Almost half (42%) of people recently surveyed by Healthwatch England experienced problems getting medicine from their pharmacy in the past 12 months.

And almost a quarter (24%) of the 1,650 people surveyed said they had experienced their pharmacy being out of the medicines they needed in the past year.

Shortages affected more women than men (26% compared to 22%), and more older people than younger (30% of those over 65, compared to 15% of those aged 18-24), the survey, which was conducted in November 2023, found.

Meanwhile, 7% of patients said they had problems getting the medicine they needed because the pharmacy was ‘unexpectedly closed’ temporarily, while 1% could not access medicines due to a permanent pharmacy closure.

Bricks and mortar pharmacies used more than online

The Healthwatch England report, published today, also highlighted a greater use of bricks and mortar pharmacies than online pharmacies, with 72% of people having used a community pharmacy in the previous three months, compared to 18% using online pharmacies.

Of those who had used an online pharmacy, 54% said they were likely to do so again, while 18% said they were unlikely to.

Almost a quarter (23%) of those who had used an online pharmacy said they could not immediately get the medicine they wanted.

And some respondents raised concerns that patients could simply change their answers to the clinical questionnaire to be supplied with a particular medicine.

Healthwatch England noted that it had not defined ‘online pharmacy’ in its survey, so patients could have been referring to the website of their local pharmacy in addition to distance selling pharmacies (DSPs).

And it suggested the possibility that ‘the figures for DSPs specifically would be lower’ than the total included under responses regarding ‘online pharmacies’.

'Allow pharmacists to amend prescriptions'

To mitigate the impact of shortages, Healthwatch England recommended that ‘where safe to do so, and in collaboration with patients, pharmacy teams should be given flexibility to make changes to medicines they dispense’.

‘And to ensure patients are kept informed as to shortages’, the relevant bodies should ‘better communicate serious shortage protocols to GP and pharmacy staff, including through their primary care bulletin’, Healthwatch England suggested.

The General Pharmaceutical Council (GPhC) said today that it had ‘already begun discussing how we may respond to the important issues raised in this report’, adding that the recommendations ‘need careful consideration by everyone working across pharmacy and the NHS in England, as well as the government’.

Last month, primary care minister Dame Andrea Leadsom said the Department of Health and Social Care (DHSC) has ‘no plans’ to allow community pharmacists to amend prescriptions.

But health secretary Victoria Atkins later said that the DHSC had ‘not made a decision’ on whether it would allow pharmacists to supply alternative medicines in the case of a shortage.

GPhC chief executive Duncan Rudkin revealed earlier this month that he had met with the DHSC on the issue.

Cost of living impacts access to medicines

The report also highlighted the impact of cost of living on pharmacy usage, with 5% of people saying they have avoided taking up one or more NHS prescriptions because of the price.

‘Awareness of PPCs [pre-payment certificates] and local NHS Minor Ailments Schemes should be raised through national campaigns and the wider rollout of NHS posters,’ Healthwatch England recommended.

The prescription charge in England is set to rise from £9.65 to £9.90 per item from tomorrow (1 May), while around 90% of prescriptions in England are free due to various eligibility schemes.

Action needed to tackle shortages

The Royal Pharmaceutical Society said the ‘timely study’ raised ‘stark warnings for policymakers around medicines shortages, consistent access to pharmacy services, and the impact of prescription charges’.

It said it was engaging with members and stakeholders on what changes might make a difference for patients regarding medicines shortages.

‘Pharmacists are really keen to use their skills to better support patients through new services such as Pharmacy First. As we ask pharmacy teams to do more, this must be backed up by enhanced communications and seamless IT systems, alongside sustainable funding and investment in the workforce,’ the RPS added.

Meanwhile, Nick Kaye, chair of the National Pharmacy Association (NPA) said the statistics around medicines shortages reflected ‘the exhausting coalface experience of pharmacy teams, who spend many extra hours to hunt down the stock patients need and frequently dispense at a financial loss’.

‘Addressing the issue will require co-ordinated, resolute action, with all eyes fixed on the needs of patients,' he added.

Mr Kaye said the report rightly highlighted how the public ‘now expects more from pharmacies in terms of integrated clinical services within the NHS’, but that ‘workforce pressures and a chronic lack of funding are affecting patient experience’.

Encouraging Pharmacy First culture ‘may be a challenge’

The Healthwatch England survey, conducted in November before Pharmacy First was launched, also asked patients whether they would prefer to go to a GP or pharmacy for certain services and support.

For the seven common conditions listed under Pharmacy First, Healthwatch England suggested that ‘shifting people from a GP-first to a Pharmacy First culture may be a challenge’.

Those surveyed much preferred to see a GP for every condition except sore throats, where there was a narrower gap between the professions. Many respondents said they would not see a healthcare professional at all for this condition.

The report also noted a ‘particularly clear preference to see a doctor for long-term condition management’.

Greater awareness was needed around what pharmacies could do and that there are consultation rooms available for people to discuss issues in private, it added.

The report also called for an ‘audit of pharmacy premises and improved estate guidelines and funding to standardise the availability and privacy of consultation rooms’.

Earlier this year, Community Pharmacy England (CPE) highlighted issues with the ‘variable’ quality of consultation spaces within community pharmacy.

And local Healthwatch reports have highlighted a lack of private space to consult pharmacists.

The pharmacy minister recently told a parliamentary committee that she does not think taxpayer’s money should be used to improve pharmacy premises, for instance by adding a consultation room.

Commenting on the report today, Janet Morrison, CPE chief executive, said that the negotiator had already had 'productive discussions' with Healthwatch England 'on how to improve services for patients'.

'We look forward to continuing this dialogue as we work to secure both sustainable funding and future service developments for community pharmacies,' she said.

The Healthwatch England poll was a 'nationally representative poll of adults in England', conducted by Yonder Data Solutions from 20 November - 26 November  2023, with 1,650 responses.