Lack of funding and workforce issues to blame for temporary closures, say LPCs
Factors including inadequate investment and workforce shortages have contributed to a rise in temporary pharmacy closures, local pharmaceutical committee (LPC) chiefs have told C+D.
The debate on part or full-day pharmacy closures and the causes behind them has intensified over the past few months, culminating in the Pharmacists’ Defence Association's (PDA) decision to flag the issue in an open letter to NHS and regulatory bosses last month.
In response, the Company Chemists’ Association defended its membership for “working extraordinarily hard to prevent temporary closures”.
C+D has spoken with four LPC chiefs to understand what they believe is causing temporary pharmacy closures and what solutions could be implemented.
Lack of pharmacy funding
Raj Matharu, chief officer for both Bexley, Bromley and Greenwich LPC and Lambeth, Southwark and Lewisham LPC, told C+D yesterday (August 10) that “poorly remunerated funding” – which fails to recognise “the need for infrastructure investment and organisational development for community pharmacy” – has triggered the rise in temporary closures.
“NHS England and NHS Improvement (NHSE&I) needs to come up with a clear strategy for community pharmacy, which, in the spirit of the NHS long-term plan, needs to be written in collaboration with the sector,” he added.
“The strategy will then need to be underpinned with sustainable funding,” he stated.
Breach notices might be next
Community Pharmacy North Yorkshire chief executive officer Ian Dean agreed with Mr Matharu that the sector is not adequately funded.
“The whole sector is under immense pressure, and it comes back to the fact that pharmacy has not had a pay rise as a profession for over seven years,” he commented.
However, the rise in temporary closures may “soon” give rise to the issuing of breach notices, he warned, although pharmacies should not receive these if they “genuinely cannot get the staff to open”.
On the issue of breach notices, Kingston and Richmond LPC chief executive officer Michael Keen told C+D that he has already spoken with the regional NHSE&I team in London, which “readily agreed” that he be informed “before issuing any breach notices”.
While the sector faces “a difficult situation with a combination of COVID-19 and absences, difficulties finding staff and everyone facing rising costs”, he added, “it is important that, should a pharmacy be faced with an unexpected closure, they have their business continuity plan in place and contact NHSE&I and 111, so that patients are looked after”.
“We do have a shortage of community pharmacists”
Coupled with “medicine shortages and the utter exhaustion of pharmacy teams”, temporary closures are also “a symptom of the self-inflicted NHS strategy to pump prime pharmacist places within general practice”, Mr Matharu told C+D.
Meanwhile, David Dean, chief executive officer at Thames Valley LPC, claimed that, locally, many pharmacists had been “lost to GP practice roles”, hired via the primary care network (PCN) Additional Roles Reimbursement Scheme.
This, “combined with COVID-19 absences and the peak of the holiday season, has caused immense pressure since the ending of the emergency COVID-19 regulations”, he added.
Last year, pharmacists were added to the government’s shortage occupation list, a decision that was welcomed by some employers but questioned by some locums and the Pharmacists’ Defence Association (PDA).
“A lot of the community pharmacy workforce has moved into GP practices, PCNs, and there’s not been a great plan for replacing them from NHSE&I or from the sector as a whole,” David Dean told C+D.
“The fact that we’ve not got enough community pharmacists to fulfil all the roles that we need them for in community pharmacy is why we’ve got these temporary closures,” he added. “We do have a shortage of community pharmacists”.
While data collated by Health Education England (HEE), published earlier this year, revealed that the number of pharmacists has grown, “there’s so many more options for people that [have] just qualified now”, he said.
“There might be more pharmacists. But there are fewer community pharmacists,” David Dean added.
It follows a continued debate in the sector about whether workforce issues in community pharmacy are down to a shortage of pharmacists or rather a lack of pharmacists willing to work in the sector in its current state.
PSNC: “Businesses cannot function sustainably”
Janet Morrison, CEO at the Pharmaceutical Services Negotiating Committee (PSNC) told C+D that contractors “of all sizes” are approaching the negotiator to flag their struggles with the current workforce situation.
“Independents and multiples alike are worried about both the availability of pharmacists, and about rapidly-inflating locum rates,” she added.
Financial data compiled by the negotiator also reveals that “many pharmacy businesses cannot function sustainably on current government and NHS funding”, with economic realities “putting great pressure on both businesses and pharmacy teams”, Ms Morrison said.
“PSNC is pressing for sustainable funding and for a long-term workforce development plan and hopes everyone in the sector can get behind these aims.”
Meanwhile, a spokesperson for the Department of Health and Social Care (DH) told C+D on Monday (August 8) that it is “working to ensure” community pharmacies “continue to provide first-rate care as needed”.
The government is “committing over £2.5 billion annually over five years to support community pharmacies in better integrating with the NHS”, they added.
“This is on top of £15.9 million over the next four years to expand frontline pharmacy staff in primary and community care – to meet the needs of patients and local communities,” they said.
Last month, supermarket chain Tesco came under fire after the PDA claimed it was shutting its pharmacies when no cover could be found under its new fixed locum rates, after allegedly pressuring locum pharmacists to walk back on pre-agreed rates or risk losing out on shifts.
Reports also emerged last week that one of Tesco’s Lancashire branches could face full or part-day closures during much of August.