Patients in rural areas could be prevented from accessing health services once NHS England ends its funding for small pharmacies next year, contractors have warned.

The Essential Small Pharmacies Local Pharmaceutical Services (ESPLPS) scheme, which pays a variable top-up fee to contractors dispensing between 6,000 and 26,400 items a year, will stop next April because NHS England had not received "direction" from health secretary Jeremy Hunt for the funding to continue, the commissioning body told C+D last week (October 15).

Contractors warned that the funding was necessary to maintain pharmacies in rural areas and the government needed to consider the consequences for patients of ending it.

NHS England could not say how many pharmacies would be affected and told C+D its area teams were "working through the consequences" of the change and seeing "what alternatives may be available". The scheme initially ran from 2006 to 2011, before NHS England extended if for a further four years.

Louisa Main, manager at Millers Pharmacy in Cheddleton, Staffordshire said the fund was "essential" to keep her business open. Without it the pharmacy would need to dispense double the number of items to survive, she said.

The government had not "thought through" scrapping the scheme, Ms Main said. If pharmacies like hers closed it would hurt patients – particularly the elderly – who rely on pharmacies in rural areas, and for whom it is "totally unrealistic" to travel further afield, she stressed.

Independent Pharmacy Federation spokesperson and contractor Graham Jones told C+D that the predecessor to ESPLPS had been necessary to establish one of his own pharmacies, and called on the government to ensure that patients in deprived rural areas would continue to have pharmacy access.

"In many areas if you don't have ESPLPS, you won't have a [pharmacy] service. It's always [been] particularly important for newer pharmacies in areas of low service provision, because they need to get a foothold established," he said.

Applications to the scheme are now closed, and in 2010-11 there were 132 contractors operating under the scheme in England. To apply, a pharmacy could not be situated within a kilometre of any other.

NHS England told C+D it was "committed" to making sure all patients had good pharmacy access, and it was working with area teams to decide how to best meet patients' needs.

PSNC told C+D it was "exploring" ways to protect the income of pharmacies who had been operating under the scheme.

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