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Will 2023 bring more of the same?

Pharmacies all but kept primary care in England running throughout Covid – but there has been scant recognition of their efforts from the Government. Will 2023 shift the dial on pharmacy funding, asks PM deputy editor Arthur Walsh

It has been yet another tough year for pharmacies in England. After two brutal years in which they all but kept primary care running — not to mention vaccinating large swathes of the population against Covid — they might have hoped their efforts would be rewarded with a rebooted contract that would give them the necessary headroom to engage with
a Bright Clinical Future. 

Unfortunately, we all know that’s not how it panned out. Instead, many pharmacies have been brought to their knees by medicines shortages, wildly inflated costs and staffing problems. After a real-terms funding cut of almost £800m since the start of the contractual framework, the announcement in September of barely improved funding arrangements for years 4 and 5 were met with disbelief by many. 

Stark picture

The picture is most stark for the largest operators – some of whom are shedding branches in a bid to return to profitability – but independents are under severe strain too. Writing in these pages last month, one contractor said their wholesaler bills are roughly 50 per cent higher than they were before the pandemic. 

A look at the latest price concession list offers no hope of immediate relief on that front, and the coming living wage increase – however much hard working teams have earned it – looms large in the minds of business owners.  

While the focus is understandably on those already mired in these difficulties, I worry too about the potential impact on the next generation of owners.

In a rare moment of optimism for the sector, the most recent Christie & Co market report shows demand for pharmacies is strongest by far among first-time buyers, who accounted for 80 per cent of all purchase applications and 40 per cent of completed sales in 2021-22. 

Will many take a look at the current health of community pharmacy in England and wonder if their future lies elsewhere? I wouldn’t blame them.

Too cynical?

This litany of woes will be familiar to all our readers in England. Is it reasonable to expect the change we need in 2023?  

The PSNC – soon to be rebranded as Community Pharmacy England – is staking its hopes on a new vision and strategy that will be developed with the help of two independent think tanks. According to chief executive Janet Morrison, attempts to reach more senior decision makers within Government and the NHS will form a crucial part of this work. 

My instant, perhaps cynical response is to say that since we have had visions galore come and go in the past, why should this be any different? But as Morrison recently told the Pharmacy Magazine podcast (see p4), much of the work now underway to embed clinical roles like independent prescribing began life as ‘blue sky’ policy briefings. Industry leaders like Numark managing director Jeremy Meader have lent their support to the initiative, so perhaps it is time for me to park my cynicism too. 

Sympathetic?

Morrison has also used her meetings with officials to raise the unsustainability of dispensing at a loss, and suggests that the people she is speaking with are sympathetic to the negotiator’s arguments. This is undoubtedly the biggest problem facing the sector, and if the Government ultimately decides to maintain its laissez faire approach it will be the clearest sign yet that pharmacies have been hung out to dry. 

All in all, another challenging year for pharmacies, with more uncertainty around the corner. But perhaps us cynics can be persuaded that some of the coming changes will be positive. I wish all our readers a peaceful Christmas and a happy, healthy New Year. 

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