10.1. Introduction

The Office for Fair Trading (OFT) has recommended the deregulation of the NHS Community Pharmacy Service. Currently pharmacists can only dispense NHS prescriptions if the Health Service is satisfied that this is ‘necessary or desirable’ for the adequate provision of pharmaceutical services in the local community. The OFT is proposing that any registered pharmacy with qualified staff should be able to dispense NHS prescriptions. This would allow supermarkets, for example, to introduce more pharmacies. The OFT expects deregulation to broaden consumer choice and convenience, provide additional customer services, widen access to over-the-counter medicines and save business and the NHS around £26m in compliance and administration costs.

However, public health, pharmaceutical and rural groups have all raised concerns that deregulation will have seriously detrimental effects particularly in rural, isolated or deprived areas. Vulnerable groups with the greatest health needs, older people, families with young children, those living in inner cities or rural areas are all less likely to have access to a car and therefore are more reliant on local pharmacies. These smaller local pharmacies may find the competition introduced by deregulation impossible to resist. This is important as current PCT utilisation of community pharmacies is mixed and closure of large numbers of small pharmacies could make it worse. The Secretary of State for Health has stated that community pharmacies are a greatly under-utilised public health resource and the UKPHA is negotiating with Government departments about maximising this potential. Recent reviews of the evidence of the contribution of community pharmacies to public health have revealed the potential importance of such a service in coronary heart disease and cancer prevention, health protection and other key public health targets such as reducing teenage pregnancies. There is also some anecdotal concern that supermarket-based pharmacies may be less likely to remain committed to services such as the supply of emergency hormonal contraception to 16 year olds, public health services to ‘challenging’ groups such as drug addicts or services with a low commercial value (home delivery for example).

A Vision for Pharmacy in the new NHS (DoH 2003) is committed to developing a coherent framework for a pharmacy public health strategy. This recognises the value of having pharmacists well placed in the community to provide convenient access to prescriptions and other services.

Figures 10.1 and 10.2 show areas of the West Midlands within a 10-minute walk (conventionally regarded as a ‘reasonable’ walk) of a pharmacy (data from the Prescription Pricing Authority). 71% of people in the region live more than 10 minutes walk of a community pharmacy. This varies from 65% in the Birmingham and Black Country Strategic Health Authority, 75% in Warwickshire and 77% in Shropshire and Staffordshire. Closures of pharmacies will inevitably lead to fewer people living in close proximity to this important service.

	Figure 10.1. Areas of the West Midlands within a 10-minute walk of a Pharmacy
	Figure 10.2 Areas of the West Midlands within a 10 minute walk of a pharmacy (Higher Resolution)

References

http://www.nfucountryside.org.uk/news/shownews.asp?newsid=633

Royal Pharmaceutical Society of Great Britain (1996). Baseline mapping study to define access and usage of community pharmacy.

Joint statement in response to the proposals set out in The office of fair trading (oft) report ‘The control of entry regulations and retail pharmacy services in the UK’ (2003)

http://www.ukpha.org.uk/cgibin/admin/uploads/documents/PharmacyHealthLink.doc

Department of Health. A Vision for Pharmacy in the New NHS. 2003. Department of Health, London.

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