Availability of community pharmacies declining in deprived areas
People living in more deprived areas with worse health outcomes were 65% more likely to lose their local pharmacy than those in wealthier areas, according to published today.
New analysis from Health Equity North, Newcastle University, and the University of 野狼社区 has shown that availability of community pharmacy services in England has reduced, particularly in deprived areas.
Researchers investigated how access to community pharmacies changed from 2014 to 2023, examining relationships between pharmacy availability and factors such as how urban the area is, and socioeconomic deprivation.
In England, more than 90% of people live within a 20-minute walk of a community pharmacy. However, overall availability of pharmacies has decreased with the number dropping from 1.6 pharmacies per 10,000 people to 1.5. The most deprived areas were 65% more likely to lose a pharmacy compared to the least deprived areas.
Pharmacies are an important part of the healthcare system and are well placed to reach those most in need. They deliver a range of public health and clinical services, such as smoking cessation advice and support, emergency hormonal contraception, hypertension screening and 鈥榝lu鈥� vaccination programmes.
Recent funding cuts and closures of community pharmacies prompted health inequalities researchers to explore whether the 鈥榩ositive pharmacy care law鈥� 鈥� which means people in more deprived areas have better access to pharmacies - is still in operation, and the implications of this on commissioning of future services.
It found that the positive pharmacy care law remains in place but has eroded over time. Pharmacy availability is decreasing, especially in poorer areas, meaning more people must rely on each remaining pharmacy.
The research team says that due to the nature to the NHS Community Pharmacy Contractual Framework in England and the tiered levels of services, 鈥渢here is potential that there will be less capacity to provide the additional enhanced clinical services for community pharmacies located in the most deprived areas鈥�.
The implications of inaction could see less capacity to provide much need services to those most in need and further widening of existing health inequalities
The study showed:
- In 2014, the most deprived areas had 2.28 pharmacies per 10,000 people compared to 1.37 per 10,000 people in the least deprived areas; by 2023, this dropped to 2.01 and 1.33 per 10,000 people, respectively.
- The decline in pharmacy availability per 10,000 people was most severe in the most deprived areas (-0.27 per 10,000 people or an 11.8% reduction between 2014 and 2023)
- Urban areas experienced a significant decline in pharmacy availability - an 8.2% reduction (from 1.81 to 1.66 pharmacies per 10,000 people) between 2014 and 2023.
The academics behind the analysis say reinvestment in the community pharmacy network will help address challenges within the sector and reduce inequalities in access to health care.
Lead author Eman Zied Abozied, Research Associate at Newcastle University, said: 鈥淧harmacies are one of the only healthcare options available on the high street where people can be seen without an appointment. They play an important role in helping people access the care they need, especially in the most disadvantaged areas where there might be fewer GPs. Funding cuts across the sector have seen many community pharmacies close, which could fuel inequalities in healthcare access.
鈥淲hile it is encouraging that our analysis shows that most people still live close to a pharmacy, the reduction in the number of community pharmacies is a cause for concern. Pharmacies are serving a higher number of people, with the biggest decline in availability in communities that have the greatest health needs, leading to immense pressure on services and staff. Pharmacies in the most disadvantaged areas may not be able to offer the full range of clinical services due to funding cuts and staffing pressures.
鈥淚f community pharmacies are required to deliver more clinical services to support other primary care organisations, it is important that they have the appropriate funding to be able to achieve this.鈥�
Dr Luke Munford, Health Equity North Academic Co-Director and Senior Lecturer in Health Economics at The University of 野狼社区, said: 鈥淭here needs to be more investment in community pharmacies if they are to effectively deliver the vital public health services they provide to people across England. Our study shows that more pressure is being placed on pharmacies with this being felt more keenly in deprived communities where health outcomes tend to be worse.
鈥淭he implications of inaction could see less capacity to provide much need services to those most in need and further widening of existing health inequalities.鈥�
The study has been published in BMJ Open. Read the full paper - "The Positive Pharmacy Care Law Revisited: an area-level analysis of the relationship between community pharmacy distribution, urbanity and deprivation in England"