The Pharmaceutical Journal
Vol 269 No 7209 p147
3 August 2002

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Trent Institute for Health Services Research (www.trentinstitute.org.uk)

Independent pharmacies are "unlikely to survive" Trent researchers claim

Independent community pharmacies face a bleak future in which they are unlikely to survive, according to a report published by the Trent Institute for Health Services Research.

The report, entitled "Small pharmacies and the National Health Service", is based on interviews carried out with 20 independent pharmacy owners in 1997, with conclusions updated to take account of subsequent developments. The interviews were carried out as a pilot for a full-scale investigation of the social and economic position of independent community pharmacists, work that was then not subsequently carried out.

Professor Robert Dingwall and Pamela Watson, MRPharmS, describe their interviews as being "stories of survival". The pharmacists were "almost overwhelmed by the long hours, the low economic rewards and the general struggle for existence in serving poor and marginal communities", they say. In general, they found that being an independent pharmacy owner was "not a goal so much as something you do when other segments lose their attractions". Independents valued their professional autonomy but were paying a high price for it in terms of long hours, heavy paperwork and disruptions to family life.

The authors describe the pharmacy plan for England (PJ, 16 September 2000, p397), as far as independent pharmacies are concerned, as being inconsistent and incoherent. Most of the developments presaged in it would be of more benefit to the larger pharmacy chains because of economies of scale.

The authors say: "Compare the overheads of a dispensing mill [located] in an industrial park (with a low ratio of pharmacists to dispensing assistants and no walk-in facilities) and of a retail outlet (which has to provide private consultation space, a high ratio of pharmacists to assistants, accessible premises and the like). Relaxation of entry controls will further increase the pressure on small providers from larger predators, who can sustain the costs of competition in a way that others cannot. A large chain can absorb the low margins and predatory pricing needed to break into a market across its whole business in a way that is not open to a small chain or solo provider."

They say that the Government has been 20 years too late in trying to bring pharmacy within the NHS in the same way as general practice.

John D'Arcy, chief executive of the National Pharmaceutical Association, told The Journal that the researchers' conclusions echoed what the association had been telling the Government for years.

"It is difficult to get information on businesses that are close to the financial edge, because people are unwilling to admit to failure, but many economic indicators point to the conclusion that the number of pharmacies in the 'at risk' category, whichever way it is defined, must be increasing," he said.

Dr Hooman Ghalamkari, MRPharmS, owner of DG Pharmacy, Worcester, told The Journal that the financial and time pressures facing independent community pharmacist were the reality of running any small business.

"Economically, things are going against us, but I still see opportunities — both financially and in terms of creating new roles — for pharmacists who are proactive and who get closely involved with their local communities."

Small pharmacies and the NHS, Trent Institute for Health Services Research, Regent Court, 30 Regent Street, Sheffield S1 4DA (tel 0114 222 0703), price £15.