Closure warning for NI pharmacies over funding difficulties

A body representing community pharmacists in Northern Ireland has said continuing funding difficulties will result in more pharmacies closing.

Community Pharmacy NI (CPNI) said the sector had been "grappling with a funding deficit of £20m per year for more than a decade".

Representatives from the CPNI addressed Stormont's Health Committee on Thursday.

Prof Cathy Harrison, the chief pharmaceutical officer at the Department of Health, told the committee that the department is "aware of the concerns of community pharmacy owners" but that Northern Ireland is "well provided for in respect of access to community pharmacies".

She noted that per head of a population, Northern Ireland has the highest number of pharmacies in the UK, with "over 99% of the population living within five miles of a pharmacy".

Prof Harrison said that funding for pharmacies in Northern Ireland is "46% higher than in England, 22% higher than in Scotland and 3% lower than in Wales".

She said that the department regularly engages with and works collaboratively with CPNI.

However, she said that in efforts to reform the sector there are "real challenges with single-year budgets… and also in terms of prioritising some of our work within a wider health system that you know is under stress finically".

CPNI said a rise in the National Insurance rate for employers, along with wage increases, will add to the current funding deficit.

Turlough Hamill, who is a community pharmacist in Portadown, County Armagh, said "community pharmacies are at a breaking point and the financial pressures passed an unsustainable level long ago".

"It is no exaggeration to say that without prompt intervention, the very future of community pharmacy services is at risk, leaving patients without essential access to medicines and advice," he added.

"Many contractors have had to subsidise costs with personal savings or defer payments, resulting in medicines being withheld, as well as take out loans at high interest rates."

Mr Hamill said there had been "17 pharmacy closures in the two-year period to December 2024 compared to nine in the previous eight years".

"Of course, we acknowledge the funding challenges within the health service, but it is important that we bring a sense of reality here today to the situation facing community pharmacy in Northern Ireland and by extension, primary care and the wider health service," he said.

"We are calling on the Department of Health to address and resolve the fundamental funding model once and for all."

Last month, a firm with more than 20 pharmacies across Northern Ireland said it may have to make redundancies or close stores if it does not get financial help to cover rises in National Insurance contributions and the National Living Wage.

At the time, the Department of Health said it "recognised these increased costs" but that it faced a "significant funding gap" over the next year.

CPNI said in a recent survey of community pharmacy contractors, "43% of respondents had been unable to pay their medicine bills on time over recent months".

The survey also suggested "that in the past six months, a concerning 81% have said that they would not recommend the profession to others".

The committee heard extracts of written statements from community pharmacy owners in Northern Ireland as part of this survey.

One respondent said they had recommended pharmacy as a career path to their children "based on the Department of Health's promise to improve the clinical focus of the role and provide fair and reasonable funding".

"My two pharmacist children and now in their mid to late 20s and are disillusioned with the profession as we struggle to keep the light's on.

"Looking back I would have recommended a career with greater job satisfaction and with a work life balance," they said.

Another pharmacy owner wrote in the survey that they were relying on their husband's wage to make ends meet.

Richard Grahame, who owns several pharmacies in Scotland and one in Lisburn said that the Scottish system of operating pharmacies should be the model for the whole of the UK.

He said that operating a pharmacy in Northern Ireland felt like working with "one hand tied behind my back", both in terms of funding and the services that pharmacies are able to provide.

One issue that he highlighted was the system of so-called clawbacks, whereby the NHS reimburses pharmacies for distributing medicines at a discounted rate, based on the assumption that pharmacies will be able to bulk buy medicines at a lower cost.

Mr Grahame highlighted that under the Scottish system these clawbacks are much lower, and added that his Scottish business is keeping the pharmacy in Lisburn "afloat".

Gerard Green, the chief executive of CPNI said that many pharmacies in Northern Ireland are contemplating reducing opening hours, service provision, and staffing levels, and ultimately closing, at a time when they have "never been busier".

He said that 17 local pharmacies had closed in the two years to December 2024, with a further closure at end of February.

Mr Green said that a "recurrent underlying £20m shortfall" in funding for pharmacies was "simply not sustainable for our sector".

He said that where pharmacies aren't able to cope, more pressure will fall of GPs and emergency departments.

Mr Green said community pharmacy owners "are in survival mode most of the time" and many are "distraught" looking at the future.