Impact of 800 Pharmacy Closures in England: A ‘Life-Ruining’ Consequence

Recent data from the NHS indicates that close to 800 pharmacies in England have permanently ceased operations over the past four years. Pharmacists attribute these closures to NHS funding levels, which they contend have not increased in real terms for ten years. The government has stated its intention to address this matter “in due course,” yet individuals residing in rural regions or areas with a higher proportion of elderly residents frequently experience the most significant impact. Deborah, a 63-year-old resident of Gloucestershire, stated, “It can ruin your life.” She suffers from a gastro-intestinal condition that necessitates consistent medication to control her symptoms. Although a local pharmacy is accessible to her, Deborah explained that it frequently fails to stock all her required medicines, compelling her to journey to a more distant location. The reduced number of available pharmacies exacerbates this challenge. She elaborated, “Within 24 to 48 hours [of not having medication], I will not be able to leave my house.” This situation “affects what I can eat, so it has a huge impact on mobility, which then stretches out to the rest of my life. I can’t see people. I can’t go places. I have to cancel appointments.” Deborah also noted that “every time” she has requested medication over the past six months to a year, “there has been a problem.” She described the experience as “quite a long process of phone calls and waiting and journeys and travel.” Deborah added, “I’m on a very low income and having to do extra trips to get my medication in the car that I can only just afford to run, really impacts my life hugely.” The anxiety and unpredictability associated with pursuing her medication have also detrimentally affected her mental well-being. She reiterated, “It can ruin your life, your ability to function, your ability to interact with the outside world.” Deborah expressed her desire to share information about actions individuals can take if their local pharmacy is unable to provide all necessary medication. She advised, “You can request a paper prescription and that can be taken physically to any number of pharmacies until you find one that actually has the the things you need.” Jeff Coy, 64, a business owner in Amesbury, Wiltshire, stated that the strain on the area’s remaining pharmacies compelled him to switch to an online pharmacy several years ago. He remarked, “I’ve no disrespect to the staff [at the pharmacies] because I think they do a fantastic job. But they’ve got a small location that can’t cope with the demand.” Coy also noted the presence of “constant queues” and voiced concern that during winter, some individuals might be reluctant to wait outdoors in cold conditions. Statistics from the NHS reveal that 752 pharmacies closed in England between January 2021 and the conclusion of November 2024, representing a 6.7% decrease. The current total of pharmacy branches in England, encompassing distance sellers, stands at 10,454, a reduction from 11,206 recorded at the beginning of 2021. Across England, 58 pharmacies closed in 2021, followed by 81 in 2022, 394 in 2023, and 219 this year. These figures were released by the NHS Business Services Authority, though various NHS divisions report differing closure statistics. Concurrently, Healthwatch, a patient advocacy organization, identified 436 pharmacy closures in 2023 alone. Their findings indicated elevated rates of both temporary and permanent closures in predominantly rural areas and those with older demographics. Healthwatch’s data specifies that five branches closed in Gloucestershire in 2023, four in Bath and North East Somerset and Wiltshire, and an additional four in Somerset. In contrast, 74 closures occurred in Cheshire, Greater Manchester, and Merseyside. However, the National Pharmacy Association has contended that rural areas face the prospect of becoming ‘pharmacy deserts’ if the present pace of closures persists. Since 2023, LloydsPharmacy and Boots, the two largest high street chemists, have shut down hundreds of outlets nationwide, contributing to the sharp increase in 2023’s closure figures. Lloyds initiated liquidation proceedings earlier this year, divesting all 1,054 of its branches. In numerous instances, independent pharmacies have assumed operations. Haseeb Malik operates the Forest Pharmacy in Lydney, Gloucestershire, which was previously a LloydsPharmacy branch. He stated, “The main challenges pharmacies are facing are funding cuts as well as staff shortages and just general difficulties in getting medication.” Malik explained that “For most pharmacies, 90% of their pay comes from the NHS and for that reason, if that has not been changed, and it hasn’t for the last 10 years, that is quite an issue.” Insufficient funding can subsequently hinder pharmacists’ ability to maintain adequate medicine stock, particularly when prices increase. Nevertheless, in certain locations, challenges extend beyond pharmacy closures, also stemming from evolving demographics and the resulting strain on existing branches. Advocates in Amesbury, Wiltshire, reported that the town’s two current pharmacies are no longer capable of serving its expanding population. Dr. Monica Devendran, who represents Amesbury West on Wiltshire Council and serves as the town’s deputy mayor, commented, “I hear feedback and representations from residents on a day-to-day basis about the difficulties they face, and the current pharmacies are too small for them.” She noted that “Amesbury has grown in size. Large developments have come up in King’s Gate and Archer’s Gate. New houses have been built.” Dr. Devendran added that “Residents complain about the waiting period, waits in queues for prolonged periods of time, and some of them have told me about a lack of medication available.” Earlier this year, the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board rejected a proposal for a new pharmacy, a decision that has since been appealed. The Board stated it plans to re-evaluate the town’s pharmaceutical requirements in the new year “to ensure the next assessment accurately reflects the needs of people living and working in Amesbury.” The National Pharmacy Association (NPA), representing independent community pharmacies, reported a 40% real-terms reduction in community pharmacy budgets over the past decade. Last month, NPA members historically voted for collective action, pressing the government for an ‘urgent uplift’ in pharmacy funding. Members also endorsed a proposal to reduce opening hours, asserting that pharmacy owners “cannot guarantee community pharmacy services will remain safe into the future if the current depressed funding, pharmacy closures and increasing workload continues.” A spokesperson for the Department of Health and Social Care commented: “Community pharmacy been neglected for years, but it has a vital role to play in the shift of care from hospital to community as we reform the health service through our 10 Year Health Plan.” They added, “At the Budget, we announced a £26bn boost for the NHS and social care. We are committed to working with the pharmacy sector and we will set out further details on allocation of funding for next year in due course.” Miguel Roca-Terry and Jonathan Fagg contributed additional reporting to this article.