Pharmacists’ Defence Association (PDA) – Written evidence (HSC0013)

About the Pharmacists’ Defence Association

The Pharmacists’ Defence Association (PDA) welcomes the opportunity to provide written evidence to the Built Environment Committee Inquiry concerning high streets in towns and small cities.

As the largest representative organisation of individual pharmacists in the UK, the PDA represents over 38,000 members, working across all areas of practice.  Our experience of dealing with over 5,000 cases each year on professional, regulatory and employment matters provide a unique insight into the issues that matter to pharmacists and where opportunities and risks arise.

A significant number of member pharmacists work in community pharmacies that are located within high street locations.

We are happy to provide any further information to the Committee upon request.

1. Background

2. There are approximately 14,000 community pharmacies in the UK and they are often located at the heart of many villages and small towns and many also form part of the high streets in towns and larger high streets in small cities throughout the UK.

3. Analysis by the Association of Convenience Stores has repeatedly found that the top three services that have the most positive impact locally are Post Offices, pharmacies and convenience stores.[1] The desirability of access to a pharmacy would apply equally for shoppers in High Street locations and especially for those who work in and close to town or city centres.

4. Of the approximately 14,000 registered pharmacies in the UK around 11,000 are in England. Data from Community Pharmacy England shows that approximately 1.6 million people visit a pharmacy in England every day. [2] This equates to approximately 150 people each day visiting a community pharmacy. Around four in five people live within a 20-minute walk of a pharmacy.

5. The financial viability of many pharmacies, across all settings, is under threat. and in England there have not only been closures but also significant reduction in the hours of operation for many pharmacies.[3]

6. Pharmacies in all communities have a dual role, the first is that they provide access to a fully qualified registered pharmacist not only for the supply of medicines but also for advice. This widening pharmacist role in providing health services beyond just dispensing is especially important in providing access to healthcare for those who work in town or city centres. One recent example is the introduction of the Pharmacy First service, which aims to free up around 10 million GP appointments per year.[4]

7. The second role of these pharmacies is that people will visit them for advice or to collect prescriptions or buy medicines and this generates footfall which in turn helps sustain other service providers and retailers to ensure the continued vibrancy of these high street locations.

8. The UK Health Security Agency recognised the importance of high street pharmacies:

“With their presence in most high streets, many rural communities, and in the places where we shop, access healthcare and enjoy our leisure time, community pharmacies are a local health and social asset interwoven with our daily lives in a way that few other professions can claim.” [5]

9. A vibrant high street plays an important role in in providing this accessible healthcare for local populations. Community pharmacies are a vital part of the UK healthcare infrastructure and are a vital part of UK high streets.

10. It is in that context that we are responding to the questions set out in the inquiry terms of reference; our key points are also summarised below.

Response to the inquiry questions

Question 1 How do you define a high street in a town or small city and what is its purpose?

11. The High Street could be defined as the core of the town or small city where the local populations can find a variety of essential services including retail outlets, supermarkets, pubs, restaurants, gyms, healthcare providers and offices. High streets are not just a place to shop.

12. Most high streets will also have a pharmacy, an optician premises and many may also have a dental practice and a GP surgery. The importance of these health care providers in generating footfall and in ensuring the vibrancy of the high street must not be underestimated.

Question 2 What should be included on high streets to meet the needs of the whole community? 

13. In August 2020, leaders from the NHS, local government, community businesses and a range of invited experts attended a high-level roundtable event to discuss how reimagine healthcare being provided in the high street.[6]

14. To give this context, the discussion took place during the height of the Covid pandemic. Part of the thinking for this healthcare in the high street approach may have been driven by an increased understanding of the services that community pharmacies were providing during this national emergency.[7]

15. Community pharmacies kept their doors open to the public during the pandemic when every other healthcare facility worked behind closed doors and with significant restrictions in access. English pharmacies also delivered around 31 million doses of Covid-19 vaccines during 2021-2022 (in comparison GPs within English Primary Care Networks - PCNs – delivered around 71 million doses in the same period).

16. This clearly shows that citizens, when given the choice, prefer healthcare facilities that are easy to access as part of their everyday life rather than having to make a specific journey to a distant hospital or a major health centre.

17. Also in 2020, the NHS published its review of diagnostic services in England. [8]  It noted that:

“The Covid-19 pandemic has further amplified the need for radical change in the provision of diagnostic services but has also provided an opportunity for change.”

18. The report noted how community diagnostic hubs could be located away from hospitals and in locations such as high streets. Case study 3 within this report showed how one centre, located in a London suburban high street had been used by 30,000 patients in one year. It was open 14 hours per day and 363 days each year.

Question 4. Who is involved in ensuring a thriving local high street and does the current structure of Government support facilitate those groups in working together?

19. The location and accessibility of primary healthcare is often neglected by local planners when assessing high streets. A thriving daytime economy needs a range of service providers especially larger high streets which may have a higher number of visitors due to office workers.

20. Accessing healthcare should not mean having to make special journeys to out-of-town locations. For example an office worker based in a  town centre should be able to access healthcare  around that location for example, seek advice from a pharmacist, pick up a prescribed medicine or have a blood test from a pharmacy in that same town centre.

21. The Pharmacists’ Defence Association published its report on the role that pharmacists and pharmacies could help support the post Covid recovery plan.[9]

22. However, the report recognised that central to this was the need for local Care Boards (in England Integrated Care Boards and in other nations generally known as Health Boards) to ensure adequacy of services commissioned from not just pharmacies but also their role to:

… coordinate the local management of care between a variety of organisations, care providers and settings.

23. Central Government must mandate that local Government work with local Health Boards to increase accessibility to health services, in totality, from high street locations.

24. Similarly, central Government has to ensure that core funding is sufficient to maintain the pharmacy (and other primary care healthcare) networks in accessible locations such as high streets.

Please contact policy@the-pda.org for further information.

21 March 2024