Pharmacies: The New NHS Frontline?

It’s estimated on average 8 pharmacies a week are closing down, at the same time as patients are facing huge shortages of life saving prescriptions. Pharmacy leaders saythe industry is in crisis, and yet they are being asked to do more to take the burdenoff a stretched NHS. Paul Brand has examined the current state of our country’schemists for Tonight.

Dr Leyla Hannbeck from the Association of Independent Multiple Pharmacies, told us that“Pharmacies are struggling immensely at the moment… It's a very difficult time. It's one ofthe most difficult times that we have ever experienced in our sector.”

To gauge the state of the sector Tonight surveyed 980 pharmacy workers from across the country and filmed throughout their busiest periods between December and early January. A whole host of issues came to light.

MEDICINE SUPPLY111 different medicines - such as cholesterol drugs and hormone replacement therapies -are routinely in short supply which is double the number in 2022. The drug shortages meanthat pharmacies regularly refer patients back to GPs to discuss alternative treatments which then increases their workload too. In York, pharmacist Vikki and her team spend hours each day trying to source medication for desperate patients. She told us, “the drug shortages are the fuel for the people needing to go backwards and forwards to their GP… And it's just basically grinding the whole system to a halt.” And the problem seems widespread, 86% of pharmacy workers that answered our survey said they cannot fulfil a prescription on a daily basis.

PATIENT’S DESPERATE FOR MEDICATIONThe Government recently announced that there are national supply issues for a range ofADHD drugs. In Plymouth we filmed with Molly who only had two tablets of her ADHDmedication left and was constantly searching to find chemists that had any available. At thetime of filming, Molly had been unable to source her medication for a month and the last time she was able to get it she travelled to the Isle of Wight - over 160 miles away.Molly told us, “Obviously, the train isn't cheap. The ferry isn't cheap. But that's howdesperate I was and I mean, it's, it's not, it's not ok”

Janet Morrison, from Community Pharmacy England, suggests reasons for these shortages, “the prices that are paid for those in England have got so low that manufacturers have veered away from making them available in the market in England. It's not just an issue in England, but it has been exacerbated by Brexit and by other sort of global supply chain issues.”

PATIENT’S RELYING ON PHARMACY SERVICESIn Uppermill, in Oldham, Avril cares for her husband Ken who is bed bound. Where they liveis quite remote making it extremely difficult to get out to the local pharmacy, so they rely on their free delivery service. Avril said, “if the chemist didn't deliver to me, it would mean I would have to walk half an hour to the bus stop, But then I would struggle to carry all this back up the hill.”

Tonight found that many pharmacies are now looking for ways to save money. Cutting freedeliveries, and dosette boxes that help patients keep track of their medicines, as wellreducing opening hours are just some of the ways they are doing this. Our survey alsoreflected this with 80 percent of pharmacy owners, that answered our survey, saying theyhad already reduced services.

FUNDING PROBLEMSPharmacies are paid through providing some private healthcare and NHS services, but their income largely comes from dispensing prescriptions. Pharmacies are supposed to make a profit overall as they buy the medicines at a cheaper price than the NHS reimburses them. In practice however, the price set by the NHS is often lower and pharmacies can end upmaking a loss. Ian, who runs three independent pharmacies in the North West told us that, “there is a very real risk now with the rate of closures that we could see pharmacies closing in huge numbers”. This concern over funding was highlighted in our survey with 89 percent of pharmacy owners surveyed, saying they have had months where they’ve dispensed medicines for the NHS at a NET loss, and 96 percent were concerned that their pharmacies are not financially viable.

A Department for Health and Social Care spokesperson said:“Community pharmacies play a vital role and are backed with £2.6 billion in governmentfunding a year. Four in five people live within a 20-minute walk of a pharmacy and there aretwice as many pharmacies in deprived areas. “We are providing thousands more training places for pharmacists and announced up to £645 million in additional funding to support Pharmacy First which has been widely welcomed by clinicians, patients, and pharmacists.“Pharmacies can request increased reimbursement prices for medicines if they cannotsecure at or below the listed Drug Tariff price to make sure they can still supply medicines to patients without losing out.”

Paul Brand reports. Pharmacies: The New NHS Frontline? airs Thursday 11h ofJanuary at 8:30pm on ITV1. It is then available on catch up on ITVX.