Pharmacy closures: the funding cuts landed me in A&E

A shuttered pharmacy

I was in A&E with pneumonia when I began to question whether I had my priorities straight.

Over the course of ten years as a pharmacy owner, I had gone from being a healthy, athletic person who could not remember the last time they had a cold, to being burnt out and pre-diabetic.

When I caught the flu in 2019, I knew I didn’t have time to be ill. One of my two pharmacies was already short staffed, so I pushed through at work, only to become more unwell and, ultimately, develop pneumonia.

Struggling to breathe, I found myself in hospital, questioning whether the strain on my marriage and the missed bedtime stories with my children had been worth it.

I realised that the impact of the cuts led me to this point and that my pharmacy needed to close, sending a decade of hard work down the drain.

It was not just my take-home pay that was an issue. We also did not have money to upskill staff and keep them on at a higher wage

The impact of the cuts to my pharmacy was devastating, professionally and personally.

We were constantly struggling to make enough money to cover rent increases on the pharmacy, wage increases and the cost of medicines. For a year, we even ran a deficit, borrowed money from the business and did not take a wage.

It was not just my take-home pay that was an issue. We also did not have money to upskill staff and keep them on at a higher wage, often losing staff we did upskill to hospital or other sectors instead.

I would spend all month grinding away to find that, at the end of the month, the amount spent on the drug bill did not even cover the cost of the medicines, leaving me unable to pay both my staff and the pharmacy mortgage payments.

On top of the funding cuts, other issues — such as the increasing number of general practices opening internet pharmacies and unduly influencing where patients have their prescriptions dispensed — became like mosquito bites, nibbling away at our efforts to provide a meaningful patient experience.

The idea of providing even more services with no more money seemed intolerable.

On a personal level, weathering the funding cuts has been soul-destroying and, at points, dark thoughts have stayed put for days.

Between working late nights and early mornings at the pharmacy and bringing work home with me, there was no time to spend with my children; no time to ask “how was school?”.

I had even roped my wife into working at the pharmacy and work became all we talked about. Our family has not had a holiday in four years.

In closing my pharmacy, I hope to at least salvage some of these more important things in life.

Mentally, pharmacists — especially contractors — are so committed to their pharmacies and communities that we don’t know when to give up.

We have entered into a bunker mindset, doing more hours, taking on more responsibility and pharmacies are creaking under the strain.

Without the economies of scale, HR and recruitment, the skills or resources to compete against the digital changes made by the multiples, independent pharmacies are the most likely to shut their doors for good as a result of funding cuts.

Even the law is biased against independent pharmacies — we are unable to set up hub-and-spoke dispensing models that would allow us to band together and start charging for deliveries.

It is such a shame because independent pharmacies bring great value in going the extra mile for our patients, whether it’s dropping off a pint of milk when it has snowed or sending a card or flowers when someone has died.

We have been working with the local area team to secure six months’ worth of continued service for patients, ensuring a level of care is maintained and transitioned appropriately. But, nevertheless, I believe the closure will be a loss for them.

For us, the closure now means weeks of negotiations with the bank to be able to pass on our debt to the other branch, so that it isn’t defaulted on.

But one of the worst things is the lack of safety net or support for us. Perhaps a trick was missed years ago, and a support system should have been setup that contractors could have paid into — like a ‘rainy day’ fund — because it is really starting to pour.

The author is a pharmacy contractor in the Midlands who wishes to remain anonymous

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Citation
The Pharmaceutical Journal, Pharmacy closures: the funding cuts landed me in A&E;Online:DOI:10.1211/PJ.2020.20207667

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