Community Pharmacies

Preet Kaur Gill Excerpts

Thursday 14th September 2023 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Mark. I thank the hon. Member for Waveney (Peter Aldous) for securing this important debate, and I congratulate him and Members on both sides of the Chamber on putting forward a compelling argument for supporting our community pharmacy sector and increasing its role in the provision of localised community healthcare. I thank my right hon. Friend the Member for Knowsley (Sir George Howarth); the hon. Member for Winchester (Steve Brine), who chairs the Health and Social Care Committee and who made some excellent contributions; my hon. Friend the Member for Bradford South (Judith Cummins), who has been campaigning on this issue; the right hon. Member for Tatton (Esther McVey); and my hon. Friend the Member for Coventry North West (Taiwo Owatemi), who is a pharmacist and who shared her first-hand experience of some of the challenges. We have heard some great contributions in this debate.

It is a great pleasure to take on this important portfolio covering primary care and public health. In this year—the NHS’s 75th—its founding mission, to deliver care to everyone who needs it, when they need it, free at the point of use, is clearly under threat. Thirteen years of Conservative Government have left the NHS flat on its back, and the rightful expectation of my constituents and people across the country of an NHS with time to care for them when they need it is being trampled. We see longer waiting times, a postcode lottery in care and, shamefully, for the first time in decades, healthy life expectancy falling in many regions across the United Kingdom, including the west midlands, which I represent. That is one of the starkest indicators of how this Government, far from levelling up the country, have let it down.

The NHS is Britain’s greatest institution and my party’s proudest achievement, and nothing gives me fire in my belly like the prospect of what a Labour Government will do to fix it. Community pharmacy is a huge part of that, relieving pressure on overstretched GPs and delivering first-class care and advice to patients. As many hon. Members have highlighted during the debate, it is high time we realised the potential of pharmacies; as with the vaccine roll-out during the pandemic, they have proven time and again that there is so much more they can deliver as part of the primary care mix.

Pharmacists are the third biggest profession in the NHS, with around 13,000 community pharmacists across the UK, and together they prescribe more than 1 billion medicines a year. Not only are pharmacists medicine experts within the NHS, but colleagues have acknowledged their wider skills and knowledge, which are under-utilised. It is estimated that pharmacists give around 58 million informal consultations to walk-in patients a year, saving 20 million GP appointments. We also know that drug-related problems, often resulting from poor medicine management, cause around 15% of hospital admissions and cost the NHS hundreds of pounds a night, so pharmacies have an enormous contribution to make to the wider system.

Chemists do far more than just dispense repeat prescriptions and sell shampoo. They provide a range of clinical services in prescribing for common ailments and have a key role to play in public health and preventive services. There are great examples of innovative public health work that pharmacists are doing, such as in Bradford, where the “Wise Up to Cancer” initiative promoted health literacy among south Asian women, or the Jaunty Springs Health Centre in Sheffield, where a shared care agreement between the pharmacy and GP surgery meant that a majority of health interventions could be delivered in the pharmacy consultation room, freeing up the GP and cutting waiting times.

There is good practice in pockets across the country that we should be building on. I know that Ministers have belatedly acknowledged that, and there has been some expansion of the clinical services that pharmacies offer in recent years. However, a few sticking-plaster proposals really miss the opportunities that are there. Will the Minister update us on how negotiations with the sector over the Pharmacy First launch are progressing, and can he promise that it will be operational in time for the flu season? What consideration has he given to expanding Pharmacy First to establish a community pharmacist prescribing service covering a broader range of common conditions?

The Minister will know that in some countries, which are way ahead of the Government on this, such as Canada, pharmacists can prescribe for dozens of common conditions, freeing up millions of appointments in general practice every year. What is his long-term strategy to equip pharmacies for a future where their talents, capacity and expertise can be fully utilised and to fix the front door of the NHS?

Hon. Members have also raised a number of concerns about the financial pressures facing pharmacies. I know that the sector appreciates the additional funding announced in May, but that is of course tied directly to its expanded responsibilities as part of the primary care recovery announcement and does not recognise how current cost pressures are impacting the sector. Since the community pharmacy contractual framework was signed in 2019, the cost of doing business has continued to rise—especially since the right hon. Member for South West Norfolk (Elizabeth Truss) crashed the economy.

The result has been many pharmacies closing their doors for good, disproportionately in the most deprived areas, as analysis from the Company Chemists’ Association has found. Last year alone, 110 pharmacies shut up shop, and many more have had to reduce opening hours, services and staffing. Will the Minister say what assessment he has made of the risk of more pharmacies closing down and reducing operations before the end of the current funding settlement in 2024 and what impact that will have on the NHS medicines supply, the knock-on pressures on other parts of primary care and the prospects for extended clinical services in the community setting?

As the Minister will know, the 2019 funding agreement was made on the promise that the Government would drive wider efficiency savings and regulatory changes across the system. For many community pharmacies, the roll-out of the hub-and-spoke model was an answer that would allow them to streamline their services. However, it has been 14 months since the Department of Health and Social Care’s consultation on hub-and-spoke dispensing closed, and we have still had no response from the Department, nor the secondary legislation that was promised. Can the Minister please give us answers today about the considerable delay in progressing with hub-and-spoke reform? What is the hold-up?

I would also like to raise the issue of staffing with the Minister. The community pharmacy workforce survey released last month revealed that, compared with 2021, there was a 6% reduction in the full-time equivalent workforce in 2022. The vacancy rate for pharmacy technicians was about 20%, whereas it was 16% for pharmacists and 9% for dispensing assistants. Two thirds of contractors said that they found it very difficult to fill pharmacist roles last year, and in turn, the bill for locum pharmacists rose by 80% last year alone. Many chemists are struggling to cope with those pressures, contributing to thousands of unplanned closures every month. That is bad for the taxpayer and bad for patients, so what assessment has the Minister made of the challenges faced by community pharmacies in hiring, training and retaining skilled pharmacy staff? Does he recognise that the Government’s workforce strategy has not kept pace with the scale of change in the sector? Does he share my concern that without a functioning community pharmacies network, the Government’s primary care recovery plan is built on very shaky foundations?

The next Labour Government have a plan to reform the NHS to shift care from acute settings to the community. As part of our plans to build a neighbourhood health service, we will realise the potential of community pharmacies, giving people services that they can rely on and access earlier on their doorstep. That will mean accelerating the roll-out of independent prescribing to establish a community pharmacist prescribing service that covers a broad range of common conditions. It will mean cutting unnecessary red tape to allow pharmacy technicians to step up, ensuring that pharmacists can work to the top of their licence and make more of their considerable expertise in prescribing and medicines management, rather than having repetitive dispensing processes. All of that will be supported by greater digital interoperability, allowing the profession to support GPs in the management of long-term conditions.

The Minister will have heard the broad support for the sector in today’s debate, as a trusted and cost-effective measure for addressing some of the chronic challenges we have come to expect under this Government. I look forward to his answers on what more he is doing to support this important sector and realise the potential of the pharmacy profession.