The decisions of some large businesses are making pharmacists furious

Philip Ross and Liz Hind, Labour Business: At the heart of our communities is the local pharmacy. What makes these community pharmacies work is the commitment of their staff, which includes thousands of self-employed (locum) members. These workers now have a voice through the Pharmacists’ Defence Association, a trade union with 32,000 members. In this piece, the latest in our new series, we have invited director Paul Day to talk about the PDA campaign to defend community pharmacy and its services.

Community pharmacy is the most accessible part of the NHS, providing access to a qualified health professional without an appointment, even if individuals are not registered with a GP. Typically, over one million people every week visit a pharmacy and 99% of those living in areas of highest deprivation are within a 20-minute walk of a community pharmacy.

As many areas of life were significantly impacted by the global pandemic, across the world it was pharmacies that remained open, even in the strictest lockdown. Yet while the virus could not stop pharmacists caring for patients, the economic decisions of some large businesses are increasingly preventing NHS care from happening, and pharmacists are furious.

Community pharmacy’s relationship with the NHS is like that of GP practices: both provide NHS services and display the NHS logo, but neither are owned by the taxpayer and can earn other income aside from their NHS contract. However, unlike GPs, most of community pharmacy is consolidated into larger businesses with some of the largest being the biggest UK high street brands and divisions of multinational, vertically integrated (combining wholesale and retail) pharmacy corporations.

Recently, pharmacists were returned to the occupational shortage list, yet somehow the typical rate of pay defies the laws of economics and is not noticeably increasing, even though demand apparently outstrips supply. Instead, the representatives of employers seem to be trying everything but improve the conditions and pay that they offer. This not only impacts on salaries for employed pharmacists, but the rates paid to the thousands of locums, which form a significant part of the pharmacist workforce – and, though better paid than many gig-economy workers, they are part of the gig economy nevertheless.

In a recent report on the community pharmacy sector workforce, the three major employer bodies identified that the “potential workforce crisis that is driven by difficulties in both recruiting and retaining colleagues” is due in part to concerns about “pay, excessive workload and pressure, inflexible working hours, and a lack of opportunities for career progression”.

Disappointingly, the report concluded with a list of actions for others to take, but not a single commitment about what the employers themselves would do to improve the situation around factors for which they are wholly responsible. This apparent attitude went even further when the employers’ representative body “Community Pharmacy Scotland” suggested that the NHS should be blocked from recruiting pharmacists into primary care roles in order to prevent pharmacists leaving community pharmacy.

The PDA Union represents employed and locum pharmacists in all parts of the UK health sector and is currently campaigning extensively against a further trend of employer behaviours, one of which has direct impact on patients and communities. It is a regulatory requirement that a pharmacist is on the premises for a pharmacy to open, however the Union is seeing an alarming trend where some operators decide to temporary close the doors for all or part of a day, rather than pay the rate of a locum pharmacist to oversee the operation of that pharmacy, and the supply of medicines that can do so much good, but also so much harm if an error occurs.

Closing the pharmacy is typically a breach of the agreement with the NHS, however it appears to cause no penalty to the business for failing to deliver their obligations to the taxpayer or the patients which depend on the services provided. The Union’s campaign is also identifying instances where businesses have failed to advise the NHS of their decision to close (a further contractual breach of the agreement with the NHS).

Locum members of the PDA have told of their offers to cover shifts to avoid closures, but the businesses often opt to close rather than pay the rate. For self-employed professionals already absorbing the impact of IR35, and having spent the last year as part of the frontline response to the pandemic, this is an unwelcome development. 

The union campaign has found that closures occur almost exclusively in branches of the largest multiple pharmacy chains, those represented by the Company Chemists’ Association. In contrast, in many areas there seem to be no instances of independent pharmacies experiencing high levels of closures. These are, in the main, owned and operated by a pharmacist rather than a retail corporation. 

The evidence raises significant questions about the so-called occupational shortage because it suggests that, in community pharmacy at least, there is a shortage of pharmacists prepared to accept the low pay and poor working conditions offered by some larger employers, but not a shortage overall.

The PDA’s campaign continues, but for Labour as opposition, or administration in the British parliaments that govern the health system, this is an opportunity to show that they will act for the interests of hard-working, self-employed health professionals, patients and communities – not just corporate shareholders.