Pharmacy Closures
Baroness Janke Excerpts(4 weeks ago)
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Baroness Janke
To ask His Majesty’s Government what assessment they have made of the impact of increasing numbers of local pharmacy closures on primary healthcare services.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, pharmacies are an easily accessible front door to the NHS and we understand the impact that closures may have. We have increased the community pharmacy budget by £340 million—a 10% uplift that builds on the 19% increase, which was at the time the largest uplift in the NHS. That was delivered in 2024-25 and 2025-26 in order to support pharmacies’ essential role. Recent data indicates that closures have slowed, with 19 net closures in 2025-26 compared with 112 in 2024-25.
Baroness Janke (LD)
My Lords, I thank the Minister for her response, but 65% of community pharmacies are now operating at a loss; 45% have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open, mainly to vulnerable people with the highest levels of need. What is the Minister’s response to the fact that individual pharmacists are subsidising essential front-line services out of their own pockets? Given that the closures are hitting deprived communities the hardest, what specific measures is the Secretary of State taking to prevent the creation of pharmacy deserts in areas with the greatest health needs?
Baroness Merron (Lab)
We are taking a number of actions on the point that the noble Baroness rightly raises. I have spoken about the uplift on the back of a major uplift in the two years previously. For underserved areas, the pharmacy access scheme provides financial support to pharmacies in areas where there are fewer of them. About 1,400 benefit from the scheme and they receive an average of £1,130 per month. Also on the question that the noble Baroness raised, local authorities have health and well-being boards, which assess whether the local provision of pharmacy services meets the needs of the population. Integrated care boards make decisions on pharmacy openings, and they can directly commission a pharmacy if necessary.
Healthcare Services: Acute, Primary and Community
Baroness Janke Excerpts(1 month ago)
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Baroness Janke
That this House takes note of the relationship between (1) acute, and (2) primary and community, healthcare services.
Baroness Janke (LD)
My Lords, it is a great privilege to open today’s debate on matters that are of such concern to so many people and which lie at the heart of our local communities. As we all know, health services are severely overstretched, whether in a local context or elsewhere. The systems are simply not coping.
Anxiety and fear are facts of life for many, particularly the elderly and vulnerable, who fear they will not have proper access to healthcare—so much so that A&E has become the default destination for desperate patients unable to find care or advice through their local doctor. Some 18% of patients attending A&E did so because there was no GP appointment available to them; this amounted to 4.5 million attendances. Nearly half a million people waited 24 hours or more in A&E last year, an increase of 150,000 patients in just three years. Over 1.1 million patients were stuck in A&E, specifically waiting for an in-patient bed to become available. Even more frightening, according to the Royal College of Emergency Medicine report published in June this year, in 2025 around 15,860 patients died in NHS A&E departments in England while waiting for care that could have saved them. That is roughly 1,300 people every month, nearly 10 times the figure recorded in 2015.
However, the Government’s 10-year primary healthcare plan promises us community-based health services with a focus on illness prevention and promotion of good health. The vision of a well-resourced community-based health service is attractive and powerful. It is what we all want, patients and professionals alike, but it could not be further from everyday experience.
With waiting times for GP appointments at record levels, people’s fears about access to healthcare are well justified, particularly among the vulnerable and elderly. Worse still, the system can be off-putting and daunting, and not everyone is able to navigate it. For example, there is the 8 am scramble: having to phone in by 8 am and then being told you are 20th in the queue; having to explain highly personal matters to the receptionist who answers your call; or having to deal with an online system, only to find that there are no appointments left and you must phone anyway and wait in the queue. There are many questions across the board as to how we get from where we are now to the reassuring and welcoming world of the 10-year vision.
The pillars of community healthcare that so often support the ailing service we have today are the community pharmacies, which offer a local service that is practical, easily available and embedded in local communities. I will use the rest of my time today to speak about the crisis in this essential service and its impact on community healthcare.
We often hear the community pharmacy described as the front door of the National Health Service, yet we are currently watching that door being systematically bolted shut in the communities that need it most. The scale of this crisis is staggering and, frankly, a damning indictment of a decade of financial neglect. Since 2015, England has seen a net loss of 720 pharmacies. Last year, closures reached their second-highest level on record, and current data suggests that the rate of closure this year is nearly 50% higher than at the same stage in 2023. Between January and April alone, 177 pharmacies closed their doors for good.
The root cause of this is a 30% real-terms funding cut since 2015. While the costs of medicines, energy and staffing have surged, core funding has remained stagnant, leading to an annual funding gap of at least £2 billion across the sector, as reported by the NHS. The human cost of this neglect is borne by pharmacy owners, 65% of whom are now operating at a loss. Nearly half—45%—have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open to the public.
Every day, pharmacies facilitate 1.6 million daily visits, providing vital triage and advice that keeps pressure off overstretched GP surgeries. However, when a local pharmacy closes, these daily visits do not simply vanish. Instead, they are forced back into the primary care system, exacerbating the crowding of emergency departments with non-urgent issues that could have been managed in the community. Acute care is designed for rapid intervention in time-sensitive, high-stakes conditions such as heart attacks or severe injuries. By removing the pharmacy buffer, we are forcing patients with minor ailments into acute settings, wasting specialised resources and jeopardising the safety of those with life-threatening needs.
Pharmacies cater for many needs, such as dispensing medicines, vaccinations, medical advice and urgent medical care, as well as provide services to promote health, such as smoking cessation and weight management—and they could do more to ease pressure on other parts of the health service. According to a 2025 Department of Health and Social Care report, 70% of people surveyed would be happy to see a pharmacist for common conditions or prescription reviews if it meant being seen sooner. The same study found that 68% of respondents are comfortable speaking to a healthcare professional in a pharmacy setting rather than a traditional GP surgery.
Pharmacies offer a range of walk-in services and can work in tandem with GPs and other primary care settings to play a greater role in long-term condition management and point-of-care testing, but this has to be with the right investment and support. Pharmacies are small businesses, and like all small businesses, they have difficult issues affecting them, such as increased national insurance charges, increases in the minimum wage and rising business rates. Incidentally, GP practices and pubs are exempt from business rates, so many local pharmacists are asking why pharmacies cannot also be exempt as an essential service. I would like the Minister to consider that in her remarks. Some 95% of pharmacies also told the National Pharmacy Association that they were not in a financial position to be able to support the Government’s ambitions to move care into the community, as outlined in the 10-year plan.
Deprived areas with high health needs saw the highest rates of pharmacy closures between 2022 and 2025, with Liverpool being the nation’s capital for pharmacy closures per head of population, followed by Blackpool, Coventry and Hull. The pharmacy network in England now stands at its smallest since 2006. Some 63% of pharmacies could close this year, with 40% unable to pay the full cost of prescription medicines for patients. The current system of reimbursement for medicines is currently failing pharmacists and patients, and it needs reform.
We are also facing a workforce crisis, where locum costs have risen by 80% in a single year and overall staffing costs have grown by nearly 70% since 2015. Pharmacies simply cannot absorb this scale of increases without a fair and sustainable funding settlement. “Lights Out” is not just a campaign slogan; it is becoming a stark reality for high streets across the country. We cannot move healthcare out of hospitals and into the community if the community infrastructure has been allowed to crumble.
Can the Minister say when the Government will deliver the urgent investment needed to close the £2 billion funding gap and stabilise this sector? What specific protections will be put in place to prevent further closures in deprived areas where health needs are greatest? How do the Government plan to prevent the withdrawal of addiction and delivery services, which will inevitably overwhelm our GPs and A&E departments? The time for warm words has long passed. We need a sustainable road map that reflects the true cost of delivering NHS pharmaceutical care. If we do not act now, the front door of the NHS will be not just bolted but gone for ever.
Baroness Janke (LD)
I thank the Minister for her remarks and her explanation. She is obviously very committed to her plan. I think it is fair to say from what we heard during the debate, which had strong contributions from both professional and patient experience, that people in this Chamber are not convinced and that there is a lot of work to be done to convince people that the plan is going to succeed—not least the people who are working in it.
I draw the attention of the Minister to the morale and the sense of crisis that there is in many communities. On my point about local pharmacies, there is a crisis, and if we are not careful there will be none left to help to deliver the plan, and I am sure the situation is similar in other parts of primary care. So, while I recognise that the Minister has tried to be helpful, I think there is still a lot of work to be done and I—and, I know, others in this Chamber—will be pursuing the plan, in the hope that we will see it succeed in the future. It will need a lot of commitment and, as we have said, a lot of resource focused on primary care in communities and making sure that that focus is kept and that we remain committed to it.
Motion agreed.