Analysis
Rural ‘pharmacy deserts’ threaten medicine supplies, says NPA
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Many rural areas risk being left as ‘pharmacy deserts’ if current pharmacy closure rates continue, suggests a new analysis of the situation by the National Pharmacy Association.
Pharmacy closures over the past two years mean that rural areas have been hit hardest by a wave of closures that have seen nearly nine in 10 council areas across England suffering a loss of community pharmacies, says the NPA.
England faces a “material threat to the availability of vital medicines if a decade of underfunding and closures is not addressed”, the Association is warning.
Rural areas which are reliant on one or two pharmacy providers are particularly vulnerable to the impact of closures. “If a particular pharmacy company closes then all the pharmacies in a specific area could close down leading to the creation of a ‘pharmacy desert’,” the NPA says.
“Many rural areas could risk being left with little or no pharmacy provision at all without urgent action from the government, potentially forcing vulnerable or older residents to travel long distances to get hold of vital medication or treatment.”
The Association is urging the government to reverse the 40 per cent real terms cuts to community pharmacy budgets over the last decade, which have forced over 1,500 pharmacies to close and many more to cut back opening hours.
The new analysis looked at the number of pharmacies in each council area compared to their population. It found:
- 87 per cent of council areas have seen at one or more pharmacy close in their area in the past two years
- 17 out of the bottom 20 areas of the country for pharmacies per 100,000 people are councils covering rural areas
- 95 per cent of the lowest 20 council areas for pharmacy provision have seen one or more pharmacy close in the past two years
- Council areas with the greater levels of deprivation have seen the highest levels of closures during this period, risking wider health inequalities
- 80 per cent of the top 20 areas for closures have higher than average levels of deprivation, including Plymouth, North East Lincolnshire, Liverpool and Torbay.
The NPA analysis shows that West Berkshire has the lowest number of pharmacies per 100,000 of their population in the country, closely followed by Central Bedfordshire, Wiltshire and Oxfordshire, with all these areas having seen pharmacy closures in the past two years.
Plymouth has seen the highest number of pharmacy closures per 100,000 of its population, with York, Liverpool, Darlington and Wakefield all close behind.
NPA chief executive Paul Rees, said:
“The Government needs to act now to stabilise the pharmacy network and lay out a route map or a properly funded future or they will put the supply of medicine to some areas at risk.”
Janet Morrison, chief executive of Community Pharmacy England, commenting on the NPA analysis, said: “Pharmacy owners don’t want to close their businesses, but without sustainable funding, many have no choice.
“This analysis is yet another clear warning sign to the government and the NHS that things cannot continue as they are. They need to prevent further closures by investing in community pharmacies and offering a sustainable funding model.
“Without this, patients, especially the most vulnerable, will find it increasingly difficult to access essential medications and healthcare services.”
The NPA analysis is based on pharmacy provision in 143 upper tier local authority areas in England. The data weights the number of pharmacies by per 100,000 population of the local authority to account for variations in population. The population data is based on the 2021 ONS census.
The data looks at changes in provision based between the NHS’s 2022/23 Quarter Two and the 2024/45 Quarter One Consolidated Pharmaceutical List.
Top 20 local authority areas with lowest provision:
2024/25 Q1 |
2022/23 Q2 |
Change per 100,000 population |
Pharmacy per 100,000 2024/25 Q1 |
Pharmacy per 100,000 2022/23 Q2 |
|
West Berkshire |
16 |
20 |
-2.5 |
9.9 |
12.4 |
Wokingham |
21 |
22 |
-0.6 |
11.8 |
12.4 |
Central Beds |
38 |
40 |
-0.6 |
12.6 |
13.2 |
Bracknell Forest |
18 |
19 |
-0.7 |
12.7 |
13.4 |
Wiltshire |
66 |
71 |
-1 |
12.9 |
13.9 |
Oxfordshire |
100 |
106 |
-0.8 |
13.8 |
14.6 |
Cambridgeshire |
95 |
101 |
-0.8 |
14 |
14.8 |
Shropshire |
46 |
48 |
-0.6 |
14.2 |
14.8 |
Herefordshire |
27 |
27 |
0 |
14.4 |
14.4 |
Lincolnshire |
111 |
115 |
-0.6 |
14.4 |
15 |
North Yorkshire |
88 |
94 |
-1 |
14.5 |
15.5 |
Rutland |
6 |
6 |
0 |
14.6 |
14.6 |
Worcestershire |
91 |
96 |
-0.9 |
15 |
15.9 |
Hampshire |
217 |
231 |
-1 |
15.2 |
16.2 |
Milton Keynes |
44 |
45 |
-0.4 |
15.3 |
15.7 |
Southampton |
38 |
40 |
-0.8 |
15.3 |
16.1 |
Surrey |
184 |
202 |
-1.6 |
15.3 |
16.8 |
Bournemouth, Christchurch and Poole |
62 |
67 |
-1.3 |
15.4 |
16.7 |
South Gloucestershire |
45 |
48 |
-1 |
15.5 |
16.5 |
Lewisham |
48 |
52 |
-1.4 |
15.6 |
17 |
2024/25 Q1 |
2022/23 Q2 |
Change per 100,000 population |
Pharmacy per 100,000 2024/25 Q1 |
Pharmacy per 100,000 2022/23 Q2 |
|
Plymouth |
46 |
54 |
-3.1 |
17.3 |
20.4 |
York |
36 |
42 |
-3 |
17.7 |
20.7 |
Cheshire East |
142 |
155 |
-3 |
35.6 |
38.6 |
Liverpool |
111 |
125 |
-2.9 |
22.8 |
25.7 |
Darlington |
18 |
21 |
-2.8 |
16.7 |
19.5 |
Wakefield |
67 |
77 |
-2.8 |
19 |
21.8 |
Hull |
60 |
67 |
-2.6 |
22.5 |
25.1 |
Coventry |
84 |
93 |
-2.6 |
23.2 |
25.8 |
North East Lincolnshire |
65 |
69 |
-2.6 |
41.4 |
44 |
West Berkshire |
16 |
20 |
-2.5 |
9.9 |
12.4 |
Gateshead |
41 |
46 |
-2.5 |
20.6 |
23.1 |
Portsmouth |
34 |
39 |
-2.4 |
16.3 |
18.7 |
Rochdale |
48 |
53 |
-2.3 |
21.4 |
23.7 |
Halton |
30 |
33 |
-2.3 |
23.4 |
25.7 |
Thurrock |
29 |
33 |
-2.25 |
16.5 |
18.75 |
Torbay |
28 |
31 |
-2.2 |
20.1 |
22.3 |
Kingston upon Thames |
29 |
32 |
-2.1 |
17.2 |
19.3 |
Richmond |
43 |
47 |
-2.1 |
22 |
24.1 |
Tameside |
51 |
56 |
-2.1 |
22.1 |
24.2 |