The impact of pharmacy closures on health inequalities: one year on

Last year the CCA published a report on the impact of pharmacy closures on health inequalities. This revealed a worrying trend of increasing numbers of net closures disproportionately affecting the most deprived communities in England. Since then, there has been a further 338 net closures, meaning that there are now over 1,000 fewer pharmacies than in 2015. The story was exclusively covered by the Daily Mail.


Since 2015, there has been a net loss of 1,008 pharmacies in England, with permanent closures occurring disproportionately in areas of deprivation. This financial year alone, an average of eight pharmacies have closed per week.

The Company Chemists’ Association (CCA), the trade association for large pharmacy operators across Great Britain, analysed permanent closures of community pharmacies in England since 2015. Between 2015 and 2023, there has been a net loss of 1,008 pharmacies across England. Deprived areas are the worst affected with pharmacy closures – between 2015 and June 2023 37.5% closures occurred in Indices of Multiple Deprivation deciles 1 and 2, the most deprived 20% of neighbourhoods in the country.

The CCA is concerned that permanent closures will undermine healthcare accessibility in deprived areas, where access tends to be more limited despite greater need (the ‘inverse care law’). The reverse is true for community pharmacy – 89.2% of the population is estimated to have access to a community pharmacy within a 20-minute walk, and crucially in areas of highest deprivation access is significantly higher (99.8%) – otherwise known as the ‘positive pharmacy care law’.

However, the significant jump in the rate of closures poses a threat to the positive pharmacy care law. Closures in areas of deprivation further contribute to “distance decay” for accessible and preventative healthcare. The further patients may have to travel to remaining pharmacies will mean they are less likely to use these services.

Community pharmacies are experiencing a worrying mix of funding, workforce, and workload pressures:

  • There is currently an annual funding blackhole of more than £67,000 per pharmacy in
  • GP recruitment of pharmacists via the Additional Roles Reimbursement Scheme (ARRS) is
    fanning the flames of an already precarious workforce crisis in community pharmacy. Over
    5,200 FTE pharmacists are now working in primary care networks. We estimate that this
    has led to almost 4,000 community pharmacists leaving the sector to work in primary care
    networks or general practice.
  • Between 2017/2018 and 2022/23 the workload demand across the network increased by
    1.7 million hours. The Government plans for pharmacies to do more, without immediate funding.

As with any business, there are many costs to operating a pharmacy, including premises and labour costs. The funding blackhole is a contributing factor for the pharmacy closures trend. Although, Government and the NHS have pledged a £645m investment in community pharmacies earlier this year – this investment for the sector is not flowing into pharmacies yet.

Pharmacies can play a significant role in relieving pressure on other parts of the health service, allowing hospitals to focus on clearing backlogs. However, significant workforce shortages and insufficient funding means their potential is not being realised.

The Government must revisit pharmacies’ core funding to reverse the trend of closures. Without action, people in deprived neighbourhoods will be robbed of the opportunity to receive essential care.

Malcolm Harrison, Chief Executive of the Company Chemists’ Association said:

“A toxic mix of funding, workforce, and workload pressures are restricting pharmacies from delivering what the Government wants them to deliver.

Pharmacies are delivering many more services and dispensing more and more medicines for an ever-shrinking pot of money. This is simply unsustainable.

Without immediate action to protect the community pharmacy network, patients in deprived neighbourhoods risk being left high and dry.

The Government must work with us to reshape what community pharmacies do and reduce our workload so patients can continue to access the face-to-face care they need from pharmacies”.

Preet Kaur Gill MP, Labour’s Shadow Minister for Primary Care and Public Health, said:

“It’s shocking that since 2015, over 1,000 pharmacies have had to permanently close, disproportionately in the communities that need them the most. Many more have had to reduce opening hours, services and staffing.

“Labour will reform the NHS, so everyone has access to healthcare when they need it. We will further expand the role of community pharmacy as part of our plan to build a Neighbourhood Health Service, cutting unnecessary red tape to ensure pharmacists can work to the top of their license and focus on their expertise in prescribing and medicines management.”

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