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Multiples’ part-closure rate 15 times higher than independents, PDA claims

Pharmacies in Scotland operated by larger multiples were found to be almost 15 times more likely than other pharmacy businesses to be closed for at least part of the day over a five-month period, a PDA investigation has revealed. 

According to freedom-of-information (FOI) requests sent by the PDA to all 14 NHS Scotland health boards, a minimum of 1,739 temporary pharmacy closures occurred across the country between January 1 and May 31.

Of these, 1,625 reported closures concerned Company Chemists’ Association (CCA) member pharmacies – including Lloydspharmacy and Boots – the PDA revealed yesterday (August 16).

Only 114 occurred in “non-CCA member pharmacies”, the union added.

In response, the CCA told C+D that recent pressures on community pharmacies in Scotland were “unsustainable” and that the recorded closures could represent very limited hours on a particular day. Read its full response below.

Read more: Lack of funding and workforce issues to blame for temporary closures, say LPCs

The PDA said that 47% of pharmacies in Scotland are CCA members. “It would therefore be proportionate if the CCA members had reported closures due to similar levels of genuine reasons on 102 full or part-day occasions during that same five-month period,” the PDA said.

But according to the union’s data, pharmacies in Scotland operated by a CCA member were almost 15 times as likely to have temporarily closed than non-CCA pharmacies.

It comes as the debate on part or full-day pharmacy closures and the causes behind them has intensified over the past few months, culminating in the PDA’s decision to refer NHS England and NHS Improvement (NHSE&I) to the Information Commissioner’s Office yesterday, over alleged failures to share data on closures.

 

CCA: Locum demand outstripping supply

 

A CCA spokesperson told C+D that its members “have been serving Scottish communities and patients without issue for decades. Recent pressures, however, are unprecedented”.

The representative group pointed to analysis by the locum agency Locate A Locum that said the average locum rate in Scotland rose by 123.5% between 2020 and 2021. “This clearly demonstrates that demand for pharmacists in Scotland is outstripping supply.”

Catch up with C+D’s sixth Big Debate, which asked: Is there a shortage of community pharmacists?

The PDA heard the “extraordinary” first-hand accounts of contractors’ difficulties in sourcing enough staff to open their pharmacies at an All-Party Pharmacy Group event in February, the spokesperson said. “The current situation is unsustainable.”

The recorded closures “may reflect very small parts of the opening day, as companies try tirelessly to plug gaps at short notice”, they added.

“It is worth remembering that community pharmacies do not earn income if they do not open. Closures are an absolute last resort, and our members are working extraordinarily hard to ensure patient access”.

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.

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).

 

NHS Lothian recorded “in excess of" 300 closures

 

Of the 1,739 recorded temporary closures, the NHS Lothian health board recorded “in excess of 300”, the highest number of closures of all Scotland's health boards,  PDA Scotland head of policy Maurice Hickey told C+D today (August 17).

By comparison, while NHS Western Isles recorded no closures, NHS Borders only recorded 53 during the five-month period.

Scott Garden, the director of pharmacy and medicines at NHS Lothian, told C+D that the board is aware of the “ongoing short notice pharmacy closures in Lothian” and is in “ongoing dialogue with the Scottish government”.

NHS Lothian continues to “regularly engage” with contractors to remind them of their obligations and “there have been numerous communications to remind contractors of the steps that must be followed when an unplanned closure occurs”, he added.

The board also continues to meet with area and regional managers of “multiple pharmacy groups” and is “collaborating on area-wide plans to manage and minimise the impact of closures on local communities”, he said.

Read more: Revealed: No open investigations into temporary pharmacy closures in Scotland

April was the month when most closures, 431, were recorded, Mr Hickey told C+D.

“Both April and May were higher than the previous months. This was caused by the number of closures involving Boots suddenly starting to increase from mid-March,” Mr Hickey added.

Of the 1,625 reported closures of CCA member pharmacies, Boots recorded the highest number of closures at 670, Mr Hickey told C+D, while Lloydspharmacy reported 555.

“It was notable that Lloydspharmacy were fairly consistent over all five months, whereas Boots closures were concentrated in the second half of the period and they overtook Lloydspharmacy in May,” he said.

A spokesperson for Lloydspharmacy told C+D that its “priority is to provide the best possible care to our patients and communities”. 

However, “when we are unable to source a pharmacist, our last resort is to temporarily close the pharmacy”, they added. 

“Where this is the case, we do everything we can to ensure that our patients can still access the care they need, and we direct them to other pharmacies in the area.”

This “situation”, the spokesperson said, “is an example of the pressures facing community pharmacy which require a sector-wide response; it is not something Lloydspharmacy and other community pharmacy providers can address on their own”.

C+D has contacted Boots for comment.

 

“All pharmacies operate in the same market”

 

However, the PDA acknowledged that “100% opening in accordance with the commitments given to the NHS are never likely to be achieved in practice, as genuinely unforeseen circumstances may occur that cause unexpected closures”.

It therefore accepts “at face value” that closures reported by independent pharmacies and smaller chains “were necessary and unavoidable”, it noted.

The PDA “also accepts” that differences between the types of business may allow independent pharmacies to find available pharmacist cover more easily.

“The owner themselves may be a pharmacist and so able to step in as the responsible pharmacist when needed,” the union said.

Read more: Temporary closures: C+D reporter discusses scale of problem on BBC

However, “all such businesses face the same weather conditions and are impacted by the same external factors, such as the pandemic”, the PDA added.

“All pharmacies operate in the same market, with the same pharmacy contract, same regulations, and recruit staff or engage locums from the same employment markets,” it explained.

“Therefore, overall, the PDA would expect unforeseen circumstances to impact CCA members in similar proportions.”

While all CCA members are headquartered in England, the temporary closure data “cannot be blamed on poor funding or previous bad policy decisions provided by NHSE&I” as the data is Scotland specific, the PDA noted.

“This information relates only to Scotland’s communities, which are covered by the separate contract funded by Scotland’s taxpayers.”

Read more: Tesco slammed as Lancashire pharmacy branch faces potential slew of closures

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 earlier this month that one of Tesco’s Lancashire branches could face full or part-day closures during much of August.

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