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Tim Gibbs's marathon working hours are typical of people who run our independent community pharmacies.
He opens his shop in Yarmouth on the Isle of Wight at 8.30am and works through until 6pm without time for a
meal break.
In the evenings he delivers medicines to housebound customers,
grabs dinner, orders drugs from wholesalers and completes the business's paperwork.
Suddenly it's midnight. This is the pattern for six days a week.
‘I'm doing 100-hour weeks. It's not sustainable,' he tells Good Health.
‘The last day I took off was my wife's birthday at
the start of June. There's no time for leisure or pleasure.
Life is hell.'
Tim isn't a money-driven workaholic. He is simply desperately trying to keep his business going in the teeth of a deepening NHS funding crisis that threatens the very existence
of England's 6,600 family-run independent pharmacy shops.
These are a lifeline in their community. Rather than simply providing vital health services,
they are sometimes the only place that offers human contact for many lonely, vulnerable and often elderly customers.
100-hour weeks: Pharmacist Tim Gibbs in the Isle of Wight
The businesses go out of their way to deliver prescriptions, and even household provisions, to those who
need help — Alpa Ghelani, a pharmacist from Manchester, and Malcolm Hill, from Newcastle-under-Lyme, whose stories are told on these pages, are shining examples of
community pharmacists at work, who pop in to check on locals they are concerned about.
Their importance is only set to increase, as they will
play a crucial role in easing the load on GPs as patients
struggle to get face-to-face appointments. NHS England
is rolling out a pilot scheme for pharmacists to provide services for those with
common health needs.
Yet this key lifeline is under threat. In August, Lord Grade of Yarmouth wrote in the Mail to highlight the plight of community pharmacies,
which he had seen first-hand — Tim Gibbs owns his local chemist.
Lord Grade tells Good Health: ‘My wife, Francesca, and I are in and out of his shop all the time.
I couldn't help but notice Tim's worsening situation whenever
I picked up my prescriptions.'
Lord Grade, along with the All-Party Parliamentary Group (APPG)
on Pharmacy are campaigning to save Tim's and thousands of
other independent community pharmacies from the brink of extinction.
Already around one in ten has gone out of business since 2015.
Last month Lord Grade wrote to the then-Health Secretary, Therese Coffey, urging that these pharmacies be given urgent financial help.
He has received no reply.
‘I have asked questions in the House of Lords,' he says.
‘But so far no action. Is the Government waiting until all of the independent pharmacies close, or what?'
Lord Grade is urging people to write to their MPs calling for their lobbying support.
‘Millions of us now depend on local heroes such as Tim,' he says.
‘We all need to campaign for their survival — and not least for our own sakes.'
At the heart of the crisis is the NHS contract for community pharmacies, which sets
payment rates for dispensing medications.
The rates were last set in 2015 and they have not been increased since
to account for inflation. A study by Ernst
& Young (EY) warned that this meant the NHS payments
that independent pharmacies rely on to keep
running had effectively shrunk by a quarter — and will fall by a further third at least by the time
the contract comes up for renegotiation in 2024.
A NHS funding crisis threatens the very existence of England's 6,600 family-run independent pharmacy shops
One in three pharmacies is no longer financially viable, according to further analysis in September by EY, the London School of
Economics and University College London. The report warned that
thousands of community pharmacies in England might close
by 2024.
On top of this, the Department of Health's financial
calculations assume that single-store independent pharmacists enjoy the same volume discounts
as Boots and other big chains, which can negotiate deals with wholesalers.
However, that's just not the reality, says Tim. ‘The Government thinks that I can get discounts on medicines,
but I can't. The big chains such as Boots and Lloyds own their own wholesalers
so they have lower costs than I do.'
As a result, he adds, ‘I don't even get paid what I spend on medicines alone.
This year I spent £85,675 and got paid £85,314 by
the Government.' Currently for every NHS prescription that Tim dispenses,
he loses 73p. That's because while the NHS contract pays
him £1.27 per prescription, dispensing that prescription costs him £2, with overheads such
as insurance, business tax, staff wages and specialised computer
systems.
Tim says he is keeping the business going by relying on family savings.
But inevitably those funds will run dry.
Independent pharmacists are also having to
meet spiralling costs for energy and staffing, on top of inflation. Unlike
other businesses, community pharmacists can't just hike their prices
to compensate, because the great majority of their income comes from the fixed NHS
contract. As a result, England's independent pharmacies are
collapsing under the strain.
The real front line of the NHS, your local chemist, is retreating, just when we
need them more than ever to alleviate the demand for GP appointments
Lord Clement-Jones, the vice-chair of the All-Party Parliamentary Group, told Good Health:
‘Some 670 community pharmacies have closed since 2015. It's a really serious situation.'
That loss represents one in ten of the 6,600 independent family-run pharmacies left
in England. The remainder constitute more than half of the 11,
200 community pharmacies now operating, according to figures from
the National Pharmacy Association, which represents independent pharmacies.
And it's not just shops that are lost but vital community
services, adds Lord Clement-Jones. ‘Independent pharmacists are invested in their
local communities to a degree that someone working for a chain won't
be. They're open all hours, day and night, contributing to the life
and health of their locals. ‘More than 40 per cent of closures
are in the poorest, most needy areas of the country, where
the elderly and ill depend on their help the most.'
The North-West of England had the largest regional pharmacy closure rate in the country over the past two years.
NHS data shows 31 were lost in the past financial year, with
39 closing down the previous year. This month a meeting of the APPG heard evidence from Janet Morrison, chief executive of the
Pharmaceutical Services Negotiating Committee,
which represents independent community pharmacists in Government contract
talks.
She warned: ‘Pharmacies, and the people who work
in them, are exhausted, worried, and most of all in desperate need of
more help and support.'
The APPG says ‘a significant cross-party push is needed to harness the potential
of pharmacy teams to take pressure off the NHS'. For the terrible irony is that England's community pharmacists are collapsing precisely at a time when the nation needs them more than ever.
The iniquities in that deal mean that the Department of Health acts
as if single independent pharmacists enjoy the same volume discounts as Boots
and other big chains, which can negotiate discounts from wholesalers —
and clearly they don't
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