So, 650 vital High Street pharmacies have closed in the past six years, it was revealed last week. The real front line of the NHS, your local chemist, is retreating, just when we need them more than ever to alleviate the demand for GP appointments.
They are closing at an alarming rate because their contract with the NHS has been frozen since 2016. As a result, the prices that all pharmacies are reimbursed for prescription drugs and other services have been frozen.
The iniquities in that deal mean that the Department of Health acts as if single independent pharmacists enjoy the same volume discounts as Boots and other big chains, which can negotiate discounts from wholesalers — and clearly they don’t.
The real front line of the NHS, your local chemist, is retreating, just when we need them more than ever to alleviate the demand for GP appointments
The burdens imposed on these heroes of the community through their National Health Service contract are endless.
In 2020, a report by Ernst & Young projected that by 2024 the average pharmacy would face a shortfall of £43,000 — based on data from before the pandemic — with the report suggesting that the pandemic is ‘likely’ to have ‘further weakened the network’.
A letter sent to the Health and Social Care Select Committee last month pointed out that the funding contract, which was agreed in 2019, had not been adjusted to reflect inflation and the costs of Brexit, as well as the pandemic.
As a result of all this, Tim Gibbs, my local independent pharmacist in Yarmouth on the Isle of Wight, is working seven days a week.
He has no time for his family. His shop can open only if he, the qualified pharmacist, is on the premises, as he cannot afford a locum.
He is out of pocket by 73p every time he dispenses a prescription: he is paid £1.27, but dispensing it costs £2 in overheads such as insurance, business tax and specialised computer systems.
So no day off, and no holiday. I see first-hand in Yarmouth how essential our local pharmacy is.
The iniquities in that deal mean that the Department of Health acts as if single independent pharmacists enjoy the same volume discounts as Boots and other big chains, which can negotiate discounts from wholesalers — and clearly they don’t
Public transport is not exactly flourishing and many residents can’t find or manage a bus to make the long trip to the nearest big town, Newport. They rely on the community pharmacy for vital medications. That is true throughout these islands.
So many of the residents around Yarmouth depend on Tim’s selfless service — he hand-delivers prescriptions to those not able to visit in person as he also cannot afford a delivery assistant.
Tim’s story is not unique.
The big chains will be all right; it’s the independent businesses that are at risk, businesses run by people like Tim, who’ve been key figures in their areas for years.
What is the Department of Health doing about this community disaster? So far, nothing, as far as I can see. I’ve been campaigning publicly in the House of Lords to stop all these independent, vital community chemists from going bust, and it’s clear that these closures are avoidable, as the Government well knows.
If this decline isn’t fixed soon, there will be no independent community High Street pharmacies left. For it is getting worse. New import regulations mean that vital drugs can no longer be stockpiled to ensure supply, as there’s not enough supply.
And drug prices are rocketing. For example, alendronic acid, used to treat osteoporosis, has gone up from 74p each to £5 each (and they’re dispensed in packets of four tablets, so from £2.96 to £20). Citalopram for depression used to cost 84p for 28 20mg tablets; now they cost £3.75.
The Department of Health’s response to this crippling disparity between a drug’s cost and the amount reimbursed is to require pharmacists to make a special claim for every item — which could well be hundreds of items per day.
When have these overstretched superheroes got the time? Fill in hundreds of forms every day instead of serving people in need?
The first to feel the effect of more closures will be GP surgeries, followed swiftly by A&E. No one in authority begins to appreciate just how much unrewarded slack these pharmacies take up in the health front line, saving appointments with a wise word and an over-the-counter consultation.
Tim Gibbs tells me he is seeing more ‘patients’ face-to-face than ever, as they can’t get a GP appointment. He does this, like all his peers, for nothing. Unpaid and, worse, utterly taken for granted until this vital service goes bust.
The present arrangements with the NHS and these independent pharmacies are straining the goodwill and commitment of this dwindling band of community service providers beyond breaking point. More and more of them are giving up the struggle.
When the rate of closures, already of epidemic proportions, reaches the doomsday trajectory to which it is hurtling, it will be too late.
This decline needs to be reversed — and soon. It should easily be cost-neutral, so many NHS appointments could be saved.
It is such a simple fix. The NHS contract needs reworking, and those in power need to appreciate community pharmacies in the same way their customers, patients and voters do.