How funding crunch could put 50 years old pharmacy out of business

How funding crunch could put 50 years old pharmacy out of business. It would be extremely difficult to find a more dedicated community pharmacist than Martin Bennett. The 76-year-old has worked for 50 years at the Wicker Pharmacy in Sheffield city centre, which is open seven days a week, including every Christmas Day, for 71 years since it was founded in 1952.

But when Martin received an official invitation to a party at 10 Downing Street in June to celebrate the founding anniversary of the NHS, he turned it down in disgust.

Martin, the lead pharmacist at Wicker, told Good Health he was avoiding the NHS’s 75th anniversary celebrations in protest at the government’s destruction of High Street pharmacies through a diabolical brew of chronic underfunding, mismanagement and neglect. Instead of attending the party, he tweeted that he would “wash my hair.” That tweet was liked 700 times.

For the past nine months, the Daily Mail’s Save Our Local Pharmacies campaign has highlighted how a funding crisis in recent years has led to the closure of hundreds of our vital, independent community pharmacies, with thousands more to follow to extinction.

Their plight is due to a huge shortfall in the amount the NHS pays pharmacists under a contract introduced in 2015. This shortage penalizes them financially every time they provide us with essential medicines. At the same time, our community chemists are also collapsing under the ever-increasing weight of personnel, energy, and computer systems bills.

76-year-old Martin Bennett (pictured) has been with the Wicker Pharmacy in Sheffield city center for 50 years, open seven days a week, including every Christmas Day, for 71 years since it was founded in 1952.

Survival for community pharmacies has become so challenging that major players Boots and LloydsPharmacy are now closing branches en masse.

In June, Lloyds closed all 237 Sainsbury’s stores, and Boots announced the closure of 300 of Britain’s 2,200 stores, a process now underway.

The country’s small, independent community pharmacies must now pick up the pieces.

But this is not a lucrative bonus for them, as Martin’s story shows, because not only do they lose large sums of money simply by providing essential prescription drugs, they also lack the staff to meet the additional requirements imposed by the government. keeps asking them. .

The supply cost crisis hit community independent chemists particularly hard in July, thanks to a drastic supply shortage of the drug atorvastatin.

Nearly eight million Britons use statins. Atorvastatin (sold under the brand name Lipitor among others) is the most popular – for the past two years it has been the most widely dispensed drug in the UK community. Recently, global problems with the production and supply of medicines have caused prices to soar. ‘It cost about £8 for a pack of 28, but in July it skyrocketed to £18,’ says Martin. “We definitely prescribe a lot because everyone and their grandmother use it.”

Atorvastatin is just the latest in a series of widely prescribed drugs that are facing delivery problems. Martin adds: ‘The situation is crazy with our standard bread-and-butter medicines. Suddenly they are no longer available at all, or they are very expensive.’

For the past nine months, the Daily Mail's Save Our Local Pharmacies campaign has highlighted how a funding crisis in recent years has led to the closure of hundreds of our vital independent community pharmacies (File Image)

For the past nine months, the Daily Mail’s Save Our Local Pharmacies campaign has highlighted how a funding crisis in recent years has led to the closure of hundreds of our vital independent community pharmacies (File Image)

Such problems can push independent community chemists into financial disaster, thanks to the government’s payment system for prescription drugs, the so-called drug fee. The Department of Health and Social Care (DHSC) sets this as the price it will pay pharmacists to buy each drug wholesale.

When the price of a drug rises, the DHSC may decide to raise the tariff price to match the new price so community pharmacies don’t take the brunt. However, it could also refuse to raise rates, but it won’t announce its decision until the end of each month, leaving pharmacists like Martin in limbo.

Martin’s chemist prescribed 60 packs of atorvastatin in July: each cost him £18 to buy – a total of £1,080.

On August 1, the DHSC announced it would pay a maximum of £3.45 for each package – a total of £207.

This means that Martin’s pharmacy lost £873 in one month just from dispensing one type of medicine.

A survey of pharmacies by the journal Chemist + Druggist found that nearly half of 182 respondents lost more than £1,000 in July just from dispensing atorvastatin.

The industry’s representative body for finance negotiations with the government, Community Pharmacy England (CPE), says it has appealed the drug tariffs decision, calling for a ‘retroactive increase’ in the price of atorvastatin for July.

A spokesman for the DHSC told Good Health it is “monitoring the situation closely.”

CPE says rising drug prices are now a common problem, pointing out that itraconazole, which is used to treat fungal infections, cost pharmacists in England more than £11 per pack to buy in July, while the DHSC charged them just £4. 27 reimburses. per pack.

Suraj Shah, the CPE’s drug pricing and reimbursement manager added, “The price concession system is flawed. We are urging the government to ensure that pharmacies are paid fairly for the medicines they supply from NHS prescriptions.

“Currently, pharmacy teams spend hours searching for limited supplies and paying high fees without knowing if they will be appropriately reimbursed. At the same time, patients are understandably worried about their health if there is a delay in receiving their medicines.”

Another clear testament to the crisis facing community pharmacies is the fact that it took Martin more than a year and a half to recruit a qualified pharmacist due to a nationwide shortage of suitable staff.

Martin first advertised the position of Chief Inspector Pharmacist at £75,000 a year in November 2021. He says: ‘That salary would be a huge burden on us, but we thought it would attract good candidates. It’s way more than I’ve ever paid,” he says. Nevertheless, his ad attracted only one applicant, who subsequently failed to attend the interview.

Fortunately, word of mouth helped, after a local GP recommended the job to a pharmacist they knew.

Campaigners say the financial problems started with the new national contract in 2015, which significantly cut NHS pharmacy revenues and has not adjusted for inflation or rising staff and fuel costs. Recent figures from NHS Business Services show that 160 community pharmacies in England had to close in the last two years alone, on top of Lloyds and Boots closure programmes.

Martin says: ‘Part of our building was a showroom for mobility aids. We had to sell it just to keep the main pharmacy business going. Even if that’s sold, it’s still tight. We have a current account credit.’ In the meantime, the government wants community pharmacists to take on more tasks. In March, it launched an advertising campaign on TV, radio and social media, urging the public to make more use of community pharmacies and relieve the burden on GPs.

The government has also announced plans this winter to allow independent pharmacies in England to prescribe certain medicines, including antibiotics, and to offer routine tests without the need for the patient to see a GP first.

The conditions they will prescribe – after extra training – include earaches, shingles and urinary tract infections. In addition, women can get contraceptive pills from pharmacies without first speaking to a GP or practice nurse.

In May, the government said it would provide £645 million to fund this expansion, an amount that Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies says is insufficient.

She told Good Health: ‘The £645 million doesn’t solve our biggest problem. The basic NHS funding we need to function is currently £1.1bn a year short and rising.”

Martin Bennett agrees. “We are absolutely snowed under by work at the moment. We can’t just do more because someone in the government has decided, ‘It’s good that we let the community pharmacies take over all this.’

A July report from a panel of experts set up by the House of Commons health and social care committee concluded that the government had underperformed in three crucial areas: computer systems, the training of pharmacists and overall funding as the was about keeping her promises to provide support. public pharmacies.

Professor Dame Jane Dacre, former president of the Royal College of Physicians and chair of the panel, told Good Health that NHS computers were slow and often unable to talk to each other, while pharmacists were often simply too busy to attend prescribing training. . In addition, there is a serious shortage of people qualified to train and guide them.

She says: “Financing has not been properly controlled since the beginning of the pandemic.” This has prevented community pharmacies from providing additional clinical services, prevented patients from accessing certain medications, and reduced access to community pharmacies, especially in underserved areas.

Martin Bennett warns that without a major increase in funding, ailing community pharmacies cannot take on new duties.

He says: ‘We should not be in a position where we lose money when we provide essential medicines to patients.

“We have to break even at the very least. . . Certainly?’