Community Pharmacies

Gary Streeter Excerpts

Tuesday 21st June 2022 Westminster Hall

[Several hon. Members rose—]

[Sir Gary Streeter (in the Chair)]

Order. The Front-Bench spokespersons are due to begin at 5.10 pm. There are four other Members who wish to speak, so you each have six minutes.

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[Anna Firth (Southend West) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Sir Gary. Community pharmacists have long been one of the unsung heroes of our NHS. Indeed, I would go as far as to say that they are a keystone species of the NHS, serving as a minor injuries unit and providing a vital prescribing service and essential healthcare out of hours for so many people around the country. They are also our most accessible form of healthcare. Their contribution throughout covid-19 was perhaps the best example of their heroic and accessible work. Community pharmacies were the first to step forward during our world-beating vaccine roll-out programme. Millions of people, just like me, had both their first and second jab from their local community pharmacy. Many of us regularly visit our pharmacies for covid tests, travel jabs, flu vaccines and a plethora of other essential healthcare services.

One of the less well known but most inspirational initiatives that community pharmacies have been involved in during the covid pandemic is their support for women experiencing domestic abuse. The Government-backed, pharmacy-led Ask for ANI scheme was a lifeline for many abused women. They could go into a pharmacy and ask for “ANI”, which was the codeword for getting a safe space to raise this important and personal issue.

It is their community nature that makes those pharmacies so valuable. Being on every high street, and having a smaller number of patients than a GP or medical centre, means they can be truly local and embedded in the area. In my constituency of Southend West, we have 18 brilliant pharmacies, each serving an average of 5,162 people. They thus serve a whopping 93,000 people a year. I am delighted that the Government have already recognised the important role that pharmacies play. Earlier this month, the NHS chief executive announced that community pharmacies will be funded to spot early signs of cancer and trained to refer people directly for scans and checks without seeing their GP. That is so welcome and important. Every Member of Parliament will be receiving a welter of emails complaining about access to GP appointments. The Valkyrie surgery, in my constituency, is clearly struggling to cope with the demand for appointments, and it is certainly not the only one struggling in Southend West.

Enabling people to access specialist services without going through a GP will massively ease pressure on GP services. It will also ease the pressure on our beleaguered accident and emergency services, which are crumbling under the pressure. Southend Hospital is safe for around 50 people going through A&E every day, but it is, on occasion, having to cope with 150 people. The obvious solution to those twin problems is to upskill our community pharmacies and ensure they have the funding and training they need to take the burden off our GPs, ambulances and hospitals.

Pharmacies already save 619,000 GP appointments every week; that is 32 million every year. The services they provide also save around 3.5 million people every year from visiting A&E and walk-in centres. We must go further to transform our pharmacies into an even more vital community resource. In Southend West we have the brilliant Belfairs pharmacy, run by an inspirational pharmacist called Mr Mohamed Fayyaz Haji—known locally as Fizz. Fizz provides a great range of services, including cholesterol and blood pressure checks, health advice and prescribing. He has recently acquired further premises so that he can expand into even greater levels of primary and community care, from ear syringing through to community phlebotomy, and to earlier diagnosis measures such as measuring prostate-specific antigen levels for prostate cancer, as well as electrocardiograms and ultrasound screening for sports injuries and pregnant women. That is exactly the sort of care that we want to be championing and supporting to ease the pressure on our other services. I am sure that my hon. Friend the Minister would like to join me in applauding Fizz’s efforts in Belfairs. That is a model for community pharmacy care around the country.

That sort of expansion is obviously not free. I applaud the fact that the Government are already investing in this area. I welcome the community pharmacy contractual framework, which will provide £2.5 billion annually. It is providing clarity and certainty about funding for the first time. I also welcome the new commitment for an additional £15.9 million to support the expansion of frontline pharmacy staff, providing people like Fizz with the training that they need to develop the skills of their staff for the benefit of everybody in the local community. I want to see this continue and for our pharmacies to be able to offer routine medical check-ups and routine injections and to be able to spot the early signs of serious illnesses and refer patients straight on to specialist departments in our local hospital.

In conclusion, pharmacies already provide a huge range of local services and they deserve greater recognition for the essential work that they do. The Government are already doing great work. I would like to see the Government go further with upskilling pharmacists, easing the pressure on our NHS and creating a healthier society all round. Pharmacies, especially in Southend West, are keen to be part of this mission and offer more to their local communities. I welcome every step to empower them to do just that.

[Sir Gary Streeter (in the Chair)]

Last but never least—Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Sir Gary. It is a pleasure to speak in this debate. First, I congratulate the hon. Member for Bootle (Peter Dowd) on setting the scene so very well. This subject is something that I am sold on. It is something that I fully endorse, as others have done. We all see the real benefits of it. I have a great interest in the topic. I believe that community pharmacies are an untapped resource that we need to unlock with clever funding and foresight. Over the years, I have worked closely with a number of pharmacies in my constituency of Strangford and have been impressed by the expertise and the potential that is ready to be unlocked.

Pharmacies were involved in covid-19 jabs. They do flu jabs, blood pressure tests and asthma checks, as the hon. Member for Bootle mentioned. Staff can look out for signs of illness and can, if necessary, refer people on—because they know the limitations of the service as well—and that is a good thing. I got the girl from the office to send through details of some of the things that they can do right there and then; people do not have to go to A&E to get these things done. Pharmacies can deal with athlete’s foot, diarrhoea, haemorrhoids, head lice, groin infections, threadworms, thrush, earwax, mouth ulcers, scabies and verrucas. Staff can deal with all those things, at the initial stage, in pharmacies. Although some of those things are probably fairly personal, pharmacies do have the ability to deal with them.

During my time in the Northern Ireland Assembly, I was a strong advocate for what was then called the minor ailment scheme. Although that may still be in operation to a small degree, the potential for more is at our fingertips. The enthusiasm and energy that local pharmacies have really excites me. I get extremely excited about the potential, about what could happen, when I speak to owners such as James McKay of McKay Pharmacy in Newtownards to hear of the schemes that he has ready to go—making space for community physio and nutritionist provision in tandem with the local GP surgery that has premises abutting the pharmacy. There is scope for a real community facility—with much more provision than perhaps pharmacies, with their space, can provide—and that needs to be progressed and replicated.

I was not surprised to read that, on average, pharmacies undertake more than 58 million informal consultations per year. I had to get malaria tablets for a trip to Nigeria just a few months ago. In the past that would have meant a trip to a Belfast private doctor to get a private script, at a large cost. But this was a matter of popping down to my local pharmacy, answering some questions and getting the malaria tablets. Last week, I had a bit of toothache. Again, I went down and spoke to the lady. She gave me the tablets; she gave me the gum rub, and there and then seemed to have solved the problem. Similarly, I believe that those informal consultations prevent an additional 70,000 people from needlessly attending A&E or an NHS walk-in centre every week. Yet community pharmacies receive no specific funding for holding such consultations. That needs to change. I look to the Minister, as I always do. She understands these issues extremely well and, more often than not, she has the answers to the questions we ask.

Delivering minor ailment care through community pharmacies rather than GPs could result in a 53% total cost reduction to the NHS. The cost of providing 40 million minor ailments GP appointments per year is £1.2 billion; it would cost just £560 million to transfer those appointments to pharmacies as a community pharmacy consultation service. Those significant savings cannot be ignored. In this day and age, when finances are important, it is important we look at these issues. It is not simple, straightforward maths and is more than just a number exercise.

We must understand that community pharmacies are ready and willing, and local GP practices are calling out for pressure on surgeries and treatment rooms to be relieved, as well as that on accident and emergency departments. This change makes sense. It has been shown to work in the past and will work again in the future. Let us make the most of the expertise we have and take the pressure off our GP practices where it is possible to do so. We need to get treatment and training in place and get the right people doing the right things.

The future of community pharmacies is intrinsically linked with that of the NHS. We need to work smart as well as expecting them to work hard, and get the minor ailments scheme in a funded and good position. This is a tremendous opportunity to do something good with our health service, in a way that we save money and also deliver better care across the whole community. Everyone of us here today is excited at the possibility of what could happen. I am sure when she responds the Minister will give us some encouragement. I know one thing: if this happens, we all gain.

[Sir Gary Streeter (in the Chair)]

We move to our Front-Bench speakers. I call Steven Bonnar.

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[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Gary. I add my congratulations to my hon. Friend the Member for Bootle (Peter Dowd) on securing the debate, and I congratulate him and Members across the House on putting forward a compelling argument for supporting our community pharmacy sector and increasing its role in the provision of localised community healthcare.

We have heard from Members from across the House that community pharmacies are the cornerstone of our local areas. For many people, community pharmacists are the most accessible healthcare professionals in the NHS, and their work is invaluable. We have heard that more than 89% of the population is estimated to have access to a community pharmacy within a 20-minute walk, but, as my hon. Friend rightly pointed out, access is significantly higher, at 99%, in areas of the highest deprivation.

We have always known that community pharmacies are important, but it was felt acutely during the pandemic. Community pharmacies helped to administer 24 million covid vaccines and were at the forefront of our response to the virus. In 2020-21, they delivered more than 4 million flu vaccinations—an increase of 75% on the year before. Indeed, as the hon. Member for Southend West (Anna Firth) pointed, community pharmacies carried us through the pandemic and reacted with extraordinary speed to a virus that shut down the rest of the country. It is therefore essential that we not only protect this vital community resource but equip it for the future.

As has been noted throughout the debate, there are two broad areas of concern within the sector, and I would appreciate the Minister’s assessment of them. The first relates to resources. Despite the additional demand for services, there has been no increase in funding for the pharmacy network since 2014, and there have been cuts of around £200 million since 2016. The current framework, agreed in 2019, has not been adjusted, despite the covid-19 pandemic, and we have seen central Government’s failure to adapt. This has resulted in pharmacies being unable to meaningfully invest in staff and has been detrimental to infrastructure development as well as innovation.

What is perhaps most worrying, however, is that an EY study in 2020 found that 40% of the large pharmacy chains sampled were operating at a loss. That is not sustainable, and unless action is taken, we could see pharmacies shut and that vital point of access for people close. I think there is consensus across all parties, including from the Minister, that we want to avoid that, so I would be grateful if she could outline what steps the Government are taking to better support community pharmacies and what assessment her Department has made of the potential impact of fiscal pressures on the sector. Furthermore, has the Department of Health and Social Care made any assessment of the additional pressures that the pandemic has placed on pharmacies? Will that inform the next community pharmacy contractual framework?

The second issue I would like to focus on is strategy and workforce. That will not come as a surprise to the Minister, given the Opposition day debate in the main Chamber earlier. There has been a distinct lack of overarching Government strategy when it comes to workforce planning over the past decade, including in relation to community pharmacies. The community pharmacy model that the NHS needs has drastically changed, as have the needs of patients. As far as I am aware, there has not been any strategy outlining the Government’s ambitions for the sector. Instead, we have seen short-term thinking, a real-terms funding decline and radio silence on the future of this vital resource. That needs to change, and I impress on the Minister the urgency of working with her DHSC colleagues to develop a strategy for community pharmacies that is fit for the future. Crucially, it needs to address the workforce issues that have been reported by parts of the sector, particularly in rural areas, where the increase in patient demand is putting pharmacies under more pressure.

I understand that the Government will argue that extra resource is going into the NHS, but we must not get into the trap of taking community pharmacies for granted, and we need to build a resilient, innovative and adaptive service for the future. We must utilise community pharmacies to tackle the key issues of our time. For example, many pharmacies already offer a range of services geared towards tackling health inequalities, but the local commissioning structures mean that access is not equal throughout the country. There is a real opportunity for central Government to step in and to ensure that no matter where people live, they can access weight-management services, emergency contraception, smoking-cessation services and much more.

Community pharmacies are already embedded in communities. They are trusted by local people. We need, therefore, to ensure that the Government give full support to the sector. Every Member who has spoken would wholeheartedly support the Minister to make sure that happens.

[Sir Gary Streeter (in the Chair)]

I kindly ask the Minister to leave 30 seconds for Mr Dowd to speak at the end.