Community Pharmacy Closures

Question

15:00:00

Asked by

To ask His Majesty’s Government what plans they have to prevent community pharmacy closures.

My Lords, the Government recognise that pharmacies are integral to the fabric of our communities. They provide an easily accessible front door to the NHS and are staffed by highly trained and skilled healthcare professionals. We have now recommenced the consultation with Community Pharmacy England on funding arrangements, which was not able to be concluded before the general election.

I thank the Minister for her response. Since 2017, there has been a net loss of 1,200 pharmacies in England, with 35% of closures occurring in 20% of the most deprived areas. The annual funding shortfall in England stands in excess of £100,000 per pharmacy—a rise from £67,000 since 2023. Between September 2022 and June 2024, the annual loss of pharmacy access was 3.4 million hours. Given this, does the Minister believe that pharmacies are in a healthy state to support the Pharmacy First service?

Some 98% of pharmacies are signed up to Pharmacy First and I am glad about how it is developing. On the noble Baroness’s very real points, the majority of recent closures were the result of large pharmacy chains optimising their portfolios. As she is aware, community pharmacies are private businesses, although they earn most their income from the NHS. Those business models vary significantly. Local authorities are required to undertake a pharmaceutical needs assessment every three years to assess whether the population is being served. Integrated care boards have to give regard to those needs assessments when they review applications from new contractors and seek to fill any gaps. This continues to be work in progress to which we must be alert, but it is also important to look at some of the reasons for the closures.

My Lords, is it not true that we have not used community pharmacies in this country to their full potential? That impression was confirmed for me when I was chairman of such a group. Should our policy not be to develop community pharmacies so that they make an even bigger contribution to public health in this country? Would it not be better if pharmacists’ income came from that kind of effort, rather than from asking them to rely on the sale of cosmetics and other over the counter, commercial products?

Commercial over the counter products will have a part to play. However, I take the point that the noble Lord makes. I am sure it is true that their vital role, and the opportunities that they offer, were not exploited as much as they could have been—when I say “exploited”, I mean that in a positive way. The Minister for Care, Stephen Kinnock, issued a press release today. In his last point he says: “I am committed to working closely with Community Pharmacy England to agree a package of funding that is reflective of the important support that they provide to patients up and down the country. I am confident that together we can get the sector back on its feet and fit for pharmacies and patients long into the future”.

My Lords, the Government are on the right track in recognising the role that community pharmacists can play in public health by preventing illness and reducing the number of people turning up at A&E. However, is my noble friend the Minister aware of reports that some GPs have been unwilling to direct patients to community pharmacists, even under the Pharmacy First programme? Will she look at whether further action is needed to ensure that GPs work with community pharmacists to deliver services to patients?

I am aware of the reports that my noble friend refers to. This is a new service; it needs to bed in. NHSE is working closely with ICBs, GPs and the community pharmacy sector to improve referrals. Funding has also been provided to ICBs for primary care network engagement leads, who should be well placed to support GP teams to refer into the service. We are aware of my noble friend’s point; we are acting on it and we will continue to keep it under review.

Further to that important point, will the Government guide ICBs to commission additional services from pharmacies? They have often not been commissioned with a sustainable funding model. Dispensing is not enough. They can provide important preventive services and minor illness services. However, they need the commissioning revenue to enable them to sustain their position.

That point is understood, which is why I thought it important to bring to your Lordships’ House the announcement in the media release from my ministerial colleague Stephen Kinnock. As I mentioned in answer to an earlier question, integrated care boards have a role to play. They should—in fact, they are required to—have regard to the pharmaceutical needs assessment conducted every three years by local authorities. That ought to identify where there are gaps and allow consideration of how to fill any such gaps.

My Lords, given the estimate that community pharmacies save some 38 million consultations that would otherwise have been in general practice each year, and the fact that 97% of pharmacy staff report shortages in accessing different medicines as prescribed, how are the Government planning to allow community pharmacies to adjust medicines—as has been recommended by Community Pharmacy England—so that they can modify prescriptions, rather than spend time recontacting the GP when they are themselves familiar with the items?

The noble Baroness raises a good point and work is continuing to resolve that. It might also be helpful to say that NHS England has commissioned an economic analysis of the cost of providing pharmaceutical services and that will inform future funding arrangements. I say that in answer to the point the noble Baroness made about the potential savings that can accrue if we maximise the role of pharmacies.

My Lords, I understand the point that the Minister made about large chains rationalising their portfolios of premises. Have the Government and the NHS looked into whether the extra money made available to pharmacies from the Pharmacy First programme can make these pharmacies viable where they would not have been before? Secondly, what conversations are NHS England and the department having with retailers, community hubs or, where feasible, GP surgeries to provide local community pharmacy services in partnership with them?

The economic analysis by NHS England that I just referred to will be helpful in informing where we go next. I confess that I did not get all the detail of the noble Lord’s second point, so I will look at it in Hansard and I will be pleased to write to him.

Community pharmacy owners rated medicine supply instability as the most severe pressure their businesses face. This instability puts operational pressures on pharmacies and financial pressures on businesses, and for patients it can mean alarming delays. What measures are the Government taking to address the problems of medicine supply and their impact on hard-pressed community pharmacies?

I recognise that, as the noble Baroness says, there are some difficulties with the supplies of certain medicines. That has been going on for some time. We are therefore working to ensure that the supply chain is secure and robust and can meet the demands on it, which requires a detailed look. Work will continue, and I look forward to continuing to update your Lordships’ House about that.

My Lords, is it not the case that the present health structures are not suitable for purpose? Do we not need to look at providing health centres that include a pharmacy, dentists, doctors and all other services in one place to get the maximum resources to the public?

My noble friend will be glad to know that bringing services together under one roof and designing them around the patient is exactly where this Government are going. I ask him to keep an eye out for the 10-year plan, which will address many of the points that he is making.