Community pharmacies closing at a rapid rate with deprived areas worst affected
As the government asks pharmacies to do more to ease pressure on GPs, Sky News analysis has revealed those in England are closing at a rapid rate – with nearly 1,000 lost since 2017, a third of them in the last year alone.
Between July 2017 and July 2023, the number of operating pharmacies in England fell by 914 from 11,723 to 10,809.
Deprived communities, where the need is greatest, have seen the biggest decline. More than one in ten pharmacies have been lost in the poorest 20% of areas in the last six years.
That accounts for 40% of losses in that period.
Dr Leyla Hannbeck CEO of the Association of Independent Multiple Pharmacies says the situation is “awful, terrible” and “the worst it has been in years and years”.
It’s been caused by a combination of government funding cuts, rising rents and costs, staff shortages and supply problems, as well as increased patient demand.
The result is that pharmacists like Reena Barai in Sutton are wondering how long they can stay open.
“Currently, we’re in what I describe as a survival of the fittest,” she says. “Within community pharmacy, the majority of my colleagues really do feel like we’re on a sinking ship.”
“We want to be that front door to the NHS because we know that people go to the GPs or A&E unnecessarily for minor illnesses and they should be coming to the pharmacy. We really want to be that first port of call, but we’re struggling.”
Impact of big chain closures
The bulk of closures so far has been driven by big companies like LloydsPharmacy and Boots. LloydsPharmacy has lost three quarters of its branches (1,087 out of 1442) since 2017 and around two thirds (629 out of 984) in the past year.
Boots, which lost 40 branches in the last year, has also just announced a further 300 closures over the next 12 months.
The loss of these bigger pharmacies has increased the burden on those that remain, many of them smaller, independent businesses, which must pick up the workload without extra funding.
An analysis by The Pharmaceutical Journal in February suggested the impact of this year’s closures could displace nearly one million prescriptions each month to surrounding pharmacies.
Dr Hannbeck says: “Pharmacies are drowning because the workload from those other pharmacies (that have closed) is landing on them.”
Deprived areas are the worst affected
Sky News analysis suggests the increased burden is being felt most acutely in England’s poorest neighbourhoods where people are more likely to depend on their services.
Richard Murray, CEO of the Kings Fund says in deprived areas “there are higher levels of ill health. They’ll probably be a lot more walk ins going into the pharmacy asking for advice, more people going in to collect their medicines, and probably more people struggling with their medicines too”.
Pharmacies in the most deprived 20% of areas are now serving a 13% more people than a decade ago, compared to just 3% more in the least deprived.
On average all pharmacies are dispensing more items, with the number of items dispensed per pharmacy up 17% since 2017.
And poorer areas have seen the greatest increase, dispensing a sixth more than those in the least deprived areas.
“The job can be harder in deprived areas,” says Richard Murray.
“The workforce crises that we see across the profession are often localised, deprived areas may suffer a bit on that front,” he added.
“Pharmacists do generate money from selling other things but at a time of cost-of-living crisis, it just might be harder for other parts of the business to prop up community pharmacy and rather easier in areas that are richer, where people have got more money to spend.”
Pharmacy First and funding cuts
It’s in this context that NHS England recently said it would invest £645 million into a Pharmacy First scheme, allowing pharmacists to prescribe medicines for seven common conditions including sinusitis and shingles. The aim is to reduce the footfall at GP surgeries, saving a potential 10 million appointments each year.
But Leyla Hannbeck and Reena Barai both believe the funding gap that already exists needs to be addressed before pharmacists can take on new responsibilities.
“The funding is absolutely not fit for purpose,” says Hannbeck. “If government really cares about patient care, accessibility to care, and people not landing in GP surgeries or A&E then they have to take pharmacy seriously. And we need an immediate cash injection.”
Cuts introduced in 2016, followed by a five-year funding deal in 2019, that didn’t take account of inflation has shrunk the value of the pharmacy contract in real terms by 30% from £2.8bn to £2.15bn since 2015.
The figures were revealed in a written parliamentary answer in January and amount to an annual shortfall of around £67,000 per pharmacy in England.
A recent National Pharmacy Association report – authored by Professor David Taylor of University College London and Dr Panos Kanavos from the London School of Economics and Political Science – found in England in 2022, community pharmacy accounted for a lower percentage of total health spending than at any point since 1948.
It means Reena Barai is questioning whether she can afford to be involved in Pharmacy First.
“I really want to take part in it (Pharmacy First) because I’ve got the skills, the training, the clinical confidence to do these things. But to do that, I also need to improve my infrastructure to expand the premises.”
“The government will say ‘we’ve just announced x million for Pharmacy First’, but that will be to provide a service. We will also have to train our team, make sure we’ve got the adequate numbers of staff. We’ll need new IT systems.”
Reena Barai, a pharmacist in Sutton, says pharmacies are on a ‘sinking ship’
Fluctuating medication costs
Increased medication costs have added to the funding gap, with some leading pharmacists saying they aren’t fully reimbursed by the NHS.
Ms Barai said: “It gets really difficult when suddenly the price of a bread-and-butter drug that was say 50p goes up to £5 and you’re having to buy the same volume of the drug but an increased cost, that’s what really affects pharmacies a lot, their cash flow.”
“We’re not even guaranteed that we’ll be reimbursed, for example one of the drugs that I’m buying, Atorvastatin, I’m buying it above the cost that the government said that they’ll reimburse us. So, we’re actually out of pocket,” she added.
Staff shortages and burnout
The cash flow crisis and overwhelming workload have made it tougher for community pharmacies to recruit and retain their staff.
Half of pharmacies responding to the Community Pharmacy Workforce Survey 2022 said they were finding it “very difficult” to fill vacancies. The survey also suggested 16% of pharmacist and 20% of technician roles were unfilled.
Mr Murray explains that many have opted to work in GP pharmacies instead: “NHS England has run a big recruitment campaign to take pharmacists into general practice to work alongside the GP teams and that’s ratcheted up the shortages.”
Being short-staffed whilst dealing with increased demand and coping with rising costs makes Reena worry for her own wellbeing.
“It’s exhausting. It’s never-ending,” she says. “Even if you take time off, you can’t put on your out of office and say sorry, you’ve always got to find staff to cover. So, it’s a really all-consuming job. I think I just have to be careful that I don’t burn out and that my team don’t burn out.”
A spokesperson for the Department of Health and Social Care said: “We are carefully monitoring access to pharmaceutical services, but good access remains.
“We have announced £645 million in additional funding in the Primary Care Recovery Plan and thousands more training places for pharmacists as part of the Long-Term Workforce Plan, on top of the £2.6 billion we provide every year to the sector.”
Methodology: To get the number of active pharmacies we looked at the number active on a given date, in this case, the last day of July for every year since 2017. We looked at each pharmacy’s open and close dates to determine if it’s open on the given date. If a pharmacy’s open date is on or before the specified date and it doesn’t have a close date or its close date is after the specified date it’s counted as active.
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
An MP has told Sky News she was attacked online by the Tate brothers after she participated in a debate in the House of Commons about violence against women.
The controversial duo, Andrew and Tristan Tate, are facing charges of rape and human trafficking in the UK – all of which they deny.
But they are still very active online, and according to Sorcha Eastwood, the MP for Lagan Valley, are targeting her.
In a document seen by Sky News, Tristan Tate has highlighted one of the MP’s tweets and writes in private correspondence: “MP, nice target, can we sue her?”
Sorcha Eastwood says at first she thought the replies were from parody accounts and not the Tate brothers.
Her original tweet was about Elon Musk, not the Tate brothers. The MP said Musk’s tweets should be looked at through a counter-extremism lens.
“I was really concerned, I was concerned because to me that is a direct attack for want of a better phrase on me serving my constituents.
“I couldn’t believe that they decided to pick this random Northern Irish MP. The fact that it wasn’t even about them. This is something I didn’t go looking for.
“I think from my perspective, it’s a very, very sinister attempt to shut down important voices in public life, political discourse.”
It was only when she started noticing an uptick in abuse from other accounts she realised she had encountered some of the brothers’ followers.
“I had rape threats. I had death threats. I had people saying I should be hung from a lamppost. I had people saying I should be chopped into liver. I also had people then who were like we’ll waste 15 minutes raping Sorcha Eastwood.”
A representative for the Tate brothers told Sky News that there was no targeted campaign against Sorcha Eastwood
A representative for the Tate brothers told Sky News that there was no targeted campaign against her.
They said: “Ms Eastwood has a distorted view regarding social media if she believes one is required to ‘invite or ask’ people to interact.
“Tristan Tate is entitled to his view in relation to her tweet regarding Elon Musk.”
The self-styled “misogynist influencer” Andrew Tate and his brother Tristan have both been charged with human trafficking, face allegations of trafficking minors, sexual intercourse with a minor and money laundering in Romania.
There is also a European arrest warrant for them as they are facing separate, unrelated charges of rape and human trafficking in the UK. They deny all charges.
Ms Eastwood now worries for others who don’t have a platform like her and who may not feel like they can speak out.
“If this is what has happened to me I have absolutely no doubt that this has happened to others where they have been attempted to be silenced.”
Keir Starmer has previously commented on the Tate brothers’ case in the Commons saying it is “a live issue”, but adding that “the principle is absolutely clear” in relation to whether the brothers should face justice.
Sorcha Eastwood says she wants to see the government do much more to protect against abuse online.
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Tate brothers deny wrongdoing
“I think ultimately the government has taken the wrong course on this. They need to step up.
“This should be an issue of national security as far as the radicalisation of young people online. It should be an issue in terms of the levels of misinformation, disinformation and the lack of trust that is had in our politics right across the UK and Europe.
“I want the government to help me, help every other person to crack down on this and get serious about it. And the only way they’ll be able to do that, is by hitting these tech companies in the only language which they understand, which is money and via robust legislation.”
A government spokesperson said: “Violence against women and girls is a scourge on our society which is why we have set out an unprecedented mission to halve these crimes within a decade.
“Tackling illegal abuse both online and offline is central to supporting victims and preventing harm in our communities and we will not hesitate to strengthen laws to deliver this mission.
“Last month, parts of the Online Safety Act came into force meaning companies must take action to protect users from illegal material including extreme sexual violence.
“Further protections from this summer will require platforms to protect children from harmful, misogynistic, and violent content.”
UK
‘It’s just nasty’: Birmingham residents ‘overwhelmed’ by foul stench and massive rats as bins strike rumbles on
In parts of Birmingham, the stench is overwhelming – enough to make you heave.
At a block of flats in Highgate, in Birmingham city centre, we find a mountain of bin liners full of rubbish spewing out of the cavernous bin store, which is normally locked.
Mickel comes out to speak to us, while all around bin liners lie open, with the contents for all to see, including used nappies and rotting food.
Mickel says they’ve had ‘foxes and rats, literally the size of cats’
Outside Mickel’s flat in Highgate, bin liners lie open, spewing out rubbish
We both find it hard to keep talking amid the awful smell.
“We’ve had foxes and rats, literally the size of cats, flies, it’s just nasty, something needs to be done,” he says.
Chris says the situation is ‘overwhelming’ as she’s ‘terrified of rats’
Around the corner, I meet Chris, in her dressing gown, popping the bins into her bin store beneath her flat before work.
She unlocks it, and although it isn’t bursting out on to the street yet, it is getting full.
She says the situation is “overwhelming” as she’s “terrified of rats”. But, even so, she has sympathy for the striking bin workers.
“It’s not an easy job; they must have a heart of gold to do that job,” she says.
“Pay them whatever they need, they deserve it.”
Striking bin workers at Lifford Lane tip, south of the city centre
There’s an awful smell coming from a mountain of bin liners outside Mickel’s flat in Highgate
At Lifford Lane tip, south of the city centre, Brigette has pulled up alongside picketing workers. The back seat of her car is full of rubbish.
She apologises for the terrible waft, mixed with air freshener.
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“It’s very pungent, isn’t it? Not nice,” she admits.
“It’s unfortunate, I have some sympathies for all the parties, but, equally, we have a duty of care to stay clean and tidy.”
She says she has her rubbish and that of her elderly aunt and plans to make weekly trips to the tip until a resolution in this pay dispute between the council and the Unite union is found.
UK
‘US is our closest ally’, Jonathan Reynolds says in reaction to Trump tariffs – but ‘nothing off the table’
The US is “our closest ally” but “nothing is off the table” in response to Donald Trump’s 10% tariffs on imports from the UK, the business secretary has said.
In a statement following the US president’s nearly hour-long address to the world, Business and Trade Secretary Jonathan Reynolds said: “We will always act in the best interests of UK businesses and consumers.
“That’s why, throughout the last few weeks, the government has been fully focused on negotiating an economic deal with the United States that strengthens our existing fair and balanced trading relationship.”
Follow the latest following Trump’s tariffs announcement
Mr Reynolds reiterated the statements from the prime minister and his cabinet over the past few days, saying the US is “our closest ally”, and the government’s approach is to “remain calm and committed to doing this deal, which we hope will mitigate the impact of what has been announced today”.
Business Secretary Jonathan Reynolds says “nothing is off the table” following the tariffs announcement. Pic: PA
But he continued: “We have a range of tools at our disposal, and we will not hesitate to act. We will continue to engage with UK businesses, including on their assessment of the impact of any further steps we take.
“Nobody wants a trade war, and our intention remains to secure a deal. But nothing is off the table, and the government will do everything necessary to defend the UK’s national interest.”
‘Get back round the negotiating table’, say Tories
The Conservative Party’s shadow business and trade secretary described the US president’s announcement as “disappointing news which will worry working families across the country”.
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Sky’s Ed Conway examines how economies across the world are impacted by tariffs
Andrew Griffith hit out at the government for having “failed to negotiate with President Trump’s team for too many months after the election, failed to keep our experienced top trade negotiator, and failed to get a deal to avoid the imposition of these tariffs by our closest trading partner”.
“The chancellor’s emergency budget of just a week ago with its inadequate headroom is now at risk, casting uncertainty about more taxes or spending cuts,” he continued. “Sadly, it is British businesses and workers who will pay the price for Labour’s failure.”
He called on ministers to “swallow their pride” and “get back round the negotiating table to agree a fair deal to protect jobs and consumers in both the UK and the US alike”.
Liberal Democrat leader Sir Ed Davey has reacted furiously to Mr Trump’s announcement of a “destructive trade war”, and called on the government to stand up against “Trump’s attempts to divide and rule”.
“The prime minister should bring our Commonwealth and European partners together in a coalition of the willing against Trump’s tariffs, using retaliatory tariffs where necessary and signing new trade deals with each other where possible.”
Speaking on Wednesday evening at a White House event entitled ‘Make America Wealthy Again’, the US president unleashed sweeping tariffs across the globe.
Mr Trump held up a chart detailing the worst offenders – which also showed the new tariffs the US would be imposing.
The UK’s rate of 10% was perhaps a shot across the bow over the 20% VAT rate, though the president’s suggested a 10% tariff imbalance between the two nations. Nonetheless, tariffs of 10% could directly reduce UK GDP by between 0.01% and 0.06%, according to Capital Economics.
A 25% duty on all car imports from around the world is also being imposed from midnight in the US – 5am on Thursday, UK time.
Read more:
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Tariffs will have consequences for globalisation, the US economy and geopolitics
Trump’s tariffs explained
The UK government had been hoping to negotiate an economic deal with the US in a bid to avoid the tariffs, but to no avail. The government says negotiations will continue.
The Confederation of British Industry said “negotiating stronger trading relationships with all like-minded partners will be foundational to any success”.
The business secretary is expected to make a statement in the House of Commons on Thursday, and we are also expecting to hear from the prime minister.
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