The Lord Bishop of St Albans
To ask His Majesty’s Government what assessment they have made of the impact of the potential reduction in pharmacy opening hours.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, this Government recognise that pharmacies are an integral part of our communities. There are processes in place to monitor opening hours and their impact, and core hours of either 40 or 72 hours would not be affected by the proposed action by one trade body. Options are available to patients to access alternative pharmacies or distance-selling pharmacies. We will make an announcement shortly on a funding settlement for the years 2024-25 and 2025-26.
The Lord Bishop of St Albans
I thank the Minister for her response. Will His Majesty’s Government publish the independent economic analysis of the pharmacy funding crisis? Also, last summer we nursed my brother-in-law as he died. We had to access medicines, often at short notice. That was very difficult, even in a built-up urban area with many pharmacies around. In rural areas, it is far more difficult. What assessment have His Majesty’s Government made of any limitation of opening hours on health outcomes in rural areas?
Baroness Merron (Lab)
I will of course discuss the right reverend Prelate’s request for publication of information with Minister Stephen Kinnock, who has been working very hard with the sector in resolving matters on funding.
On opening hours, as I have said, there are core hours, but there are also additional supplementary voluntary hours that community pharmacies can choose to do. There is also a whole range of ways in which people can access pharmacy services—notwithstanding the point the right reverend Prelate made about his personal experience—including being able to contact distance pharmacies, which can provide things through online contact, by telephone call or by other means.
Pharmacies are key to making healthcare fit for the future, but we want to make sure that they are completely accessible. We will work with them to make sure that they, as largely private businesses, do so.
Lord Kakkar (CB)
My Lords, I draw noble Lords’ attention to my interest as chairman of King’s Health Partners. Just to build on the point made by the right reverend Prelate, what assessment have His Majesty’s Government made of the impact on population health outcomes of the intersection between limited access to primary care services and diminishing availability of pharmacy services?
Baroness Merron (Lab)
I know the noble Lord talked about primary care more generally, but the assessment on pharmacies is that there is quite a good coverage. Some 80% of the population live within a mile of a pharmacy and, as I say, there are other online and not-in-person ways of contacting pharmacies. The Pharmacy Access Scheme provides financial support to pharmacies in areas where there are fewer pharmacies. Local authorities, along with ICBs, continue to monitor changes, look at provision and have the ability to intervene where necessary. On all these counts, in respect of primary care provided through pharmacy, which is so important, we continue to monitor the impact across ICBs. With regard to a particular assessment, I will gladly write with more details to the noble Lord.
Lord Kamall (Con)
My Lords, the Minister has rightly talked about some of the alternatives, particularly when hours are limited. Can I ask her about some of the long-term thinking in the department on the future of pharmacy services? We know that some chains, for example, have in-store pharmacies. What thought has been given to more of these partnerships—and also, perhaps, pharmacies as part of future primary healthcare centres? While many people may want a bricks and mortar pharmacy, those who use the NHS app, for example, may be happy to order repeat prescriptions and have them delivered or pick them up from a local location.
Patients are also more open to ideas of online consultation. We have seen Royal Mail trialling delivery by drones in remote areas. There is a whole host of things happening in other sectors that the pharmacy sector and other parts of our health and care sector can learn from. What is the department learning from this innovation in other parts of the economy?
Baroness Merron (Lab)
The noble Lord makes some very constructive points and illustrates further the point that there are many ways to deliver pharmaceutical services. I can assure him that we are exploring how pharmacy can best be positioned—and indeed levered—to fit our ambition for a neighbourhood health service within the NHS 10-year plan. More will be heard about that soon.
The noble Lord will also be aware that one of the challenges that community pharmacies raised with us is about funding, which was cut or held flat between 2015-16 and 2023-24, representing a cut of some 28%. That is why we have concluded the consultation about funding; we will shortly announce the outcome, looking at how these private businesses can operate in the market. We are keen to ensure that they play their part and continue to work very constructively with them.
Lord Scriven (LD)
My Lords, the financial year ends in two weeks, and the ongoing delay in this year’s financial settlement for pharmacists has created a cash-flow problem and exacerbated the financial issues, which means that on average eight community pharmacies a week are closing. In December the chief executive of Community Pharmacy England wrote to Ministers asking for a remedial injection of cash to help cash flow and keep pharmacies open. I gently ask the Minister why Ministers have so far ignored that request.
Baroness Merron (Lab)
I feel that the most constructive response I can give to the noble Lord is the response of the Secretary of State, who has made it quite clear in Parliament that discussions will conclude shortly and an announcement will be made in the normal way. That will be via an open letter to contractors, which will be published on GOV.UK. I hope the noble Lord will understand that I cannot say more until our engagement with Community Pharmacy England, the representative body, comes to a conclusion. I can add for the benefit of noble Lords that NHS England commissioned an independent economic analysis of the cost of providing pharmaceutical services. It has informed the consultation with the sector and will be published in due course.
Baroness Wheatcroft (CB)
My Lords, is the Minister concerned that GPs’ tendency very easily and readily to sign repeat prescriptions increases the demand on pharmaceutical services? Does she agree that there should be a much more rigorous review of repeat prescriptions on a regular basis?
Baroness Merron (Lab)
I appreciate the noble Baroness’s views. Indeed, community pharmacies in England are dispensing around 1.1 billion NHS medicines with a value of over £10 billion each year. Prescribing is of course a clinical decision. We are nevertheless keeping an eye on the situation, of course. What matters is that people seek help, and I am very glad to say that pharmacies are playing an increasing role in the availability of assistance, so people do not always have to go to GPs, particularly for some of the more common conditions.
Baroness Ritchie of Downpatrick (Lab)
My Lords, does my noble friend agree that community pharmacies play a vital role in addressing NHS waiting lists through the administration of the vaccination programme—whether it is influenza or the Covid-19 vaccine—and thereby contribute to the reduction in the waiting lists that are faced by many hospitals throughout the UK? Will all efforts be made by government to ensure that the challenges faced by community pharmacies at present will be resolved in the near future?
Baroness Merron (Lab)
I certainly agree with my noble friend’s point. I hope that she has noticed my enthusiasm for the role that pharmacies play. The introduction of Pharmacy First was a tremendous contribution to some common-sense approaches so that people who have common conditions can more immediately access services. Many of us will have experienced that. As I have said, we will conclude matters shortly and look forward to making the decision about future funding known ASAP.