Community pharmacies closing at a rapid rate with deprived areas worst affected

Published

2 years ago

August 29, 2023

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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.”

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.

UK

Sir Keir Starmer could be ousted as PM within months, two senior Labour MPs tell Sky News

Published

2 hours ago

July 3, 2025

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Sir Keir Starmer could be ousted as PM within months, two senior Labour MPs tell Sky News

Two senior Labour MPs have suggested the prime minister may have to go within months if the government continues to perform poorly.

Sky News’ deputy political editor Sam Coates said his sources – a member of the government and a prominent politician – have “put Sir Keir Starmer on notice”.

Both warned that, if Labour performs badly in next May’s elections across Wales, Scotland and London, it could mark the end of his time in Downing Street.

Coates added: “The level of unhappiness and despair in parts of the Labour Party is so striking that right now, on the first anniversary, I am hearing from ministers in government that Starmer might have to go in months.”

Reform UK is surging in the polls in Wales, while Labour faces a threat from left-wing parties such as the Greens in London.

It comes as the prime minister made it clear that Rachel Reeves has his “complete support” as chancellor and remains integral to his project, Sky News’s political editor Beth Rigby understands.

She looked visibly upset during Prime Minister’s Questions, with a spokesperson claiming she had been affected by a “personal matter”.

A day earlier, Sir Keir’s controversial welfare bill was passed despite a sizeable rebellion from Labour MPs, with major U-turns meaning a new £5bn black hole has appeared in the country’s finances.

One senior figure told Rigby that the pair were as “as close politically” as any chancellor and prime minister have ever been.

“She is going absolutely nowhere,” they added.

Ms Reeves’s tears sent markets spiralling, with the value of the pound and long-term government bonds falling sharply.

Later in the day Sir Keir, said Ms Reeves will be chancellor for a “very long time to come”.

The prime minister said it was “absolutely wrong” to suggest her tearful appearance in the Commons related to the welfare U-turn.

“It’s got nothing to do with politics, nothing to do with what’s happened this week. It was a personal matter for her,” he said while speaking to the BBC’s podcast Political Thinking with Nick Robinson.

“I’m not going to intrude on her privacy by talking to you about that. It is a personal matter.”

Asked if she will remain in post, he said: “She will be chancellor by the time this is broadcast, she will be chancellor for a very long time to come, because this project that we’ve been working on to change the Labour party, to win the election, change the country, that is a project which the chancellor and I’ve been working on together.”

He said Ms Reeves has done a “fantastic job” and added: “She and I work together, we think together. In the past, there have been examples – I won’t give any specific – of chancellors and prime ministers who weren’t in lockstep. We’re in lockstep.”

Wes Streeting, the health secretary, also offered a strong defence for the prime minister and chancellor.

He told Sky News this morning that Sir Keir has been “consistently underestimated” and was “of course” safe as prime minister.

And he said Ms Reeves was a “tough character” who was ” resilient” and “here to stay”.

UK

Greater Manchester Police investigating grooming cases with more than 700 victims

Published

2 hours ago

July 3, 2025

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Greater Manchester Police investigating grooming cases with more than 700 victims

Despite making “significant improvements”, Greater Manchester Police (GMP) has lost the “trust and confidence” of some victims of grooming gangs, according to a report by the police watchdog.

Michelle Skeer, His Majesty’s Inspector of Constabulary, said that since 2019, when GMP started to review its non-recent child sexual exploitation investigations, “the force has improved its understanding and approach to investigating allegations of child criminal and sexual exploitation”.

The document, published today, said police have live investigations into “multi-victim, multi-offender” child sexual exploitation inquiries, involving 714 victims and survivors, and 1,099 suspects.

Grooming gangs scandal timeline

But despite recording improvements, a report by His Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) also identified:

• Various training gaps within the investigation team
• Lack of consistency in evaluating case files between social care, health and police
• Failures to initially support victims meant they had “lost trust and confidence” in police

The report was commissioned by the Mayor of Greater Manchester Andy Burnham in 2024 to evaluate whether police, councils and health services can protect children from sexual exploitation in the future.

Its release comes days after Sir Keir Starmer announced he was launching a new national inquiry into grooming gangs after previously arguing one was not necessary,

The findings were issued as the final part of the CSE (child sexual exploitation) Assurance Review process which started in 2017. The first three reports examined non-recent child sexual exploitation in Manchester, Oldham and Rochdale.

Mr Skeer said that the force has been trying to improve its service to those who have experienced sexual exploitation, but previous failings have badly affected trust in GMP.

He said: “For some, trust and confidence in the police had been lost, and the force would not be able to rectify their experiences.

“It is vital that improvements are led by victims’ experiences, and if they do come forward, they are supported, protected and taken seriously.”

A recent report by Baroness Casey found a significant over-representation of Asian men who are suspects in grooming gangs in Greater Manchester, adding though authorities are in “denial” more needs to be done to understand why this is the case.

Inspectors also said there were “training gaps” in some investigation teams and issues with data sharing, with local councils sometimes not willing to provide detectives with information, leading to “significant delays in investigations” into grooming gangs.

It cites problems with intelligence provided by Manchester City Council, which took months to arrive and “was so heavily redacted that some pages contained only a few words”, the report said.

GMP is the only force in the country to set up a dedicated team to investigate grooming gangs. Called the Child Sexual Exploitation Major Investigation Team (CSE MIT) it has about 100 staff and a ringfenced budget.

In October 2024, the force told inspectors there were 59 live multi-victim, multi-offender child sexual exploitation investigations, of which 13 were being managed by the CSE MIT.

The report adds: “The force fully accepts that it made mistakes in the past.

“It has taken positive and effective steps to learn from these mistakes and improve how it investigates recent and non-recent child sexual exploitation.”

Separately, the Baird Inquiry published in July 2024 found officers at GMP were abusing their power – making unlawful arrests, unlawful and demeaning strip searches, sometimes treating victims as perpetrators, and traumatising those who have suffered sexual abuse or domestic violence.

UK

Wes Streeting defends chancellor and PM ahead of ‘seismic’ 10-year plan for NHS

Published

2 hours ago

July 3, 2025

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Wes Streeting defends chancellor and PM ahead of 'seismic' 10-year plan for NHS

The health secretary has offered a strong defence of the prime minister and chancellor – ahead of Sir Keir Starmer setting out his 10-year vision for the NHS.

PM ‘might have to go in months’ – politics latest

Wes Streeting dismissed suggestions the prime minister could be forced out in months following the toughest week of his premiership yet, and described Rachel Reeves as “resilient” and would “bounce back” following her tearful appearance in the Commons on Wednesday.

Overnight, two senior sources – a member of the government and a prominent politician – told Sky News’ deputy political editor Sam Coates that they had “put Sir Keir Starmer on notice”.

The health secretary, who was speaking as Sir Keir prepares to set out his 10-year vision for the NHS, said the prime minister had been “consistently underestimated”.

Asked by Kamali Melbourne on Sky News Breakfast whether Sir Keir was “safe”, Mr Streeting said: “Of course.

“Keir Starmer has been consistently underestimated. I wonder when people will learn.

“They said he couldn’t win the Labour leadership, but he did. They said he couldn’t change the Labour Party, but he did.

“They said he couldn’t take the Labour Party from its worst defeat since the 1930s to election victory last year. And he did and now the cynics say he can’t change the country, but he will.”

As for Ms Reeves – whose tearful appearance in the Commons spooked markets after the prime minister initially failed to back her, Mr Streeting said the chancellor was a “tough character” who was “resilient and she will bounce back”.

The health secretary declined to expand on why Ms Reeves was in the chamber at all yesterday, repeating that it was a personal matter.

“Rachel Reeves as chancellor is here to stay,” he continued.

“We need her to get the economy from strength to strength, to make sure that family finances are in better health than we were when we came into office.”

Speculation about the futures of the two most senior members of the government threaten to overshadow the announcement today, which the government says is “one of the most seismic shifts” in the health service’s history.

Sir Keir will pledge three main facets of the plan: moving care into the community, digitising the NHS, and a focus on sickness prevention.

The prime minister will announce neighbourhood health services will be rolled out across England to improve access to the NHS and to shift care out of overstrained hospitals.

Sir Keir has already promised thousands more GPs will be trained, and to end the 8am “scramble” for an appointment.

He also previously said his government will bring the NHS into the digital age, with “groundbreaking” new tools to support GPs rolled out over the next two years – including AI to take notes, draft letters and enter data.

And he will promise new contracts that will encourage and allow GP practices to cover a wider geographical area, so small practices will get more support.

Unite, one of the UK’s largest healthcare unions, welcomed the plan cautiously but said staff need to be the focus to ensure people are better looked after.

‘Reform or die’

Sir Keir said: “The NHS should be there for everyone, whenever they need it.

“But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future.

“That ends now. Because it’s reform or die.”

Neighbourhood health services

The newly announced neighbourhood health services will provide “pioneering teams” in local communities, so patients can more conveniently access a full range of healthcare services close to home.

Local areas will be encouraged to trial innovative schemes like community outreach door-to-door to detect early signs of illness and reduce pressure on GPs and A&E.

The aim is to eventually have new health centres open 12 hours a day, six days a week to offer GP services as well as diagnostics, post-operative care and rehab.

They will also offer services like debt advice, employment support, stop smoking help or weight management.

More NHS dentists

Dentists will also be part of the plan, with dental care professionals part of the neighbourhood teams.

Dental “therapists” will carry out check-ups, treatments and referrals, while dental nurses could give education and advice to parents or work with schools and community groups.

Newly qualified dentists will be required to practice in the NHS for a minimum period, which they have said will be three years.