Pharmacies in England are facing significant financial difficulties, with three-quarters currently operating at a loss, according to a report by Community Pharmacy England (CPE). This economic strain, exacerbated by widespread medicine shortages, is forcing pharmacies to consider cutting services previously offered for free, such as home deliveries and the sorting of medications into daily pill organizers.
The CPE survey of over 2,900 pharmacies and 900 staff members revealed that only 14 percent of pharmacies are profitable. This financial pressure comes at a time when the number of pharmacies in England is at a 20-year low, following numerous closures. Many pharmacy workers, 72 percent according to the survey, report that patients are affected daily by medicine shortages, with 88 percent stating that patients often need to visit multiple pharmacies to obtain their prescriptions.
Sourcing medications has become a daily challenge, with pharmacies spending more time on the phone with wholesalers. Nearly nine in ten pharmacies (86 percent) reported spending longer procuring medicines than in the previous year, diverting attention from direct patient care. Consequently, 73 percent of pharmacies are experiencing longer wait times for patient advice, and 83 percent are struggling to respond promptly to patient inquiries via phone and email.
CPE has characterized the current system as "not fit for purpose" and is calling for "urgent, large-scale reform" to safeguard both patients and pharmacies. Community pharmacies have been under financial strain since funding cuts were introduced in 2015. While a recent funding increase was agreed upon by the Department of Health and Social Care, the sector estimates a significant funding gap of £2 billion between its current receipts and its needs.
Nearly all pharmacies (99.7 percent) are experiencing higher costs than last year, and 99 percent report that NHS reimbursement does not cover the cost of medicines. In response to these financial pressures, 25 percent of pharmacy owners or directors have not taken a salary in the past year, and 15 percent have used personal savings to keep their businesses afloat. To manage expenses, 18 percent of pharmacies are making staff redundant, and 21 percent anticipate reducing their opening hours. Furthermore, 29 percent of pharmacies may need to start charging for services that were previously free.
CPE stated that some patients are experiencing delays of several days to receive necessary medications, with some individuals requiring psychiatric drugs going without. The frustration has, in some instances, led to threatening behavior directed at pharmacy staff.
Janet Morrison, chief executive of Community Pharmacy England, highlighted the unsustainable nature of the current situation. "These stark results show us once again that pharmacies are not sustainable, and that the pressures on them are directly affecting patient access to medicines and care," Morrison said. "It is very troubling that pharmacies are having to reduce opening hours and introduce new charges for things that have previously been free to patients – and this goes directly against Government's ambitions to shift more healthcare, closer to home."
Morrison added that without additional investment, pharmacy closures will persist, leading to concerning consequences for patients and the public, particularly impacting access to medicines and advice. She warned that closures often occur in areas with the greatest need for healthcare support, which would worsen health inequalities. The closure of pharmacies would also strain local healthcare networks, increasing pressure on general practitioners and hospitals, and negatively affect local high streets and employment.
A spokesperson for the Department of Health and Social Care acknowledged the vital role of community pharmacies as "a vital front door to the NHS." The department stated that the government has provided the largest funding increase to community pharmacies for the third consecutive year. "We recognise that community pharmacies continue to face pressures and we are committed to working in partnership with the sector to deliver the long-term reform it needs," the spokesperson said. The department also highlighted the planned rollout of independent prescribing for pharmacies in autumn 2026, aiming to expand their clinical role and ensure a more sustainable future within the neighborhood health service.