Pharmacists concerned they will see ‘very little’ of contract funding boost

Pharmacists are worried they will see very little of the £340 million funding boost set out in the new contract.

A number of pharmacists said that rising business rates, national minimum wage and inflationary costs are likely to eat into the extra funding announced for 2026/27.

They also expressed disappointment in the lack of action to address drug pricing and reimbursement issues while expanding clinical services through adding independent prescribing (IP) to Pharmacy First.

Tabarak Sadik, a pharmacy owner in Barnet, north London, told The Pharmacist the sector cannot focus on clinical services while 'haemorrhaging cashflow' due to drug procurement.

He said: ‘Previous governments have either treated community pharmacy with disdain or, at best, sheer indifference. This means that the bar for this government to do better is incredibly low, and what they’ve given us is ever so slightly above this low bar.

‘This new contract means we’re not losing money in real terms, which is great, but what they’ve not done is relieve the pressure of drug pricing and remuneration.

‘We cannot turn our focus onto clinical services whilst we are haemorrhaging cashflow due to drug procurement. If the NHS want us to relieve pressure on primary care by increasing pharmacy clinical services, then they need to relieve the monetary pressure on us first.’

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Under the new contract, the retained medicines margin will increase by £200 million to £1.1 billion, while up to £239 million of net contract funding over-delivery accrued up to March 2026 will also be written off.

These measures aim to ‘improve stability and predictability in the medicine margin system’ and support the supply of medicines to patients, the Department of Health and Social Care (DHSC) said.

But the Office of Health Economics (OHE) think tank has warned that a £239 million write-off will be on the ‘lower end’ of what is needed, and might not cover the cost of worsening supply chain issues.

Mr Sadik felt that an increase to the medicines margin will only encourage wholesalers to increase their prices.

Superintendent pharmacist for pharmacy group PillBox Chemists, Davinder Virdee, responded to the contract on social media, saying: ‘In summary, it’s bad news. More hours looking at price lists. More dispensing at a loss. More misery.'

Locum pharmacist and health tech advisor, Aditya Aggarwal, said that the new contract is good news for pharmacist independent prescribers but bad news for ‘older, more experienced pharmacists’ who do not have an IP qualification.

He added: ‘We're likely to have a two-tier pharmacist workforce where older, more experienced pharmacists will be biased against in favour newer qualified IP pharmacists. This has been a long standing problem and one many have been burying their heads in the sand about.’

Pharmacies in rural or deprived areas that cannot rely on clinical services for extra funding may be hit particularly hard, according to contractor Kevin Simpson, who owns several pharmacies in the north east of England.

He described the contract as an ‘inflation-only deal’ and warned that more pharmacies will close this year, leaving patients to travel further to access a pharmacy.

‘Pharmacists will awaken to the hard reality that in many cases, there will be little to no return from their core business. And if they operate in a deprived location they cannot survive on services alone,’ he said.

‘Community Pharmacy England (CPE) is rightly concerned about the “deteriorating quality of service” – this is a slippery slope for community pharmacy, and I fear we are some ways down this slope at present.’

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On the other hand, chief executive of Community Pharmacy North East London Shilpa Shah was disappointed by the lack of remuneration for pharmacists who are IPs.

Consultations delivered under the new Pharmacy First clinical pathways will be paid the same item of service fee as other Pharmacy First pathways of £17.

Pharmacies will receive £25 for an initiation or ongoing contraception consultation and £20 for an emergency hormonal contraception consultation – in line with the fees for a patient group direction (PGD) consultation.

Ms Shah said: ‘It’s great to see IP on the contract but disappointing that the fee doesn’t demonstrate the work involved when prescribing compared to following a patient group direction (PGD).

‘The government are committed to working with CPE on a sustainable long term solution. This is much needed and I look forward to seeing how this develops.’

Peter Thnoia, superintendent pharmacist at online pharmacy PillTime, largely supported the contract allowing pharmacists to prescribe in a way that more closely reflects prescribing within general practice, particularly when considering the current pressures on the NHS.

He said: ‘Pharmacy has already demonstrated that it can safely and effectively deliver a wide range of clinical services. Many of these are currently provided privately, and patients are increasingly choosing them because they are often easier and faster to access than traditional NHS routes.

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‘The growth of online private services, including treatments for weight loss, hair loss and other common conditions, shows that patients are comfortable accessing pharmacist-led care when it is convenient, clinically appropriate and delivered to high standards.’

But he criticised the ‘relatively limited’ expansion of Pharmacy First, given that many pharmacy IPs are already able to prescribe a much broader range of medicines within their scope of competence.

However, he also said that NHS-funded treatment should not simply replace services that patients are already willing and able to access privately.

‘There should be a clear clinical and economic rationale for each service, showing how NHS-funded pharmacist prescribing could improve outcomes, reduce demand elsewhere in the system, or create longer-term savings for the NHS,’ he added.