, said: “[This] is only possible if there is action to protect the existing community pharmacy network through additional investment.
“We hope that the report’s findings spur action before it is too late, and patients lose access to the local pharmacies that they have come to rely on,” he added.
Janet Morrison, chief executive of Community Pharmacy England, said: “The report’s findings paint a bleak picture of primary care. This is even more so for community pharmacy. We have received less than any other part of the NHS, with a 30% cut in real terms over the past seven years and a fall in share of the NHS budget from 2.4% to 1.6%.
“At the same time, pharmacy teams have delivered far greater efficiency with year-on-year increases in dispensing of 160 million items and a 350% increase in service delivery.
“The stark financial situation has reached a tipping point, and the degradation of service and risk of collapse is now putting at risk the most basic of the public’s expectations of the NHS — the safety of their medicine supply — critical to the 48% of the population who rely upon their pharmacies for their repeat prescriptions.”
Tase Oputu, chair of the Royal Pharmaceutical Society English Pharmacy Board, said: “While today’s report sets out some significant challenges, as a key contributor to the report I’m pleased that our evidence has highlighted the real opportunity for pharmacist prescribing to enhance patient care.
“Policy discussions must now turn to how we can make the most of this potential, backed by workforce planning, prescribing budgets, and the commissioning of new services to use pharmacists’ skills.
“At the same time, warnings of pharmacy closures must be addressed so that patients can continue to access a resilient community pharmacy network.”
