Lloydspharmacy’s “difficult” decision to charge patients for diabetes screening and blood pressure checks this week won’t come as a surprise to many. After all, limiting their free delivery service and divesting around 200 branches hadn’t been enough to mitigate an ongoing drop in profits caused by two-a-half-years of reimbursement cuts.

But this latest news from the multiple is a salient reminder that while the anger of the anti-cuts campaign may have settled into begrudging acceptance, the erosion of pharmacy businesses in England, and their offering to patients, shows no sign of letting up.

The government always looked at the impact of its funding cuts in terms of closures. “Clusters” of pharmacies – so the thinking at Whitehall went – served no purpose and would be the first to be thinned out.

But while closures have sadly taken place – 140 between November 2016 and May 2018 alone – C+D readers warned from the beginning that it would be services – and their users – that would be the biggest victims.

Of course, Lloydspharmacy is only the most high profile example. C+D’s findings indicate pharmacies at every level are having to consider – or already are – stripping back their offering. The Department of Health and Social Care has forced pharmacies’ hands, and seems uninterested in the results, either on patients or the wider NHS.

The government claimed to have done an impact assessment, however flimsy, on its cuts to pharmacy funding. But has anyone assessed the public health impact of withdrawing free diabetes checks and blood pressure tests from more than 1,500 Lloydspharmacy branches? And how does this fit into the government’s alleged prevention strategy? It’s these questions we can only hope will be ringing in the ears of NHS England negotiators during their ongoing talks to decide a funding settlement for the sector.

Matt Hancock reminded C+D this week that he is still fascinated by the French pharmacy model. The health secretary would do well to remember that the current success of that country’s pharmacies is founded upon a multi-year funding settlement – and a recognition of the sector’s ability to deliver national public health services.

James Waldron is editor of C+D. Let him know how your pharmacy is coping in 2019 by tweeting him @CandDJamesW or emailing him at [email protected]