The provision of pharmacy services is currently balanced ‘in a different way’ amid community pharmacy closures and a rise in distance selling pharmacies (DSPs), NHS England’s director for primary care has suggested.

Dr Amanda Doyle was speaking as part of the Health and Social Care Committee’s (HSCC’s) pharmacy inquiry this week when she said that alongside a recent 9% reduction in the number of local community pharmacies, the sector had also seen a 9% increase in DSPs.

‘We are seeing a balance in a different way of offering the service,’ she said.

But she acknowledged that bricks and mortar pharmacies were still important to deliver accessible clinical services for patients.

‘Equally, if our strategy – which it is – is to increase the role of community pharmacy as first of all a provider of clinical services to the community, then it's really important that we do have that estate,’ she told the inquiry.

She said that 80% of the population live within a 20-minute walk of a community pharmacy, with twice the number of community pharmacies within more deprived areas.

Dr Doyle also acknowledged the need for the pharmacy estate to increase its consultation room capacity, after concerns were raised around variability of provision.

She said that as NHS England looks to expand clinical services through community pharmacies, and as contractors take up this opportunity, ‘for lots of pharmacies, that means more than one room’.

While Dr Doyle said that each integrated care board (ICB) was expected to have an understanding of, and a strategy, for all estates through which it commissioned clinical services – including community pharmacy – she acknowledged that ‘the challenge is real’.

And she said the cost of contractors investing in suitable estate was recognised through the setup payments for services like Pharmacy First.

Dr Doyle added that unlike general practitioners, community pharmacies also use their premises for private services, such as travel vaccinations.

HSCC chair Steve Brine asked government and NHS England officials whether they would consider funding improvements to pharmacy premises.

His suggestions included the possible return of an establishment fee for pharmacies, or a more targeted payment to cover the cost of investment in premises and equipment to get ready for the new clinical services commissioned nationally under Pharmacy First.

Chief pharmaceutical officer (CPhO) for England David Webb stressed that having a consultation room was a contractual requirement for community pharmacies offering NHS services.

Pharmacy minister Dame Andrea Leadsom told the committee that she does not think taxpayer’s money should be used to improve pharmacy premises, for instance by adding a consultation room.

‘Personally, I think the basis on which pharmacy is a private business with a contract with the NHS is the right approach, so that those private businesses can offer other services to members of the public,’ she said.

‘I don't think it's right that the taxpayer should take on the burden of updating or upgrading those premises.’

Dame Andrea also suggested that pharmacy closures were ‘because the owner has decided to retire, or to rationalise a number of stores within a chain’, leaving patients ‘unfortunately with a period where the one or two remaining pharmacists in the area have got queues’.

In such cases, she suggested that the ICB should ‘rapidly ensure that anybody else who wants to apply can get that licence quickly’.

And while she acknowledged that there had been a net loss of around 400 pharmacies in the last year, ‘we also now have 400 distance dispensing pharmacists who will deliver to people's homes free of charge’.

‘If [patients are] finding those temporary queues [within pharmacies] or if they're finding that a pharmacy is closed, they will be able to go online and access medicines through those distance pharmacists,’ she said.

And she highlighted access payments to support pharmacies in more remote areas.

While Dame Andrea said that the government monitors pharmacy closures ‘very carefully and very closely’, she added: ‘What we're not about is ensuring that a pharmacy never closes or that another one definitely opens because pharmacies are private businesses.’

‘The government is responsible and takes very seriously the responsibility to ensure access to medicines for all residents here in England,’ she added.

The pharmacy minister’s comments follow recent concerns raised by contractors that pharmacy closures are a 'worry' for patients and could 'double' if action is not taken to prevent them.

At the same Fight 4 Pharmacies campaign event, Conservative MP for South Swindon Sir Robert Buckland told The Pharmacist he thought that the process of licensing new community pharmacy premises should be made ‘as convenient as possible’ for contractors.

Contractors have also told The Pharmacist that the Pharmacy First set up payment does not cover the cost of adding a consultation room, warning that the service they can offer will be 'limited' as a result.

One contractor compared the overwhelming demand for his sole consultation room to 'Gatwick airport with one landing strip and five planes trying to land.'