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‘Last man standing’: How will NHS strike action affect community pharmacy?

Amid widespread disputes over NHS pay and conditions and a vote by nurses to take strike action, C+D has asked pharmacy bodies for their view on how community pharmacy teams and demand for services could be affected

Members of the Royal College of Nursing (RCN) union are set to stage their first national strike across all four UK nations – for the first time in the body's 106-year history – after a ballot saw most NHS Trusts in England reach the 50% turnout threshold needed for strike action.

All nursing staff in Northern Ireland and Scotland will be included, and all but one of the health boards in Wales met the threshold.

Read more: Could England’s community pharmacists go on strike?

On November 17, the RCN urged the government to start pay negotiations within five days or else it would announce strike dates for December.

Strike action is anticipated to begin before the end of the year and the RCN’s mandate to organise strikes remains in place until early May 2023.

Last week, the British Medical Association announced that a ballot for industrial action by junior doctors in England will open on January 9, 2023.

Meanwhile, several unions – including the Chartered Society of Physiotherapy, Royal College of Midwives, and Unison – are also currently balloting members over industrial action, amid ongoing pay disputes.

But what impact could all of this have on the community pharmacy sector?


“Pharmacies will be the last man standing”


Company Chemists’ Association (CCA) chief executive Malcolm Harrison warned that strike action by healthcare workers would “inevitably force patients to seek the urgent care they need outside of hospitals”.

Many people seeking care “will once again turn to their local pharmacy when they find that their GP cannot help them, as they did during the pandemic”, he told C+D.

Given the “years of underfunding” and cost pressures contractors face from a “workforce crisis brought about by poorly planned NHS recruitment”, the pharmacy network is on the brink of collapse, he warned.

Read more: Sector in crisis: Thousands of pharmacies at risk of closure as inflation bites

Last month, NHS Business Services Authority data revealed that the number of community pharmacies across England had dropped to its lowest figure since 2015, with 11,522 open in 2021/22.

This marks a 3.6% decrease on 2015/16 levels, when there were 11,949 community pharmacies.

“Once again, pharmacies will be the last man standing to help patients in need,” Mr Harrison cautioned.

“But with pharmacies closing at an increasing rate, they might not be able to provide this safety net for the NHS for much longer.”


“No employee takes industrial action lightly”


Meanwhile, the Pharmacists’ Defence Association (PDA) told C+D that “health professionals that act together as a trade union are still first and foremost health professionals and will be trying to balance their commitment to patient care with their need to exercise their rights at work”. 

The union expects those considering taking industrial action “to ensure that essential patient care is provided, and that patient safety will remain a priority”, it added.

However, industrial action at hospitals “could cause some extra patients to present at their community pharmacy”, the union acknowledged.

“No employee, let alone a health professional, takes industrial action lightly,” the PDA told C+D.

Read more: Pharmacy2U urges patients to be ‘mindful’ amid Royal Mail strike action

“But having exhausted other options, this seems to be the only option left to try and make the government listen and hopefully act upon the very serious issues that NHS employees know need to be addressed in the interests of patients and the wider population, as well as the workers themselves,” it added.

While unions are planning strikes that are anticipated to have a national impact, the results of the RCN ballot demonstrate that not every NHS trust will see the same levels of industrial action, the PDA noted.

Pharmacists should ensure they are aware of what is happening in their local area and when, the union said. The PDA has put together guidance for those not on strike to help them respond to a picket line.


“We expect some knock-on effects”


National Pharmacy Association (NPA) director of corporate affairs, Gareth Jones, acknowledged that “some knock-on effects on pharmacies” from RCN strike action are to be expected.

However, their extent depends “on whether there is significant disruption to community nursing and urgent care”, he told C+D.

At this stage, it is “hard to predict the scale of the impact in terms of additional demand for pharmacy-based support”, he noted.

But as proven by the COVID-19 pandemic, community pharmacy is often “the go-to place for healthcare advice and treatment when access to other parts of the health service are reduced”, Mr Jones added.

In July, when asked by C+D about pharmacist’s rights to take their own strike action, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Janet Morrison conceded that contractors could “ultimately…decide if they, too, wanted to withhold their labour at any point”.

However, this would constitute a breach of their contract, she warned.


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