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GPs go forth

3,000 pharmacy closures could be 'disaster' for GPs

The closure of up to 3,000 pharmacies in the UK will be a ‘disaster’ which could lead to more GP patient demand for minor illnesses and severe problems with repeat prescriptions, GP leaders have warned. 

The Government is currently consulting on plans to slash funding for community pharmacy in 2016/17 by £170m - a cut of more than 6% - which a health minister says could see as many as 3,000 pharmacies close.

At the same time, the Pharmaceutical Services Negotiating Committee (PSNC) says that its talks with ministers have suggested that there may be an increased focus on warehouse dispensing and online services.

The proposed cuts, which were announced in December, saw the community pharmacy budget cut from £2.8bn this year to £2.63bn in 2016/17.

Part of the Government’s rationale for implementing the cuts was because it wants to introduce more pharmacists into general practice.

The consultation highlighted the initiative to place pharmacists in GP practices as an example of how it wants community pharmacy to function, adding that it wants to pharmacists working in care homes and urgent care as well.

But it also said that there were too many pharmacists in some areas. 

A letter from NHS England and the DH to Sue Sharpe, the chief executive of the PSNC, said: ’In some parts of the country there are more pharmacies than are necessary to maintain good access. Forty per cent of pharmacies are in a cluster where there are three or more pharmacies within ten minutes’ walk.’

The PSNC and the All-Party Pharmacy Group (APPG) have claimed that health minister Alistair Burt had told them that ’up to 3,000’ pharmacies could close. 

Minutes of a meeting between Mr Burt and the APPG on 13 January 2016 state: ’[Mr Burt] could not be certain how many would close but suggested it could be between 1,000 and 3,000.’

GP leaders said this could be a ‘disaster’ for practices.

Peter Higgins, chief executive of Lancashire & Cumbria Consortium of LMCs, told Pulse: ‘It will be a disaster if community pharmacies close. They are part of the network of community services available to patients and it is not possible to ”hit” one part of this network without it having an impact on the service as a whole.

’A great deal of emphasis is being placed on relieving pressure on doctors’ surgeries by encouraging patients with minor ailments to seek help from their pharmacy. This can’t happen if the pharmacy is not there.’

GPC negotiator Dr Brian Balmer said: ’The Government appears to just be imagining that the world without community pharmacies will be fine and that the pharmacists will just be able to set up shop in GP practices. There will be an effect on the entire service.

’Community pharmacists are trained to do a certain job, they are not trained to work alongside GPs. There will need to be significant retraining done for them to work in practices and many practices won’t have room to house them. It’s not a clever move.’

Pharmacists working in GP practices

pharmacist practice pharmacy 1  PPL

pharmacist practice pharmacy 1 PPL

pharmacist practice pharmacy 1 PPL

An NHS England scheme identified 700 practices to take on a clinical pharmacist backed by £31m over three years.

This was a doubling of the original funding pot of £15m as a consequence of higher-than-expected demand, but the pilots are to demonstrate that pharmacists can be self-funding in practices when funding is withdrawn.

It is part of the Government’s ‘new deal’ for reducing workload pressures on GPs, and it plans to help practices - likely as part of federations - to directly employ clinical pharmacists in ‘areas of greatest need where GPs are under greatest pressure’.

Readers' comments (25)

  • Why its a disaster for GPS?
    Who make money from medications? Dr or pharmacist! What's stopping patients to walk few more steps to buy their medication?

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  • @Tilip Yong 5.42 pm.

    The government are planning a cull of the weakest rather than trying for a planned distribution of pharmacies so there may not be another pharmacy "a few more steps"

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  • If they want to save money a good idea would be to scrap the dispensing rules and allow GP surgery's to dispense to any patient.

    The more I think about it this a brilliant idea. It could bring much needed funding into Primary Care and create a level playing field.The GP's could employ pharmacists.

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  • GP partner@ 6.50pm I don't see how that would save money. I'd agree so long as employing a pharmacist or having a pharmacist partner would mandatory for all dispensing practices

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  • Why is everything getting worse under this government?

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  • it could however save many rural practices if it allowed them to run dispensaries providing potential new income streams....not possibly what HMG has in mind but would be a consequence if small pharmacies were to close.....

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  • They are hoping to close pharmacies by stealth I.e. Reducing payments until the small can't survive. I can't see them keeping payments at a level where a rural dispensary would be an attractive option. I imagine that they could have their eyes on rural dispensaries too as they'll feel that remote pharmacies can do their job even easier as they don't offer other services.

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  • Warning they're coming after dispensing doctors next.
    They get paid 3 x the fee a phrmacy gets for dispensing you will be wrong if you think hunt wont see that as an easy target

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  • @ 8:45 - I am not entirely up to speed on the numbers but we have a pharmacy and dispensary. They each dispense an similar number of items, but the pharmacy's revenue is much higher.

    Obviously the pharmacy has to pay for pharmacists to be present, and dispensary can use 2 dispensers - so it is right that the pharmacy should make more.

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  • Pharmacy Contractors are quaking in their boots because the a light has finally been shone on the vast profits made in the last 15/20. All whilst imposing ever worsening conditions and pay for their pharmacist employees. The 6% cut should only hurt the very low volume dispensing pharmacies.

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  • Anonymous | GP Partner 17 Feb 2016 9:48am

    This is not an inflammatory question, but there must be a reason why you don't close the dispensary if it is far less profitable than your pharmacy pro rata? Unless you're just talking about income and not factoring in expenses, wholesaler discounts etc.

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  • No contractor will be happy moving in with a GP to be an employee. Firstly some contractors are terrible employers themselves with regards pay and conditions(treat fellow pharmacists with contempt) and secondly they opportunity for vast frauds practised in community pharmacy is much reduced if not nonexistent.

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  • I am interested to read about the 'vast frauds' in community pharmacy, are there any known examples?

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  • No need for details, however, MURs / NMS......

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  • As I have said for may years, allow all GPs to dispense to all patients. Surely a conservative govt would like a level playing field and competition and an injection of cash into GP not coming from existing NHS budget. Allow us to see pts private if they want would further solve the probs.

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  • @9:58

    That has been an issue - but the shareholdings in the pharmacy are different from the GP surgery partnership.

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  • @ 12.27pm

    I'd consider doing something as you're possibly up for a double financial hit if you have shares in both. I don't see these cuts stopping at pharmacy.

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  • @ 12.09pm

    Every need for details. Might as well have claimed GP's were committing fraud, only to add 'prescribing' when pressed.

    I think I have come across these comments on a pharmacy website. This troll is now lurking underneath both of our bridges.

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  • I am aware of some pharmacy contractors who are less than honest as I am sure there will be similarly GPs also. Dismissing someone as troll can often be a way of stifling a different viewpoint. And that would mean this site is also full of GP trolls.

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  • @ 4.13pm

    You're 'off topic' making unsubstantiated claims to cause trouble. Therefore you are a troll. The other posts on here are relevant.

    Validate your claims or get back under the bridge.

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  • GPs should be aware there is no impending disaster so it is certainly not off topic. A 6% cut will not suddenly evaporate 3000 pharmacies. That headline is straight from a daily rag such as the daily mail. GPs do not need to throw themselves off a cliff just yet.

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  • 6% cut is just the start troll. Nice attempt using the universal dislike of the Daily Mail to win hearts and minds. The DH have suggested the number of pharmacies that may end up closing not pharmacists themselves.

    Validate your claims or go away. I challenge you to back up claims of vast fraud. You're not a GP and no end of pharmacist bashing will make you one. Go back to school and study, but I imagine you scraped into pharmacy let alone medicine so you'll have to go right back to O-level.

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  • Dear GP Colleagues we all need to stand in solidarity together exactly as we have done with the Junior Doctors. Here's a piece I wrote for GPOnline (sorry Nigel) which makes the point

    http://www.gponline.com/viewpoint-community-pharmacists-gps-natural-allies/article/1361746

    And here's but one example of the potential knock-on effects of pharmacy closures. Please bear in mind this is NOT a planned cull but instead year upon year of incremental financial attrition with the stated aim of making 3000 pharmacies financially non-viable thereby forcing them to close.

    http://www.theguardian.com/healthcare-network/2015/mar/18/closure-small-pharmacies-threatens-overload-gps-a-and-e

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  • I couldn't agree more with Graham's comment about standing together as healthcare professionals. The proposed pharmacy cuts are top-down without being properly thought through and the inevitable damage this causes will be extremely difficult to reverse.

    I made a presentation at the House of Commons last month, together with contributions from a GP, director of Social Services and chair of a local Citizen's Forum. As well as MPs, the invited audience included representatives from patient groups, GPs, hospital consultants, nurses, local councils, and academia. There was broad agreement that working collaboratively would realise far greater savings than indiscriminate cuts without a coherent, evidence-based plan.

    We need to consider the true cost of the so-called 'efficiency' savings to frontline patient care through poorer service and increased medicines wastage, if cuts are implemented as proposed.

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  • What's the betting that the government consulted Boots (a company registered offshore), before it made this announcement.

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