Pharmacy 2024: a year of crises and closures

In Opinion

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Record learning outcomes

It was quite a year for community pharmacy as observed by me, an ageing, retired pharmacist with investments remaining in the network. As a landlord to two separate pharmacy businesses, I have encountered one bankruptcy and one change of ownership during the last 12 months.

The pharmacy that went into administration in December last year was fairly rapidly snapped up by a larger chain of pharmacies at a knock-down price and within one month, the rental income had been restored. Sighs of relief all round. The lease assignment has now been signed off and all the signals indicate that the business is being better managed. 

The other pharmacy changed hands seamlessly in June through a transfer of shares, so there were no changes necessary to the lease and the rental has continued as before. However, the current financial structure propping up the national contractual framework in England is in serious and immediate need of review and renewal to prevent disaster. 

Labour has listened before

The most recent major contract overhaul was in fact carried out by the last Labour Government in 2005 which, for the first time, rewarded service provision as well as dispensing volume. The contract introduced a range of new services including MURs and locally commissioned smoking cessation schemes, which I enthusiastically became involved with. 

As I see things now, with glorious hindsight, the downhill slope was deliberately created first by the Tory-Lib Dem coalition (which largely ignored pharmacy for five years) and then, post-2015, with the arrival of Jeremy Hunt, at whose door can be laid the blame for the origin of the current crisis.

At some stage during this period, the Department of Health simply stopped engaging with PSNC and started implementing remuneration and reimbursement conditions based on whatever misinformation came into its hands. I am hoping that Mr Streeting can bring common sense to bear in future negotiations. 

The Government has already acknowledged the scale of the problem it faces post-election with community pharmacy, brought to everyone’s attention by the NPA vote on collective action. In my 35 years of active duty as a community pharmacist, I can look back and definitely say that the NHS (and therefore community pharmacy) has fared better and been listened to more under a Labour Department of Health. I hope this is still the case in the coming months.

Closures paint a grim picture

Back to the here and now, I am increasingly worried by the number of pharmacy closures, as illustrated by those in my neck of the woods (see below). As I have said many times before, this is what a real pharmacy strike looks like – permanent loss of workforce and provision. 

I take some comfort in the fact that the staff I meet in pharmacies – particularly the ones I deal with regularly – are always cheerful, ready to smile and give me a warm greeting. I always try to talk to them, to tease out their problems, just to get a flavour of the daily grind they face. 

Stock shortages and dispensing at a loss appear to remain the main challenges – apart from being swindled every month over remuneration. One owner summed up her situation succinctly by telling me her main issue was with wholesalers. They appear to want to ‘sell’ her additional services not directly aligned with the supply function – and all she really wants is for them to concentrate on getting their core service right. 

In other words, to stop diverting attention to these add-on services and start actually delivering medicines in a prompt, timely fashion without delays, stock errors and shortages. 

‘Pharmacy closures are increasingly visible in our communities’

I suspect that like all involved in community pharmacy, wholesalers are also looking to build business through alternative services because the core NHS supply function is so unprofitable and now a loss leader.

One issue I see on the horizon is not so much a more sympathetic ear being given to pharmacy by this government, but ministers’ apparent inability to carry anything through properly. Let’s see what the much trailed “relaunch” will achieve...

Poorly qualified 

In the meantime, the latest budget and fight with farmers and pensioners continue to look ugly. Pharmacies, like other businesses, won’t like the new NI contribution increases for employers. I agree with Ricky Gervais that ‘went to Eton’ should not be an automatic qualification for a senior government post, but where can talented politicians be nurtured and cultivated?

Nobody in the new cabinet looks to possess the necessary experience or ideas needed for their posts.  

Leadership is not something acquired through education and training – it’s in the DNA. I may be shouted down on this, but the UK has only had a handful of great Prime Ministers since the office was created by Walpole in the late 1700s. There have been none in this century, and very few overall who created and oversaw social change on a scale that affected all citizens. 

Attlee gave us the NHS, which is still at the centre of national life and of great significance to this country. Yet how the NHS is managed and financed has troubled every Government since 1948 – and will continue to do so. Pharmacy is, and always has been, part of the central core offer and cannot be denied its place in every community, high street and locality. 

I have never believed that online pharmacy is a solution to secure medicines supply. Only a bricks and mortar community pharmacy with a qualified team can deliver this when properly funded. We all need to be able to contact healthcare professionals and have face-to-face conversations. 

Streeting & Co surely recognise that this vital aspect must continue without further erosion. I hope he possesses the skill and determination to drive through change with a proper and realistic package of support. Have a great Christmas and hopefully a better new year for pharmacy.