In a report published on Saturday (November 2), the Northern Ireland Affairs Select Committee said pharmacies “are a valuable healthcare resource and highly rated by the communities they serve…yet many are struggling to survive in the face of prolonged underfunding”.

The MPs called on the country’s Department of Health (DH) to produce a “sustainable funding package” that is reflective of its 2017 cost of service inquiry (COSI) and to implement a Drug Tariff system “based on Northern Ireland’s unique set of circumstances”.

According to written evidence from Community Pharmacy Northern Ireland (CPNI), “since 2011, community pharmacies have been underfunded by at least £60m, due to the extrapolation of English Drug Tariff funding models, which are not appropriate for Northern Ireland”.

Northern Ireland has the second highest number of items prescribed per head of population after Wales and the highest net ingredient cost per head of population in the United Kingdom – £226.32 per head in 2018, 43% higher than in England – CPNI claimed.

The English Drug Tariff does not “take into account the higher level of community pharmacy workload and medicine procurement per head of population in Northern Ireland”, it added.

Increased funding

In November 2018, Northern Ireland’s 532 pharmacies received an additional £11.1 million in funding up to March 2020, to address “immediate pressures” and to fund a minor ailments scheme over the winter period. This was on top of the £104m global sum for both 2018-19 and 2019-20, which was also confirmed last November.

However, the DH’s 2017 COSI found that pharmacy running costs and profits in 2011-12 came to a total of £130-136m a year and Northern Ireland faces a “unique set of circumstances” compared to its UK counterparts, which the select committee MPs argued warrants a more “sustainable funding package”.

While Northern Ireland’s chief medical officer Michael McBride acknowledged the “very significant financial challenges for community pharmacy”, he told the select committee the COSI “was never designed to determine what the financial envelope was like, but to inform it along with other inputs”.

“The DH faces significant financial constraints and many priorities across a number of budgetary areas. We do not have the luxury of spending money that we do not have,” he added.

MP: Community pharmacy is untenable

Commenting on the report, Ian Paisley, Democratic Unionist Party MP for North Antrim and member of the select committee, told CPNI the “situation in community pharmacy is untenable”.

He urged the DH to “take heed of the committee’s recommendation” and “address the funding issues that are at risk of undermining the entire network”.

CPNI chief executive Gerard Greene said he is “pleased that the committee is calling for action” and highlighted the need to invest in “transformative services” to avoid “putting the entire service at risk”.