Layer 1

Expect more cuts to NHS services, LPCs warn

Practice LPC representatives, including Essex LPC chief executive Ash Pandya (pictured), predict another decrease in local enhanced services over the next year, after data revealed that the number had dropped for the second year in a row

Pharmacists may have to endure another year of cuts to NHS services while commissioners settle into their roles in the reformed health services, LPCs have warned.

LPC representatives Ash Pandya and Hiten Patel said that pharmacists should expect another "small decrease" in services over the next year, in response to NHS data that revealed that the number of local enhanced services had dropped for the second year in a row.

PCTs cut up to 800 local enhanced services across England's community pharmacies between April 2012 and March 2013 – a drop of 2.7 per cent, according to data published by the Health and Social Care Information Centre (HSCIC) last week (November 20). It was the second year of cuts to services in a row, following a steady rise since 2005.

"Eventually there will be some collaborative working, when GPs finally realise they can't do it all themselves," said Essex LPC chief executive Ash Pandya

More on the NHS reforms

Pharmacists should be ‘beating a path' to GPs, NHS leaders say

Jeremy Hunt's vision for pharmacy

Pharmacy leaders undecided on impact of NHS reforms

Essex LPC chief executive Ash Pandya said he expected the cuts to be followed by an increase in the number of public health services commissioned by local authorities and Public Health England, once the organisations had a better understanding of pharmacy.

But he said that it could take up to 18 months before GPs increased the number of services they commissioned from pharmacy, he told C+D. "Eventually there will be some collaborative working, when GPs finally realise they can't do it all themselves," he added.

Ealing, Hammersmith and Hounslow LPC chairman Hiten Patel said pharmacists should not be "relaxed in the assumption" that pharmacy services would recover next year and needed to continue to engage with commissioners.

PSNC said it was "disappointing and worrying" to see the number of pharmacy services in decline, but the data was not a "useful indicator of the present situation".

"It is difficult to draw any firm conclusions from this data because it was collected from PCTs at a time of great change as they prepared to be dissolved," said PSNC head of NHS services Alastair Buxton.

Number of local enhanced services provided by community pharmacy

The drop in commissioning levels could have been the result of uncertainty among PCTs ahead of the introduction of the new commissioning system in April 2013, the HSCIC said in its report.

The annual number of prescription items dispensed by community pharmacies in England rose by 3.3 per cent to 914.3 million in 2012-13, and 259 community pharmacies were added to the PCT pharmaceutical list last year, said the HSCIC.

Community pharmacy also delivered a record number of MURs, with 2.8 million conducted in 2012-13, a rise of 15.9 per cent on the previous year. The average number of MURs provided by each pharmacy that offered the service increased from 239 to 267.

Have you been affected by the cuts to local NHS services?

Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook


Andrew Butterworth, Pharmacy owner/ Proprietor

It is not realistic to expect a "world class pharmacy service fit for the 21st century" if the funding available to pharmacies is cut to a level where investment in premises and service development is no longer possible. Quantity and quality are two very different things.

Gerry Green,

This person "Del Boy" has verbal diarrhoea and unfortunately most of his comments about pharmacy finances must be based on "hearsay". He might wish to see the restrictions on the pharmacy contract dropped but if that happened and he opened a pharmacy he would "go bust" pretty quickly without the practice allowance.
Pharmacy owners need all the income they can acquire from present as most independents are struggling to make ends meet (hence the need to resort to the rogue lenders like R.B.S.
Might I remind you Del Boy that it is not only pharmacists who read his comments and those who hold the purse strings in the NHS will cease any chance they see to make savings . That will mean many locums as well as ind.owners will be out of work soon if you have your silly way. Gerry Green ( retired pharmacy business consultant)


Just to add:

Pharmacy owners need all the income they can acquire from present as most independents are struggling to make ends meet (hence the need to resort to the rogue lenders like R.B.S.

I'm AFRAID that just boll**ks. The average independent is dispensing around 4500 items a month and if he/she needs to resort to the RBS, then they derserve all they get.
I don't claasify that as struggling. They need to question their buying and ask for greater discounts from the generics companies. With the advent of MURs, thats another £10000 plus in the coffers. If a pharmacy dispensing 2400 a month is on the market for £375k then U can double that for someone dispensing 4500...£750k
It beggers belief that out mate green thinks thats a struggle. DISGUSTING!!!!

No sympathy here.......I am on the side of the average locum/employed pharmacist


Gerry Green,

I note Del Boy you have to resort to expletives when your counter argument looks thin.
I am quite sue as an owner you too would appeal against a new application on your patch if an application was lodged and you were notified of this.
Your info about profitability of NHS work in community pharmacy is four or five years out of date. Unfortunately many owners are not up to date with their accounts and so may not be aware how bad things have become in 2013
Do not look at any one goodwill price and brand all pharmacies as the same. It does not work like that! One business has high street rent whilst another has a "peppercorn" rent on a council estate parade of shops. Same turnover totally different costs!
I could go on but suffice to say your arguments are pathetic not least your wishful thinking that some "fairy godmother" in government is going to subsidise any type of pharmaceutical service espec. when folks like you write the rubbish that you do


Control of entry changes – the verdict

Read the article on c and d website


You have failed to address anyone of my points I made in the above...
Locums hvn't had a payrise in 10 years - what part of that don't you understand...

Go read an economics book - WHEN SUPPLY IS GREATER THAN DEMAND, THE PRICE FALLS - for both locums/contractors.



ps: it's friday, are you someone that needs a sip of alcohol to drown your sorrows?

If your struggling, then you should sell up...and not moan...WHY do locums get on with it but contractors just moan?????


1. You need to speak to charles russell about the number of appeals they are dealing with - if pharmacy wasn't viable, then why would pharmacists go to the expense of appealing for a licence.

2. Most independents are struggling - Hmmm, what independents are they? I have yet to meet a poor independent. There was a pharmacy on sale for £375,000 doing 2400 items a month...- do you clasisify that as struggling?

3. Why should contractors be protected?

4. Locums are struggling too, yet the majority get on with it.

5. If contractors are struggling, they should sell up. Why should the tax payer prop them up?

6. If Pharmacies can't survive withot the allowance, it would be up to the government to subsidise the profession not the current rules where one can't see if things would work without the allowance due to the monopoly.

7. Locums are recieving hourly rates similair to those 10 years ago...

8. Out of work? Thats just nonsense. Market forces will make sure this never happens.
May I remind you that there are locums struggling to get work so it's tough for both contractors and locums. Why are locums the forgotten people??????????

The brown stuff is running out of your mouth Sir......


As one flicks through the glossy pharmacy magazines, there are very few pharmacies for sale. This will show potential buyers that phamacy is still a very good viable business model to invest regardles of the doom/gloom shown by the contractors...
As a tax payer I would like to see value for money first and foremost and this should mean further funding cuts to a level where both contractors and the tax payer recieve a good deal. I think we have a long way to go and working in the profession for over ten years has shown me that there are areas where there further cuts need to be made namely:

3. MURs

The current model can't reflect this as the monopoly enjoyed by the contractors is distorting the true market.


Serious consideration should be given to decreasing the practice allowance as there are pharmacists willing to forego this in return for an NHS contract.

Reeyah H, Community pharmacist

What do u mean? How would that benefit us?!


I know the contractors will rate this bad but there are 100s pharmacists who are willing to forgo the practice/establishment fees in return for an NHS contract.
This could save the NHS millions which could be re-invested into expanding the roles of pharmacy and hopefully trickle down to the employed/locum pharmacists who have been left behind without a payrise in years...The current system benefits the contractors who want to protexct their goodwill until the day arrives when they are ready to sell


Do you mean how will it benefit U?

It will mean that market forces will dictate how pharmacies are funded/rewarded and not a monopoly which we currently have. We have a situation where we have two companies, namely the shoe company and lloyds which have control 50% of the NHS market. It's vitally important to open the NHS market and achieve a truly world class Pharmacy service fit for the 21st century. It should be easy to open a pharmacy and not this current bureaucratic system.

Job of the week

Pharmacist (qualified Independent Prescriber)
London (Central), London (Greater)
Annual salary to start at £52,000 based on a 40 hour week.