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A study published this month reported that over the past decade the number of community pharmacies in deprived areas in England fell by 12%, compared with a drop of 3% in the least deprived areas. To most observers, this is not surprising.
The Pharmaceutical Journal mapped pharmacy closures against measures of deprivation in early 2023 and found that while the positive pharmacy care law still held true, the ability of pharmacies to provide more services for the least well-off was slowly being whittled away by the pattern of community pharmacies shutting their doors for good.
There was hope in several quarters that the first Labour government for 14 years would make narrowing health inequalities a priority.
The Labour Party manifesto, published ahead of 2024’s general election, promised to halve the gap in healthy life expectancy between the richest and poorest regions in England, and added that “Labour will stop the chaos in our health and care services, turn the page, and reform them in line with the principles of the NHS that Labour founded”.
The new government’s promised ten-year plan for the NHS, due to be published soon, does not explicitly aim to tackle health inequalities, but its three stated aims — focusing on prevention, shifting care into the community and making better use of technology — could all contribute to fairer healthcare.
The annual shortfall in the cost of delivering NHS pharmaceutical services across England in 2023/2024 was an astonishing £2.3bn
In terms of moving care from hospitals to the community, the recently agreed two-year community pharmacy contract shows mildly positive signs. It was cautiously welcomed by most in the pharmacy sector, but with one crucial proviso — while it did provide a financial boost, it is still a long way off the sums needed to sustain a thriving community pharmacy sector.
An independent analysis of the costs of delivering NHS pharmaceutical services, commissioned by NHS England and published in March 2025, just before the contract, revealed the depth of this funding crisis.
The analysis, conducted by Frontier Economics and IQVIA, looked at data provided by 1,166 pharmacies across 102 companies and found that the annual shortfall in the cost of delivering NHS pharmaceutical services across England in 2023/2024 was an astonishing £2.3bn.
The Pharmaceutical Journal this month reported that the Pharmacy First scheme in England has passed its 5 million appointment milestone in not much more than a year of operation.
To give the previous Conservative administration its due, it took the bold step of following Scotland’s lead by introducing the Pharmacy First programme at the end of January 2024, and so far, despite the occasional teething problem, the service has been broadly seen as a success.
Despite the number of pharmacy closures in deprived areas, they’re still the most accessible ‘front door’ to NHS services for the vast majority of the population, and if the Pharmacy First service can be expanded to include a wider range of services, possibly using the skills of prescribing pharmacists, then accessibility for hard-to-reach patients could see a marked improvement.
However, for this to really work, the community pharmacy sector needs a significant boost in funding. This may be a difficult argument for a government to make, when it has made great play of what it claims is a financial black hole left by the previous administration. However, as one of its stated aims in the forthcoming ten-year NHS plan is prevention rather than cure, a substantial investment in community pharmacy could address this and reduce health inequalities simultaneously. PJ
