- The community pharmacy workforce is facing an ever-worsening crisis. Funding cuts coupled with growing patient demand have created a downward spiral.
- The continued recruitment of pharmacists from community pharmacies into GP surgeries is fanning the flames of an already precarious situation.
- The year-on-year growth of the pharmacist workforce [1] hides the true picture. By 2024, eight years’ worth of growth in the workforce will have been funnelled away from community pharmacy.
- More than a year ago, the CCA warned about the detrimental impact the Government’s flagship healthcare policy to recruit more primary care professionals was having on pharmacies.
- The Government’s whack-a-mole approach to addressing the primary care crisis, has put the community pharmacy workforce on the brink.
The CCA’s workforce findings featured in The Mirror. You can access the CCA’s workforce paper here.
CCA analysis shows that by 2024 eight years’ worth of growth of the pharmacist workforce will have been funnelled away from community pharmacies.
In 2019, when NHS leaders realised they were unable to find enough GPs to meet the public’s needs, they hastily decided to recruit pharmacists and other healthcare professionals to fill the gaps. This was implemented without any corresponding efforts to increase the supply of pharmacists, creating huge shortages.
The bulk of the NHS’s recruitment drive was paid for using additional money ringfenced by the NHS – the £2.4bn Additional Roles Reimbursement Scheme (ARRS). We estimate over the life course of ARRS funding (2019-2024), the equivalent of eight years of growth in the number of pharmacists in England will have been funnelled directly into primary care at the expense of other sectors.
Since 2015, the community pharmacy has been blighted by a lack of investment and insufficient policy support:
- In 2016, the sector saw £200m in funding cuts. Funding has not increased since, despite rising inflation and business costs.
- Recent analysis found a current annual funding shortfall of more than £67,000 per pharmacy in England. This has forced pharmacy businesses to find efficiency savings.
- At the same time, patient demand for local pharmacies has drastically risen. In 2022 pharmacies spent 107 minutes a day providing advice, a 43% increase compared with 2020. [3].
In 2000, the pharmacy degree increased from three to four years meaning no pharmacy students graduated for one year – infamously known as the ‘fallow year’. Our calculations show primary care recruitment has had an even worse impact.
At the current rate, we estimate that community pharmacy has experienced the equivalent of almost four fallow years.
To ensure the pharmacy network is protected and able to take pressure off other parts of the NHS, there are several urgent measures which must be implemented.
- Countering the impact of primary care recruitment: Community pharmacists should be commissioned to provide ‘packages of care’ on behalf of GPs, rather than taking pharmacists away from accessible high street settings.
- Funding: an immediate uplift of funding for pharmacies is needed to meet spiralling costs and enable investment in staff to ease pressure and support retention.
- Pharmacy First: The Government should immediately implement a fully-funded Pharmacy First service in England. This would enable patients with minor conditions to be seen, diagnosed, and treated at their local pharmacy, freeing up GP capacity.
Malcolm Harrison, the Chief Executive of the CCA said:
“The Government must act without delay on the ever-deepening community pharmacy workforce crisis.
Although GP recruitment of pharmacists is not the only factor contributing to the workforce crisis, it is undoubtedly fanning the flames. This downward spiral is creating untenable pressure on pharmacists and their teams.
Robbing Peter to pay Paul is short-sighted and such ‘whack-a-mole’ policies are doing more harm than good to patients.
The Government must devise an evidence-led workforce plan for all professions across primary care, ensuring patients can access the care that they need when and where they need it.”
NOTES TO EDITORS
- The Company Chemists’ Association (CCA): The CCA is the trade association for large pharmacy operators across Great Britain. Our members are Asda, Boots, LloydsPharmacy, Morrisons, Rowlands, Superdrug, Tesco and Well, who between them own and operate around 5,500 pharmacies, almost half the market.
- Additional Role Reimbursement Scheme (ARRS): To support Primary Care Networks (PCNs), the Additional Roles Reimbursement Scheme (ARRS) has been made available. This provides funding for 26,000 additional roles to be recruited into primary care networks. Funding is available to support 12 roles including clinical pharmacists, pharmacy technicians, physiotherapists, physician associates’ and community paramedics. Further information is available here.
- Primary Care Networks (PCNs): PCNs are groups of general practices who work alongside other primary care providers, community services, social care and voluntary organisations to provide personalised care to local populations. Further information available here.
REFERENCES
[1] Between March 2019-March 2023, the number of pharmacists on the GPhC registrants grew by an average of 1,593 pharmacists a year. A 2019 survey conducted by the GPhC found 82% of registrants work in England. Based on this, we estimate 1,306 of the 1,593 pharmacists work in England across all sectors.
[2] CCA, Funding gap in England equates to more than £67,000 per pharmacy, January 2023
[3] PSNC, Pressures Survey confirms rising costs, patient demand and medicine supply issues continue to grip community pharmacy, April 2023, available here. 92% of pharmacy staff reported seeing a significant increase in requests from patients unable to access General Practice, as well as increases in requests for help with symptoms for both serious (81%) and minor (98%) conditions within the last three months.