BIG INTERVIEW
Paul Rees
8 DECEMBER 2024
Paul Rees has urged the
government to be transparent
with the sector on negotiations
for a new pharmacy contract,
Sarwar Alam reports...
t was an unprecedented move, to call for
the first ballot in the 103-year history of the
National Pharmacy Association (NPA), and
now, outgoing chief executive officer Paul Rees,
has warned that its more than just a scare tactic
and pharmacies will go through with action
January if there isn’t an acceptable resolution
forthcoming from the government.
“We’re looking for the government to
consider our ballot, digest the results, and then
come up with a proper proposal for community
pharmacy - a fair deal,” Rees told Pharmacy
Business a few days before it was announced he
would become the Interim Chief Executive and
Registrar of the Nursing and Midwifery Council
from January 20th.
“If that’s not forthcoming, we’ve got a board
meeting in a couple of weeks, we then need to
decide when to take action, but we would be
looking at taking action in January.”
The NPA announced the results of the
collective action ballot on November 14th
in which nearly all pharmacy owners, who
participated in the ballot, voted to limit their
services, insisting that a lack of additional
funding is jeopardising patient health and safety.
“Our members have voted, they’ve spoken
clearly, and unless the government come up with
a fair deal soon, we will regrettably have to move
to the next step, which is calling for action,” said
Rees.
The NPA estimates about 700 pharmacies
have shut in England in the last two years, with
more than 1,250 closing in the last decade and
three quarters struggling with debt.
“The global sum for community pharmacy 10
years ago was £2.6 billion. Today, that sum is still
£2.6 billion,” said
“There’s been inflation. There have been
utility bill increases, there have been national
living wage increases. Community pharmacies
had no increase (in-line with inflation) from the
NHS or the government.”
Rees added that in real terms, what this means
is that funding has fallen by 40 per cent after
adjusting for inflation since 2015/16.
“Community pharmacies are actually
delivering more services. Pharmacy First is a
good example of that. They’re dispensing more
medicines because the average person is taking
more medication, so they’re doing more and
more work for less and less money.
“They reach a tipping point when they can’t
keep delivering services that are safe for patients.
They feel they’ve reached the point when they
need to start reducing services in order to ensure
that they can still honour patient safety.”
Rees revealed the strength of turnout by
community pharmacies for the ballot exceeded
what he had expected and showed the level of
desperation that pharmacy owners are feeling at
the moment.
Over 63 per cent of NPA members in
England, Wales and Northern Ireland took part
in the ballot– representing 3,049 independent
community pharmacies in England alone, or
3,399 with Wales and Northern Ireland included.
Nearly 98 per cent of pharmacy owners in
England voted to reduce their opening hours to
the minimum required by their contract. This
could result in fewer pharmacies remaining open
during evenings and weekends.
More than 93 per cent voted to stop offering
“unfunded” free home deliveries of medicines,
and over 96 per cent voted to withdraw from
locally commissioned services, including certain
addiction support, emergency contraception, and
stop smoking services.
Almost all voted to refuse cooperation with
data requests from other healthcare providers
beyond what is necessary for patient safety and
contractual requirements.
The majority of pharmacy owners also voted
to stop supplying free monitored dose systems
(medicine packs) that are not funded by the
NHS, except those covered by the Disability
Discrimination Act.
“The extent to which pharmacy owners are
prepared to reduce services did surprise me in
one respect, but having said that, the level of
anger and desperation is clear when you go and
speak to them,” said Rees.
“There’s a state of emergency, there’s a
crisis within community pharmacy. There are
pharmacists taking out loans, second mortgages,
borrowing money from relatives, taking money
out of pension pots because every month they are
dispensing medicines and they’re not being fully
reimbursed by the NHS.
“They’re doing work on behalf of the state
and they’re not being paid for it, so the money’s
going to come from somewhere.
“The reason there haven’t been more closures
is that so many pharmacy owners are dedicated to
their communities that they carry on working.”
He added that the timing of the Budget
further exasperated the difficult situations the
many community pharmacies find themselves
in.
From April 2025, the national living wage
New Year action on the cards, says N