The Pharmacist caught up with National Pharmacy Association (NPA) chief executive Paul Rees during today's ‘day of action’ to save community pharmacies, at a branch of Green Light Pharmacy in central London. 

Paul, tell us how the Save Our Pharmacies day of action campaign has been going today?

For the first time ever, community pharmacies joined together across the independent sector. We reckon about 6,000 pharmacies have taken action across England, Scotland, Wales and Northern Ireland.

They've been doing things like turning off the lights between 9am and 11am, people have been wearing black - there’s a banner outside this pharmacy as well.

People have been really enthusiastic, we've been overwhelmed by the level of enthusiasm.

One of the things that I've heard from pharmacy teams is that they often feel quite isolated. They're not part of a larger group. They're all aware individually about their own economic, budgetary challenges. So many of them are in the red, but they often feel that they're on their own, whereas this campaign has brought everyone together, and they feel part of a bigger team - a unified team. So, that's been really powerful and fantastic.

We're really pleased that the political parties are taking today seriously. Daisy Cooper, the deputy leader of the Liberal Democrats, came to our HQ this morning and did a video for us and supported the campaign, and the Labour health team asked to be kept updated about today. So, it's made its mark with the politicians, which was the aim.

What are you hoping the NPA day of action will achieve?

I think to really put community pharmacy on the map, one has to keep plugging away and take actions like today's activities. And you see the political narrative changing. So the three main parties’ manifestos, for the first time ever, all talked about community pharmacy – that’s never happened before. That's because politicians are thinking about community pharmacy more than before.

You've got a Pharmacy First initiative, in England, Scotland, Wales and Northern Ireland and so community pharmacy is increasingly seen as being at the heart of health care.

Politicians in this election are talking about community pharmacy, obviously we need the money to follow the ambition.

Why are issues particularly affecting community pharmacies in the UK?

There are certain shortages of medicines across Western Europe, but they’re worse in the UK.

There are issues in the supply chains that have come to the fore since Covid. There’s obviously an expansion in the demand for medicines globally, but in the UK, Brexit is an issue.

And then the other issue is the underfunding of community pharmacy. The amount we spend on community pharmacy and delivering medication through community pharmacies, half of what is spent in France, Germany and other comparative Western nations.

In essence, what the government has chosen to do is to squeeze cost out of the NHS, by keeping the amount that is spent through the drug tariff on medicines at an artificially reduced level – £800 million – and in other nations, they’re paying the market price, which means that pharmaceutical firms as global companies are prioritising other countries. Why would they prioritise the UK when they know they’ll be paid less for their medicines here than is being paid abroad?

So you could say the government strategy has worked because it has squeezed cost out with the NHS. But the impact is patients can't get the medicines they need. If they can get the medicines, they often have to wait longer, they have to shop around. Pharmacy teams have to spend hours trying to find medicines in line with the drug tariff – hours and hours and hours.

And then, of course, because of the fact there's been a 40% decrease in real terms funding over the last 10 years, 75% are in the red, and people are having to resort to things like borrowing from their aunties and uncles and re-mortgaging their homes.

It's a really pressurised time for community pharmacists.

I think that the owners feel very similar to post office sub-postmasters because they feel that they're delivering a key community asset, they know they're valued by the public, the public comes to see them every day, they're very accessible. And yet there's a system in the background that doesn't work, that doesn't make any sense.

There are no other clinicians who in effect are expected to put their own their own hands in their pockets to deliver NHS care.

Were you shocked coming into the sector to realise how much pharmacists and owners were subsidising the care that they were giving?

Yes, I couldn’t believe it. So I've worked with GPs at the Royal College of GPs, I’ve worked with psychiatrists at the Royal College of Psychiatrists, and that doesn't exist – [they] don’t subsidise the work of the NHS.

I went on to a podcast with Steve Brine, who's the chair of Health and Social Care Committee, and Helen Stokes-Lampard, who was the chair of the Academy of Medical Royal Colleges and had been the chair of the Royal College of GPs. I was explaining how the system worked and as an experienced GP, she was shocked. She didn't know just how muddled and confused the system was.

So even though GPs are also private contractors, you don’t see the same thing there?

No! They are properly supported by the NHS. They're seen as clinicians first and foremost, whereas unfortunately, the NHS still sees pharmacists as shopkeepers.

And that's such an outmoded idea, particularly with the fact that [community] pharmacy now isn't only dispensing medicine, but delivering clinical services through Pharmacy First, and also private clinical services. So they need to be recognised as the clinicians that they are.

What’s your message to community pharmacists following today’s day of action?

We've been bowled over by the response, we've been getting messages from pharmacy teams across all four nations about what they're doing today.

It's really good that the politicians are listening, but we've got to keep the pressure up. I would ask anyone in the pharmacy team to use the hashtag #SaveOurPharmacies on social media, encourage patients to sign the petition.

We just need to keep the pressure up and hope that in the end, common sense will prevail.