An increase in overhead costs and a shortfall in the amount they are paid to dispense medicines means a record number of pharmacies are closing their doors.
But research by Good Health has identified another threat: the growing number of online pharmacies.
These should provide services nationwide, but some now do so only in specific areas, putting local pharmacies out of business.
While the number of community pharmacies fell by 673 between 2015 and 2023, the number of distance selling pharmacies, which are online pharmacies contracted by the NHS to issue prescriptions, increased by 247 over the same period.
Distance selling pharmacies, or DSPs, which do not offer the option to serve patients and benefit from lower overhead costs, should not target areas where physical chemists are already in operation.
An increase in overhead costs and a shortfall in the amount they are paid to dispense medicines means a record number of pharmacies are closing their doors.
Last week, the role of pharmacists was further expanded under the NHS-backed Pharmacy First programme.
This is to try to safeguard traditional pharmacies, which are increasingly relied upon to offer more services, easing pressure on hospitals and GPs.
Last week, for example, the role of pharmacists was further expanded under the NHS-backed Pharmacy First programme.
Pharmacists can now treat ailments such as earaches, skin infections, basic urinary tract infections and shingles, and can prescribe antibiotics.
But more worryingly, research by Good Health has shown that from 2015 to 2023, 155 local pharmacies closed where they were now serving 11 online pharmacies in the area.
DSPs are advertised online but are also found on the NHS app, encouraging patients to register with them as their provider of choice, as they increasingly do.
NHS data showed that in 2021, DSPs issued 53 million prescriptions in England, up from 29 million in 2019.
While DSPs are intended to dispense medicines to anyone, anywhere in the country as part of their contract with the NHS, our investigation showed that many were refusing to care for patients outside their local area.
When a journalist approached a sample of 11 DSPs, eight of them said they only delivered locally.
And while physical pharmacies can only open in areas where necessary, DSPs do not need to comply with this requirement.
Some fear this means the situation will get worse as online pharmacies open wherever they want.
All Party Pharmacy Group MP Taiwo Owatemi says it is the patients who will lose out.
He told Good Health: ‘The danger is that unfair competition will harm patient care, because community pharmacies cannot compete and have to close.
All Party Pharmacy Group MP Taiwo Owatemi says it is the patients who will lose out
The Company Chemists’ Association (CCA) has accused NHS England of turning a blind eye to the threat posed by DSPs.
‘This harms in-person health services in that area. This will only get worse if we have unfair competition in the market between physical pharmacies and DSPs.’
He wants the NHS to crack down on DSPs targeting local areas and refusing to care for patients across the country, and to suspend any new DSP contracts until the situation has been resolved.
The Company Chemists’ Association (CCA), which represents chains such as Lloyds Pharmacy and Boots, has accused NHS England of turning a blind eye to the threat posed by DSPs.
Malcolm Harrison, CCA chief executive, said: “Pharmacies in England are closing at an alarming rate – almost 1,000 since 2015 – and these dishonest businesses are making matters even worse.
“What’s more, patients will no longer be able to access the services, care and advice of their local community pharmacy if these traders close it.”
All pharmacies are paid to dispense NHS prescriptions and are reimbursed a fixed price for the medicines they source and dispense.
As part of our Save Our Local Pharmacies campaign, Good Health has reported on how pharmacies are, in some cases, being reimbursed less than the cost of medicines, because the payment scheme has not been reviewed since 2015. At the same time, We’re finding that your overhead costs are spiraling.
They have increasingly found themselves on the frontline as the NHS seeks to relieve pressure on GPs and hospitals, and are being promoted as the first port of call for the treatment of minor ailments.
Janet Morrison, of Community Pharmacy England, said local pharmacies are “under significant pressure” with some “reporting record losses”.
He added that while initiatives like Pharmacy First “will provide some additional funding, this funding is specifically targeted at pharmacy first services.”
‘This will not solve the underlying funding gap in the sector. Finding the capacity to deliver (these initiatives) will be a real challenge,” Janet Morrison said.
And it’s not just community pharmacies that are at risk. Last year, 244 supermarket pharmacies were expected to close, with the NHS budget for the sector frozen since 2017-18.
Distance selling pharmacies, or DSPs, which do not offer the option to serve patients and benefit from lower overhead costs, should not target areas where physical chemists are already in operation.
Meanwhile, an investigation has identified that DSPs, regulated by the General Pharmaceutical Council, are breaching a central part of their contract.
They are intended to deliver medicines anywhere in England by post or courier for free, so they are not in unfair competition with traditional pharmacies with much higher overheads.
NHS data analyzed by the CCA showed that 72 per cent of DSPs deliver more than half of prescriptions within ten miles of their warehouses. And only 16 percent of DSPs receive prescriptions from more than one ZIP code area.
The 11 distance selling pharmacies contacted by Good Health were chosen because NHS data showed that almost all of their prescriptions were issued within a single postcode.
Malcolm Harrison said the CCA believed DSPs were “targeting the population of that area to absorb the business”.
Their analysis, revealed exclusively to Good Health, showed that there have been 155 brick-and-mortar pharmacy closures within a ten-mile radius of the 11 DSPs since 2015, although a direct correlation cannot be proven.
One DSP, Docpharma, based in Cheetham Hill in Manchester, issued 80,606 prescription items in 2022, but NHS data showed that all prescriptions came from within a ten mile radius of its registered address.
On the official NHS app, where people can choose their designated pharmacy, Docpharma states: “We offer free prescription delivery within three miles of the M8 Manchester.” This is despite the NHS insisting that deliveries should be free nationwide.
The official NHS app allows people to choose their designated pharmacy
When a journalist called Docpharma to ask if he could see a patient in London, the assistant said “no” and that “we’re only in the Manchester area.”
The CCA says 56 pharmacies within a ten-mile radius of Docpharma have closed since 2015.
Another distance selling pharmacy, Advantage, based in Leeds, rejected an online request from an out-of-town patient. The automated response said “online prescribing is not currently enabled for your location.”
This is despite the DSP website stating that Advantage “focuses on providing a free prescription collection and delivery service anywhere in England”.
The DPS issued 40,240 prescription items in 2022, according to NHS data, and 98 per cent of them came from within a ten-mile radius.
The CCA estimates that 30 local pharmacies have closed within a ten-mile radius of Advantage since 2015.
The provision of physical pharmacies is especially important for older people, people who do not have access to the Internet, and those who do not have private transportation.
The CCA estimates that 30 local pharmacies have closed within a ten-mile radius of Advantage since 2015
Malcolm Harrison said the CEC had repeatedly raised this issue with NHS bosses but claimed “no action had been taken”.
A spokesperson for the General Pharmaceutical Council said: “Our targeted inspections of pharmacies have resulted in the identification of serious patient safety issues in relation to some online pharmacies and online prescription services.”
The council added that since April 2019, 69 “enforcement measures have been taken against ‘online activity'”, although this related to issues such as the ‘inappropriate prescribing, dispensing and supply of prescription medicines’.
An NHS spokesperson said: “Distance selling pharmacies are required to deliver medicines to anyone who requests them anywhere in England, and where there is evidence that a company is failing to do so, it will be investigated by the local NHS and action will be taken. appropriate measures.” .’
Docpharma director Shaheen Chaudry said: ‘Our aim is to comply with all regulations relating to our distance selling contract.
“We will remind all staff and locums of the pharmacy’s obligations in terms of providing nationwide coverage and will also review our promotional materials with a view to correcting any errors.”
Advantage did not respond to a request for comment.