Preserving Vital Care Fostering Resilience in Independent Pharmacies
At the start of November, Sigma Pharmaceuticals hosted the 2023 UK community pharmacy conference in London, where delegates addressed the UK government’s May 9 pledge to invest £645 million in pharmacy services over the next two years. In a letter to the sector presented during the conference, Prime Minister Rishi Sunak expressed gratitude and support for the hard work of pharmacy teams, underscoring the important role pharmacies play in maintaining the care of local communities throughout the United Kingdom.
“It’s a very complicated process”, notes Asif, a pharmacist at Earls Court Chemist, describing the procedure for registering independent pharmacies with the NHS. Located just outside of Earls Court Station, through family generations, Asif qualified in 1982 and his family pharmacy has been caring for the vibrant surrounding community in the London borough since 1987, providing services such as private and NHS dispensing, delivery, and vaccinations seven days a week. “All you once had to do was promise the government you were open for 100 hours trading per week”, he reports, adding that the supermarkets pioneered this contract model 10 years ago. This appealed to the government, as supermarkets could stay open later, enabling more people to benefit from pharmacy services. “We had the 100-hour contracts, which were quite easy to apply for. Then, once the government realized there were hundreds of independents with contracts to finance, they decided to shut us down, so to speak,” Asif explains the vast majority of applications for a pharmacy licence are refused which creates a very high barrier to entry. The result is an environment where pharmacies are seldom allowed to fail, given the substantial list of potential buyers waiting to acquire a pharmacy and capitalize on the associated licence.
It helps us enormously, you know, where the banks can’t fill the hole – it works for us almost like a bridge
– Asif Qureshi.
Independents drive positive impact with a business model focused on patient-facing healthcare. Currently, the UK pharmacy market includes over 14,000 registered pharmacies, including 3,500 that are independently operated. Out of the 11,000 pharmacies in England alone, 80% of their transactions involve the NHS, enabling higher regard for payment terms and counterparty risk. Where chain pharmacies are exclusively dependent on the retail model of corporations to remain sustainable, independents focus strategically on providing an array of customer services to sustain and differentiate their businesses. “What creates the underlying value of the goodwill in pharmacy is this intangible asset’’, shares AGC’s partner whose relationship began with AGC in 2020. ‘’Where I am is semi-rural, so the nearest independent is probably a mile away but for out-of-town rural areas, there might not be a pharmacy for miles, he adds. He emphasizes that the revenue of pharmacies in such areas relies heavily on the services they offer, as they contend with limited footfall compared to their counterparts in retail settings. Asif has been able to sustain his local pharmacy and avoid the funding strains on the NHS thanks to the facility arrangement. “It helps us enormously, you know, where the banks can’t fill the hole – it works for us almost like a bridge”, Asif remarks of the funding support.
As for the prescription pricing model, it involves a government deduction of 10% — making the pharmacy’s financial dynamics tied to their relationship with wholesalers. Reliance on the prescriber means the pharmacy receives payment from the NHS within a 50-day window. “We are reliant on the prescriber”, Asif explains. “Let’s say everything has been purchased in April. It has to be paid at the end of May, but we will not get the final payment until the end of June. So, the government is behind.” Additionally, during the pharmacy’s latest venture, the establishment of a new site, they navigated their funding application to a traditional bank in the fall of 2022. The approval process, however, unfolded over the course of eight months. “To be honest, I no longer have interest now, so [instead] we used AGC’s facility to ensure everything went ahead as we wanted it to”, Asif shares. As a family-run business with a team of two dispensers and a pharmacist, hands-on involvement extends to managing both their primary establishment and a newly acquired site. As NHS data signals the challenges arising from a lack of funding, significant strain continues to loom over pharmacies, ultimately contributing to closures and leaving a lack of faith in the promise of committed funding to become more apparent. “The model is dependent on four things”, Asif elaborates on the £645 million announcement. “But we don’t know what the four things are. We have yet to see the ink dry. For us, the future is in services. Otherwise, if we’re dependent on the NHS, there might not be enough margin”, he adds.
AGC seeks to address the pervasive challenge faced by SMEs globally in obtaining adequate financing to facilitate their business growth. However, it is crucial to recognize that this struggle is not exclusive to developing markets. We’ve acknowledged the universal nature of these challenges and are committed to addressing them inclusively. By funding businesses such as independent pharmacies in the UK, they can continue to play a vital role in serving the communities around them and remain resilient and adaptable in navigating the nuances of the healthcare industry.
[1] Community Pharmacy England. Government pledges £645m investment in community pharmacy. Accessed Nov. 20, 2023.https://cpe.org.uk/our-news/government-pledges-645m-investment-in-community-pharmacy/
[2] Christie & Co. Christie & Co analyses UK pharmacy market in latest in-depth. Accessed Nov. 20, 2023. https://www.christie.com/news-resources/press-releases/report-launch-pharmacy-market-review-2022/
[3] Oak North Why independent pharmacies are gaining momentum again. Accessed Nov. 20, 2023. https://oaknorth.co.uk/blog/independent-pharmacies-gaining-momentum/
[4] Hansard UK Parliament. Community Pharmacies, Volume 737: debated on Thursday 14 September 2023. Accessed on Nov. 20, 2023. https://hansard.parliament.uk/commons/2023-09-14/debates/22A994CC-6D07-4C71-9A96-7FEE53F2CCEF/CommunityPharmacies#:~:text=Government%20figures%20show%20a%20decrease,recruiting%20and%20retaining%20community%20pharmacists
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