Community pharmacy can help deliver the three shifts in healthcare that the government is calling for in its 10 Year Health Plan for England, the Company Chemists Association has said in its submission to health minister Wes Streeting’s ‘national conversation’.

Pharmacies are integral to each of the three shifts envisaged by the government – moving from hospital to community care, from analogue to digital, and from treating sickness to prevention - the CCA says.

However, while the sector can deliver services that would support the government’s vision for healthcare, this is only possible “if there is concrete action to address the current funding crisis”.

Community pharmacy could enhance its role in prevention, it says, through:

• An expanded role in vaccination delivery – a recent CCA analysis shows pharmacies could free up 10 million GP vaccination appointments each year, and drive uptake in vaccine hesitant and under-served groups
• A greater role in screening – a CCA report published in September demonstrates how a diabetes screening service could screen 1.5 million adults, would save the NHS £50 million in recurring costs, and prevent almost 7,000 heart attacks and strokes, each year
• A national emergency hormonal contraception (EHC) service providing free-at-the-point-of-access to EHC, ending the postcode lottery patients currently face
• A national smoking cessation service, given that smoking accounts for approximately 75,000 deaths a year and costs the NHS £2.6 billion annually.

The CCA believes that the expansion of Pharmacy First is key to moving more care into the community. As of October, pharmacies had delivered 1.4m urgent care consultations for conditions that would otherwise have been seen elsewhere in the NHS, it says. An expanded Pharmacy First service could free up over 30 million GP appointments each year, it suggests.

Independent prescribing, the CCA continues, offers a “generational opportunity” that must be harnessed through the commissioning of services which utilise prescribers, the CCA’s submission argues.

Funding shortfall hindering innovation

The rollout of these services and the take-up of additional workload by pharmacies is only possible if the existing funding black hole is addressed, the CCA says. “Continued underfunding is hindering businesses from being able to invest in the innovative services that patients need.”

The CCA estimates the annual funding shortfall has risen to £100,000 per pharmacy in England since 2015. In January2023, a response to a parliamentary question indicated shortfall of more than £67,000 per pharmacy in England when compared to 2015/16 The CCA estimates that in the intervening period, this has risen to more than £100,000.

The government’s own figures show that between 31 March 2017 and 30 September 2024, there was a net loss of 1,250 pharmacies in England. CCA analysis shows that closures are disproportionately skewed towards more deprived communities, with 35 per cent occurring in the 20 per cent most deprived communities.

Moreover, CCA continues, further analysis has found that the equivalent of 3.4m hours of pharmacy access per year were lost between September 2022 and June 2024.

As well as core funding, the CCA is urging policymakers to “address several barriers which are inhibiting community pharmacies”:

• Continued ARRS recruitment, depleting the community pharmacy workforce
• A lack of impetus and planning on how to harness independent prescribing and upskill the legacy pharmacist workforce to become prescribers
• A postcode lottery of commissioning which is creating unnecessary legal, financial and administrative inefficiencies for pharmacy businesses that operate across regional boundaries
• Failure to update out-of-date regulation which is preventing the best use of skill mix within pharmacy teams
• Insufficient integration of patient records and interoperability between general practice and community pharmacy.

“Pharmacies are absolutely integral to delivering the shifts to prevention and care closer to the community. The network is ready to do even more – but the foundations need fixing,” said Malcolm Harrison, CCA chief executive.

“Community pharmacy can help to release capacity elsewhere in the NHS, but with each pharmacy in England now suffering a funding shortfall of £100,000 every year, the conditions for investment are simply not there.

“Policymakers must, urgently, remedy the funding crisis. Any action on funding needs to go hand-in-hand with action to address the workforce challenges, updating outdated regulation, and ensuring commissioning provides patients in different postcodes with a universal offer”.