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Pharmacy owners have voted for the first time in favour of collective action over funding levels in a ballot run by the National Pharmacy Association (NPA).
NPA members, representing 3,399 independent community pharmacies in England, Wales and Northern Ireland, voted in the ballot, with 99% in favour of limiting their services in the interest of patient safety if improved funding is not forthcoming.
The vote turnout was 63.5% of NPA membership and the result is only advisory for members because the NPA is not a trade union.
Of the members who voted in the ballot, 3,049 represented pharmacies in England, and 98% of pharmacy owners in England said they would be willing not to open for hours above the minimum required by their contract — meaning fewer pharmacies would be open in the evenings and on weekends.
Meanwhile, 96% of owners voted to withdraw from locally commissioned services, such as smoking cessation and emergency contraception services.
Additionally, 93% of pharmacy owners in England voted to withdraw from providing free home deliveries of medicines which are not funded; 99% voted to refuse to cooperate with certain data requests above those required for patient safety and contractual minimums; and 97% voted to withdraw from supplying free monitored dose systems that the NHS does not pay to provide, aside from those covered by the Disability Discrimination Act.
In Wales, turnout was 56% of NPA membership, with 89% of members reporting that they would be prepared to close outside core contract hours.
Funding and contractual arrangements from pharmacies are devolved; however, medicines funding arrangements are set by the UK government for pharmacies in England, Wales and Northern Ireland.
Scottish pharmacies were not included in the ballot as they have a separate system.
The ballot opened on 19 September 2024 and ran for six weeks.
A statement from the NPA published on 14 November 2024 alongside the ballot results aid that it was urging the government to “meet and discuss an urgent uplift for pharmacy funding to guarantee patient safety and services for vulnerable people — alongside a modernisation of pharmacy with a funded expansion of clinical services”.
“Without an urgent and significant uplift in funding delivered in the coming weeks, [the NPA] would have no choice but to recommend pharmacies to withdraw services to patients,” the statement warned.
Nick Kaye, chair of the NPA, said: “The ballot result overwhelmingly shows the sheer anger and frustration of pharmacy owners at a decade of cuts that is forcing dedicated health professionals to shut their doors for good.
“Pharmacies desperately want to support their local communities with access to medicines and advice but have been forced into an untenable position by a decade of underfunding which has led to a record number of closures.
“The sense of anger among pharmacy owners has been intensified exponentially by the Budget — with its hike in National Insurance employers’ contributions and the unfunded National Living Wage increase — which has tipped even more pharmacies to the brink.”
Commenting on the ballot result, Janet Morrison, chief executive of Community Pharmacy England, said: “The results of this ballot show just how deeply community pharmacies are feeling the pain of intolerable funding cuts, combined with ever-rising costs and workload.
“Many businesses are already making impossible decisions and being left with no choice but to take some of the actions outlined, just to keep their doors open. Community pharmacies have much to offer – but only if the sector can be stabilised with an immediate funding uplift.”
Paul Bennett, chief executive of the Royal Pharmaceutical Society (RPS), commented: “We recognise that community pharmacists are experiencing unprecedented pressures in the workplace, including funding issues and concerns about pharmacy closures.
“As the professional leadership body for pharmacy, it’s not for the RPS to comment on the outcome of ballots or contract negotiations, but we urge pharmacy employers, national and local commissioners of pharmacy services and pharmacists to work together to ensure patients always receive access to high quality, safe pharmacy services.”
A spokesperson for the Department of Health and Social Care said: “Community pharmacy has a vital role to play as we move the focus of care from hospital to the community under the fundamental reforms in our ten-year health plan.
“Unfortunately, we inherited a system that has been neglected for too long and is no longer supporting the pharmacists we need to deliver for patients at a local level.
“We are committed to working with the sector and would encourage all pharmacists to work with us to achieve what we all want – a service fit for the future.”
The NPA statement said it would await a government response before deciding to advise members to take collective action, but that the action could take place in the new year.
Analysis by the NPA in June 2024 revealed that 63% of pharmacies in England have cut their opening hours since 2015 owing to a 40% decline in funding over the past decade.
