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The funding system for community pharmacy must be completely overhauled if the existing network of pharmacies is to survive, pharmacy representatives have told MPs.
Appearing at the first in-person hearing of the House of Commons Health and Social Care Select Committee inquiry into pharmacy on 21 November 2023, Malcolm Harrison, chief executive of the Company Chemists’ Association, said the biggest problem facing the sector was funding of core dispensing businesses.
“The real challenge facing the sector is that while there is new money available to deliver new workload, which is good, the funding for the existing workload, the 80–85% of what pharmacies currently do, is chronically underfunded and there is a risk that the ability to deliver for the future will be impacted by the ability to deliver today,” he said.
Asked by select committee member Rachael Maskell if the whole community pharmacy contract and funding system needed review, Harrison said: “I’m not sure ‘review’ is enough — we’ve been quite clear that it is not fit for purpose and is completely broken.
“We have got to a point now where NHS work doesn’t pay. We need to look to see what the NHS wants community pharmacy to do, how much they can afford and then ensure that the two meet.”
Jay Badenhorst, deputy chair of the National Pharmacy Association, told the committee that while its members welcomed the introduction of a Pharmacy First service in England, and the new money that would be provided to fund it, a lack of core funding was putting the whole system of community pharmacies at risk.
“The ambition is great, but the challenge is greater for all pharmacies at the moment, and this is demonstrated by the attrition we are seeing in pharmacy numbers,” he said.
“There is a real risk that the invaluable network of community pharmacies that we currently have will slowly erode up to one point and then there will be a massive downturn, and we could potentially see uncontrolled closures, which will then have a further impact on the pressures we are already seeing on GP practices and the rest of the NHS.
“If the community pharmacy network is not sustainable and appropriately funded, and at some point that network isn’t there any more, we’re not going to get it back again,” he added.
On 16 November 2023, Community Pharmacy England and the government announced that pharmacies in England will be paid £1,000 per month for providing a Pharmacy First service, plus £15 per consultation, when it begins on 31 January 2024.
Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, also called for a complete reappraisal of the way community pharmacies are funded.
She told MPs: “The whole medicines reimbursement system leaves a lot of our members, particularly independents, out of pocket. If the system makes it too complicated for pharmacies, even to pay their wholesalers’ bills, it shows it is not fit for purpose.”
The select committee’s inquiry into pharmacy was launched on 8 June 2023. The committee will be holding future hearings looking at pharmacy workforce and drug pricing.
