Pharmacy First should start earlier than the tentatively announced February 2024 launch, vice-chair of the National Pharmacy Association (NPA) Jay Badenhorst urged MPs at the first session of the health and social care committee’s (HSCC) pharmacy inquiry yesterday (November 21).

He was joined by Association of Independent Multiple Pharmacies (AIMp) chief executive Dr Leyla Hannbeck and Company Chemists’ Association (CCA) chief executive Malcolm Harrison at in an inquiry session that had the precarious state of funding for the sector as its focal point.

Read more: Pharmacy First funding breakdown: Upfront, monthly and consultation fees

NHS England (NHSE) last week (November 16) announced the long-awaited launch of the new Pharmacy First service from “early next year” and expansion of the pharmacy contraception and blood pressure check services from next month.

Community Pharmacy England (CPE) said that the Pharmacy First service is due to start on January 31, subject to the necessary IT being ready.

Read more: ‘Huge vote of confidence’: Sector reacts to the primary care recovery plan details

Mr Badenhorst said that the £645 million allocated over the next two years for the Pharmacy First, contraception and hypertension services and clawback write-off was a “step in the right direction”.

But he told MPs that “the winter pressures don't start in February, they actually start now”.

He added that while there are “certain delays” that needed to be considered, it would be “ambitious” but “very good” to “bring forward” the service’s start date “to meet patient demands” over winter.

 

“Tough” times driving sales

 

But Mr Badenhorst warned MPs that “uncontrolled closures” of community pharmacies were a “great risk” given the “flat” core funding and other challenges facing the sector.

He told the committee that pharmacies were being put up for sale because “there's just no way for them to further operate”, with the “attrition” in numbers of community pharmacies due to “poor funding”. 

Mr Badenhorst also serves as superintendent pharmacist and managing director of Whitworth Chemists Limited, which operates 34 pharmacies in the North of England and was put up for sale earlier this month.

Read more: UPDATED: Family-owned Whitworth Chemists puts all 34 branches up for sale

He said that “tough” conditions led to the pharmacy group being put on the market and that for many independents “there is no other way out but to sell”.

He warned MPs that the market would face “a lot of instability” in the face of an increasing number of pharmacies up for sale.

 

Medicines reimbursement “not fair”

 

Labour MP for Sheffield Central Paul Blomfield recounted the perspective of pharmacist Martin Bennett, who had told Mr Blomfield that the “most exposed” pharmacies were those that had invested in staff and infrastructure, and who had predicted that “a significant number” of pharmacies would close in the next year “without a cash injection”.

Dr Hannbeck told MPs that the medicines reimbursement system was “too complicated”, highlighting that the slow process of pricing medicines leaves many contractors “out of pocket”.

Read more: HSCC launches new inquiry on future role of pharmacy services

She said that NHS work accounted for more than 90% of AIMp members’ activities, but the system used by the NHS to reimburse this work was “not fair” and “not fit for purpose”.

She called for a “cultural change” in the way that community pharmacy was treated by the “NHS hierarchy” and integrated care boards (ICBs). 

Dr Hannbeck and the other panellists were united in calling for the additional roles reimbursement scheme (ARRS) to be extended to community pharmacies to help resolve the workforce crisis.

 

“Continual squeeze of the margin”

 

Mr Harrison told the committee that it was “quite clear” that the contract and funding system was “broken”.

He told MPs that, alongside the 30% real-terms funding cuts for the sector since 2014, pharmacies had been called on to dispense 10% more items since 2017, leading to a “continual squeeze of the margin” over the last ten years.

Read more: CCA: Funding model ‘broken’ as each pharmacy facing £67k yearly shortfall

Mr Harrison said that medicines shortages had been caused by manufacturers deciding that there was “not enough money in the market” and choosing instead to sell elsewhere in the world, returning only when prices had risen. 

He added that the sector needed a “simplified and more stable model” of drug reimbursements that would let pharmacies predict their finances better.

Read more: New five-year drugs pricing deal could lead to shortages, warns BGMA

Mr Harrison said that “medicine security” needed to be considered by the government in the same breath as “energy security”.

It comes as the British Generic Manufacturers Association (BGMA) has warned that a new five-year voluntary scheme for branded medicines pricing could lead to “increased medicines shortages”.