Community pharmacies in Northern Ireland are ‘struggling to survive’ in the face of an ‘unprecedented’ funding crisis, a report by a cross-party House of Commons committee has found.
The report, published on Saturday (2 November), is based on the Northern Ireland Affairs Committee’s inquiry into funding priorities in the Northern Ireland health service.
The committee, chaired by conservative MP Simon Hoare, heard that the 532 community pharmacies in Northern Ireland are facing an ‘unprecedented’ funding crisis that is ‘threatening their viability’, according to the report.
It added: ‘Many [community pharmacies] are struggling to survive in the face of prolonged underfunding.’
In the report: Northern Ireland chief medical officer Dr Michael McBride said: ‘The Department of Health (DH) faces significant financial constraints and many priorities across a number of budgetary areas. We do not have the luxury of spending money that we do not have.’
‘Crude’ funding allocations
The ‘fundamental problem’ with community pharmacy funding in Northern Ireland is that it is based on the English drug tariff, which ‘does not take into account Northern Ireland’s higher levels of community pharmacy workload or medicine procurement per head of population’, the report said.
It added: ‘We were told that extrapolations have been carried out at a crude population level and omit funding provided to dispensing doctors in England, resulting in a distortion of baseline figures.
‘This had led to underfunding of at least £60 million since 2011.’
Many contractors in Northern Ireland are now dispensing at a loss or without knowing whether they will be fully reimbursed, the report added.
With pharmacies ‘finding it increasingly difficult to remain open’, patient safety and access to medicines could be affected, it warned.
The report recommended that in the absence of a health minister, which has been the case since the collapse of the Northern Irish assembly in January 2017, the DH should agree a ‘sustainable’ community pharmacy funding package and drug tariff based on the country’s ‘unique set of circumstances’.
A spokesperson for the committee added: ‘The committee emphasises that decisions over health services in Northern Ireland are the responsibility of the minister of health in the Northern Ireland Executive.
‘However, if the Northern Ireland Assembly has not formed by the end of the year, the UK Government will need to take action to address unsustainable pressures across the service.’
Gerard Greene, chief executive of Community Pharmacy Northern Ireland (CPNI), welcomed the report and said the negotiator is keen to work with the DH and Health and Social Care Board to ensure that any community pharmacy investment is effective.
He added: ‘If we do not invest in transformative services, then we are putting the entire service at risk.’
The 2017/18 Northern Ireland community pharmacy funding package saw a drop of an estimated £20m, according to CPNI.
Meanwhile, a funding boost of £11m was granted in November 2018 to last until March 2020 but was branded a ‘sticking plaster’ by the CPNI.
In July, Northern Irish contractor Eoghan O’Brien told The Pharmacist that community pharmacy is being ‘undervalued’ in the country.