Community pharmacy was left reeling from the news that the Government is cutting funding for the sector by £170m in 2016/17.

The news was delivered to PSNC in an open letter at a meeting hosted by pharmacy minister Alistair Burt on 17 December. The cut, from £2.8bn to £2.63bn, is a reduction of more than six per cent in cash terms.

The move to publish the letter, which was signed by the director general, innovation, growth and technology, Department of Health, and the chief pharmaceutical officer, was described by PSNC as “unprecedented” as NHS negotiations have previously always been kept secret.

PSNC chief executive Sue Sharpe responded to the news by saying: “At a time when primary care and urgent care services are struggling to manage demand, this is a profoundly damaging move. It will deliver a destructive blow to the support community pharmacies can offer to patients and the public.”

She continued by warning that “the letter speaks of the potential for far greater use of community pharmacy and pharmacists in prevention of ill health, support for healthy living and minor ailments, but almost inevitably the impact of the cuts will force pharmacies to reduce staffing levels and direct more people to GP or urgent care.”

A slap in the face

Pharmacy bodies have come out in condemnation of the cuts with NPA chairman, Ian Strachan, describing the move as "heartless as well as visionless". There is a fundamental contradiction in the position of NHS England, he said. "It calls for community pharmacy to step forward to meet spiralling health challenges, whilst announcing cuts that will severely hamper our ability to deliver."

This "misinformed" set of proposals rest upon a questionable evidence base, unbalanced opinion, and ignore the truly transformational opportunities in community pharmacy, Mr Strachan continued. Most worrying of all, they imply that pharmacy is just a distribution mechanism for product, rather than a valuable health and social care asset at the heart of communities.

"Taken together, the statement looks like an assault on the very part of the health system that holds the key to solving many of its problems. Patients would be the biggest losers, if the combination of measures proposed in this statement come to pass."

He added: “The fact that this news was announced publicly just before Christmas, at a particularly busy time for pharmacies, means it is heartless as well as visionless. It shows a lack of concern for a profession that gives its all throughout the year. Many people working in the pharmacy sector will be worried during this festive period about what the future holds”.

Chief executive of Pharmacy Voice, Rob Darracott, commented: “Many contractors, currently in the midst of the Christmas rush, will be rightly anxious as to how this £170m cut will affect their patients, their businesses, their livelihoods and those of their pharmacy teams and other employees.

“It is a complex picture and there are many items being discussed from hub and spoke dispensing, the role for clinical pharmacy to pharmacy numbers. At this stage we do not have the detail of how these elements can affect the bottom line. What we do know is that the expertise and knowledge of how to achieve change is within the sector, rather than in Whitehall. Community pharmacy has already delivered 4% efficiency savings to the NHS which is proof that we already play a highly efficient part in NHS service delivery."

While John D’Arcy, managing director of Numark, called the move "nonsensical" and "an outright insult to a sector that has done so much to ease the burden on the NHS".

He added: "Closures are now inevitable (that is clearly the intention) and, as always, independents will be affected disproportionately. Unlike the supermarkets, who can subsidise their pharmacies as a ‘loss leader’, and the multiples, who can spread the affect across the group, independent pharmacists will be left to shoulder the burden of a massive cut to their gross profit.

"Crucially, the letter suggests that the proposed “efficiencies” can be realised without compromising the quality of service or access to them. To suggest that a minimum 6% cut in remuneration along with an untested radical overhaul of the pharmacy sector will not impact negatively on quality of service or access is at best naïve and at worst totally reckless.

"This letter is a slap in the face to a sector that is committed to patient care and represents a clear disincentive to further investment in enhancing service delivery. More importantly it creates a real risk to the continuity and quality of services to patients."

Something different

In response to the news, the chair of the Royal Pharmaceutical Society’s English Board Sandra Gidley said: “It is clear that the Government wants something different from the sector. If we choose to provide no answers to the questions we are asked then others will make decisions about our future. I am not going to allow that to happen.

“We will be working with our members, patients and the public to make clear how our profession can implement a new role within primary care, alongside GPs and other health and care professionals. The days of secret negotiations between community pharmacy and Government are over, something I welcome wholeheartedly. For the first time the RPS will have a substantial role in providing a voice for those employees and locums who have felt completely disenfranchised by the current community pharmacy negotiating arrangements. I will be announcing in the New Year how you can make sure your voice is heard through the RPS.”