CCA submission to Darzi review urges recognition of the sector’s potential to tackle health challenges and health inequalities

The CCA’s submission to the Darzi review highlights how chronic underfunding and a broken Community Pharmacy Contractual Framework (CPCF) have led to 1200+ fewer pharmacies compared to 2015. This, together with growing workforce pressures, is exacerbating health inequalities in deprived communities.

The CCA’s submission urges the government to safeguard access to pharmacy care by addressing historic underfunding. With this, the government can then take advantage of the sector’s huge potential to confront the nation’s health challenges and tackle health inequalities. Pharmacy First, whilst positive, only harnesses a fraction of community pharmacy’s potential.

Independent Prescribing, with ambitious NHS commissioning, is key to relieving pressure from other parts of the NHS, particularly general practice. The CCA’s submission concludes that a sustainably funded CPCF, with investment towards transformation and legislative change, are needed to harness the unrivalled accessibility of community pharmacies.

The CCA has highlighted several concerns which we urge the Darzi review to examine in greater detail:

- - Core funding for pharmacies has remained static since 2015/16 despite an 8% growth in dispensing volumes in that time, and a significant increase in clinical service delivery. Community pharmacy’s share of NHS funding has shrunk, growing slower than the NHS England budget and GDP. This has contributed to the loss of nearly 500 pharmacies in the last financial year alone, with closures disproportionately affecting more deprived communities.
  - Retained margin has not kept pace with increased prescription volumes, medicines costs or inflation. Combined with the underfunding of the Drug Tariff, this is contributing to medicine shortages and price concessions. This reduces patient access to medicines and drives up prices for taxpayers.
  - The most deprived communities are bearing the brunt of insufficient funding, suffering disproportionately from reduced pharmaceutical provision.
  - At the current rates of growth, it would take 88 years to increase the size of the community pharmacy workforce to the 2035/36 ambition set out in the NHS Long-Term Workforce Plan.
  - NHS England’s current plans fall well short of the opportunity offered by Independent Prescribing. The CCA believes that they will fail to take advantage of existing independent prescribers and changes made to initial education and training.

Appropriate funding and an overhaul of the CPCF are necessary to remedying these concerns for the sector. Investment is key to ensuring that community pharmacy can continue to deliver new care such as Pharmacy First. Service provision through pharmacies is greater in areas of higher deprivation, making national community pharmacy commissioning a ‘no-brainer’.

Targeted changes could release over 42 million GP appointments every year, through an independent prescribing Pharmacy First service, cardiovascular disease (CVD) screening and treatment, contraception and vaccinations. These changes would also enable current and future pharmacist independent prescribers to use their skills in NHS-funded community settings, which they currently cannot do in England.

Dr Nick Thayer, Head of Policy at the Company Chemists’ Association said:

“Community pharmacy is currently operating with two hands tied behind its back. Historic underfunding and workforce challenges has led to a worrying contraction of the network. At the same time, pharmacies are expected to dispense more NHS prescriptions and deliver more NHS services.

We urge the Darzi review to closely examine the worrying mix of challenges community pharmacies face.

Harnessing pharmacies is imperative to confronting national health challenges and tackling health inequalities. The opportunity to free up 42m GP appointments each year through investment in community pharmacy still stands.

The healthcare challenges of today and tomorrow can only be tackled if we ensure that the current pharmacy network is sustained. We urgently need the contractual framework to be overhauled with new investment to unlock this latent capacity.

We urge the new government to carefully consider the evidence we have presented and take action to harness the potential pharmacy presents.“

Read the CCA’s submission here: