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The systematic closure of Pharmacies

In December 2021 the PDA highlighted the issue of sporadic and temporary pharmacy closures in Scotland by meeting with civil servants and engaging with the National media in Scotland.

Tue 1st March 2022 The PDA

Questions were also asked in the Scottish Parliament about the issues the PDA had highlighted. The intention was to help ensure that pharmacies continued to open after significant numbers of members raised concerns that pharmacies were appearing to be temporarily closed by their owners in a systematic fashion.

The PDA made Freedom of Information (FOI) requests to the Scottish Health Boards in which it was discovered that in three months over summer 2021, 574 reported closures of pharmacies in Scotland were identified.

In July 2021 alone there were 338, 331 (98%) were in pharmacies owned by UK multiple pharmacy chains (LloydsPharmacy, Well, Boots, and others), a few others occurred in Scottish owned pharmacies. Informed by a members survey the PDA believes that the number of actual closures may be somewhat higher than officially reported or recorded.

The majority of closures are concentrated in urban areas. What was of particular concern is that there is a distinct correlation between deprived neighbourhoods and the frequency of closures seen. Many of the areas worst affected are among the 20% of most deprived neighbourhoods in Scotland.

Health Board data identified that LloydsPharmacy was responsible for the majority of closures (56.6%) and this was seen in all the larger Health Boards, they were responsible for as many as 81.0% of reported closures in Tayside. Because the independently owned and smaller local chains in Scotland appeared able to engage sufficient staff to open, the closures in the multiples did not appear indicative of a shortage of pharmacists. Furthermore, the closures seen amongst just a small number of companies cannot easily be explained by the indiscriminating effects of the pandemic.

Members have indicated that the working conditions are a factor in where they chose to work, and that chronic underinvestment in systems, staffing, and premises are all factors that may deter pharmacists from opting to work for some pharmacy companies.

In Scotland, pharmacies are more generously funded than in England, and different and increased service levels are required. Unless the UK-wide chains reflect this in their business models, they could potentially be using payments made by the Scottish government to subsidise the rest of their UK networks at the expense of Scottish taxpayers.

There is no provision to withhold payments from pharmacy companies who close a pharmacy to the detriment of patients. The only sanction available to the NHS is for the Health Board to remove their contract and close the pharmacy. This is not sustainable unless other provisions can be made to protect continuity of the pharmaceutical service.

Elsewhere in the health system, there is provision to take over GP surgeries from their GP partner owners. The GPs that work in these ‘salaried’ practices become NHS employees and are paid a competitive salary. These facilities are wholly NHS operated and staffed, any efficiency savings and profits made in these ‘salaried’ practices are retained by NHS Scotland.

Such a remedy has been proposed to the Scottish Government. Under such arrangements in a failing pharmacy situation, the continuity of service to the community could be assured. Pharmacy staff including pharmacists could deliver their services as NHS employees, enjoying all of the benefits of NHS employment and any ‘profit’ generated would return to the NHS. In a recent meeting with civil servants, the PDA was told that the companies involved have been spoken to and asked to address the closures issue.

The employed and locum pharmacists working in Scotland’s communities have striven hard to deliver services throughout the pandemic. The vast majority of independently owned or small chain Scottish pharmacy owners have never routinely shut their doors. However, certain companies have chosen to do so, and they are in breach of the 2009 NHS regulations and the NHS (Scotland) Act 1978.

The PDA believes that these unexplained closures have caused anxiety amongst patients and staff, and they have let down the poorest communities and the most vulnerable patients. Ultimately, they will have damaged the reputation of the profession at a time when the vast majority of pharmacies in Scotland have worked tirelessly to provide the people of Scotland with access to pharmaceutical care.

In the interests of patient care and safety, the PDA wants to see this situation improve and continues to monitor the situation, engaging with other Scottish stakeholders. Any information from members about ongoing closures of pharmacies in Scotland will be gratefully received and acted upon.

Please note, this article first appeared in the Scotland edition of Insight magazine (Spring 2022). Download the full magazine here

Related link

Insight Scotland magazine – Spring 2022

 

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