By Neil Trainis

Rowlands managing director Nigel Swift has accused NHS England of failing to check that distance-selling pharmacies are providing a service to patients across the country and not just in their localities under NHS regulations, prompting NHSE to insist the responsibility for carrying out investigations lies with "local NHS systems."

Swift (pictured) urged NHSE to “quickly” look into claims by the Company Chemists’ Association in the last few days that “pseudo” DSPs are breaching their NHS contracts by only delivering medicines locally and “starving local community pharmacies of vital trade” as a result.

The CCA said its research showed more than 70 per cent of DSPs dispense over 50 per cent of their prescriptions to patients from a single postcode area within 10 miles of the pharmacy.

The CCA warned: “By removing core dispensing work and associated funding from local pharmacies, these ‘pseudo DSPs’ are placing the physical network of pharmacies in jeopardy. Patient access to essential face-to-face care is at risk.”

Swift suggested the CCA’s research proved “what has long been suspected” and said that although DSPs have a role “in a mixed provider market,” many were undermining the “network of bricks and mortar pharmacies by playing fast and loose with regulations.”

“This report demonstrates clearly that NHSE is not policing its own regulations – either a DSP is providing a national service, which allowed by the regulations, or it is not. If it is the latter NHSE must take action,” he said.

“It is easier for a DSP to get permission to operate than traditional pharmacy because they do not need to demonstrate a local pharmaceutical need. In theory, they are meant to service the whole of the country, but it appears NHSE does not currently check they are doing so in practice. This is dereliction of duty and contrary to government healthcare policy.”

NHSE: Local NHS systems are responsible for checking DSPs 

NHSE told Independent Community Pharmacist that “local NHS systems” such as integrated care boards are responsible for checking whether DSPs are meeting the regulations.

“Local community pharmacies play an important role in delivering a range of NHS-funded services, and it is right that patients should be able to choose where and how to get their prescriptions,” an NHSE spokesperson said.

“Distance-selling pharmacies are required to deliver medicines to anyone who requests them anywhere in England and where there is evidence that a company is failing to do so, it will be investigated by local NHS systems and appropriate action taken.” 

CPE: NHSE and DHSC must enforce the regulations

Community Pharmacy England told ICP the responsibility for ensuring DSPs meet the regulations was devolved to ICSs but insisted NHSE and the government must enforce those regulations. CPE also said NHSE, alongside ICBs, was responsible for checking that all pharmacies comply with their terms of service and take action to enforce them where necessary. 

“The CCA report once again highlights the need to tighten up the regulatory provisions around establishing and running distance-selling pharmacies, and for NHS England to ensure that these pharmacies all do what they were intended to do – to provide pharmaceutical services at a distance,” said CPE’s director of legal Gordon Hockey.

“The report supports our existing arguments on this topic which we have already set out to the Department of Health and Social Care and NHS England on many occasions, over a period of several years: they must enforce their own regulatory provisions.

“In terms of remote provision of pharmacy services, Community Pharmacy England supports this where it can be carried out safely and within the conditions described in the service specification and Secretary of State directions. The impressive choice and accessibility of community pharmacy is the sector’s USP, and the safe provision of pharmacy services remotely is a valid part of this.”

Insisting all pharmacy owners of bricks-and-mortar and distance-selling pharmacies are “broadly subject to the same terms of service and must be compliant with them,” Hockey said it was “important that all businesses are operating on the level playing field set by the pharmaceutical regulations.” He again urged NHSE and the government to enforce the regulations.

According to the NHS Business Services Authority, there were 374 ‘active’ DSP contracts in England at the end of 2022. Swift said if DSPs “are not playing by the rules, NHSE must act and do so quickly.”

“At a time when most pharmacies in England are facing severe financial pressures and we see hundreds of closures and mergers, unfair competition and a lack of a level playing field simply adds to the woes of the sector,” he said.

“Ultimately, it is patients who lose out if they cannot drop into their local pharmacy for professional healthcare advice and services.”