Funding cuts were a "slap in the face" for pharmacy and provided a clear disincentive to further investment in service delivery, according to Numark chief executive John D'Arcy (pictured).

Contractors would be reeling after reading the Department of Health's letter published last Thursday, said Mr D'Arcy. "Pharmacy has been told repeatedly by government about the important contribution it makes to healthcare in England. But to demonstrate this by imposing a minimum 6 per cent cut in remuneration is not only nonsensical but an outright insult to a sector that has done so much to ease the burden on the NHS."

The letter talked of “the need for greater efficiency and productivity”. But it did not take any account of the efficiencies that already characterised the sector, including the absorption of year-on-year prescription growth of around 5 per cent, the delivery of a plethora of locally commissioned additional health services and most recently, the commissioning of a national flu service. All of these had been delivered out of a global sum of funding which had not kept pace with inflation or real increases in cost.

Although the letter suggested that there were opportunities for efficiencies, it gave no hint of the methodology behind those assumptions. It would be a long time before anyone could test the business case behind hub-and-spoke schemes, and even longer before they could make the necessary investment in such systems.

The DH also claimed that there are too many pharmacies. "It does appear that the pharmacy network is now being penalised for following a government-led system of control of entry which is of itself based upon necessity of pharmaceutical services." Closures were  inevitable (that is clearly the intention) and, as always, independents would be disproportionately affected.

"To suggest that a minimum 6 per cent cut in remuneration along with an untested radical overhaul of the pharmacy sector will not impact negatively on quality of service or access is at best naïve and at worst totally reckless."