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On my patch – England: ‘The sector is on its knees’

By Costanza Pearce

18 Jul 2019

Graham Phillips, superintendent pharmacist at Manor Pharmacy Group in Hertfordshire, speaks to reporter Costanza Pearce about how he sees the state of community pharmacy in England


How would you describe the current state of the sector in England?

The sector is on its knees and if there aren’t radical and rapid changes, it won’t survive. It’s facing an existential crisis and I’m not histrionic or hysterical. I’ve been in community pharmacy my [whole] life and my dad’s a community pharmacist – it’s almost like I was doing it before I was born.


What have been the biggest changes over the past 10 years?

As society has become more disparate and more isolated – particularly as you see GP surgeries closing and hospitals becoming fewer and more remote – then having community-based healthcare in an accessible setting becomes more and more important. Community pharmacy as a social capital asset has grown immeasurably compared to where either pharmacy or the NHS was ten years ago.

Pharmacists are also incrementally increasing the clinical value of what we do, for example through the new medicines service (NMS) and medicines use reviews (MURs). My ambition would be for community pharmacy to not only be the first-post provider of prevention and public health, but also where the majority of long-term conditions are managed.

All of that is possible, but not with the current attitude of the NHS.


What are the particular threats you perceive to independent community pharmacy in England?

They’re going to close down. People are literally funding their businesses from their savings. I’ve known pharmacists end up paying their NHS bills on their private credit card and re-mortgaging their homes.

If that was short-term that would be fine, but it’s not. People are propping up their fundamentally unviable businesses from their private resources. That means when they do go bankrupt, they won’t just go bankrupt in business terms. They’ll lose their house, they’ll have no pension. They’ll have nothing.


Any particular opportunities?

Currently no, [it feels like] they’ve deliberately locked us out. If England went the way of Scotland and, increasingly, Wales, the potential would be huge for community pharmacy to add far more value to the system.


What would you like to see in the future?

There must be an urgent and immediate injection of cash to stabilise the system. And then we need to evolve to a model that’s much closer to the one that’s already taking place in Scotland and Wales, in particular.


If you could ask for one thing from your politicians, what would it be?

It would be two things really – recognition and investment. But you won’t get investment without recognition. They need to value the network that they’ve got.


A sector in limbo

  • In March, interim funding arrangements were put in place, leaving funding at the same levels agreed in October 2018 – a £2.592 ‘funding envelope’
  • Controversially, the 2018/19 contract did not include any extra money on the settlement imposed on pharmacies in 2016, which many in the sector still refer to as ‘the cuts’
  • A £15m per month rise in category M reimbursement prices was announced in July

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