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Following reports that some Jhoots branches are failing patients, should prospective pharmacy owners demonstrate their financial viability? David Reissner says there are a number of reasons why this probably wouldn’t work…

The rules governing how pharmacies get an NHS contract, how to provide services and what sanctions an integrated care board (ICB) can impose if the NHS terms of service are breached, are all contained in the National Health Service (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013.

These rules have been thrown into sharp relief by events reported in the pharmacy press surrounding some pharmacies trading as ‘Jhoots’. (It has been reported that Jhoots pharmacies owned by Manjit Jhooty are unaffected by alleged problems).

All pharmacies that provide NHS services must be open to provide services during their contracted hours. From time to time, some pharmacies may find they are unable to open, or they fail to comply with some other requirement in their NHS terms of service.

Typically, closures happen because a pharmacist is not available. ICBs can serve breach notices or remedial notices and decide to withhold remuneration when they believe the NHS terms of service have not been complied with.

Pharmacies have a right of appeal to NHS Resolution. NHS Resolution has adopted a firm line when dealing with appeals, taking the view that pharmacies should make their arrangements so that closures are avoided.

The NHS Regulations even give a power to remove an NHS contract if a pharmacy has repeatedly breached its terms of service and is likely to persist in breaching the terms of service without good cause. Removal must be justifiable and proportionate.

Proportionality is a high bar to justify removal when one considers the financial impact on a pharmacy owner. However, Hampshire and Isle of Wight ICB overcame the proportionality test when removing a Jhoots contract in 2025.

The scale of the closures by some Jhoots pharmacies was significant enough for questions to be asked in parliament. In response, the pharmacy minister Stephen Kinnock said Labour is “working speedily to consider how to strengthen regulation of these pharmacies”. 

The prime minister Keir Starmer said in parliament on October 22, 2025:

“Officials are currently reviewing whether the integrated care boards and General Pharmaceutical Council (GPhC) need additional powers to address pharmacy businesses that do not play by the rules … that could include powers for the Council to go after business owners in addition to the pharmacy professionals.”

This begs the question: what additional powers should ICBs or the GPhC have? For example, prospective football club owners have to satisfy a ‘Fit and Proper Persons’ test before they take over a club. The GPhC already has powers to deal with misconduct.

Applications for NHS pharmacy contracts already have to include detailed fitness information for individuals and companies. Until as recently as October 2024, individuals had to provide two references with applications.

This requirement was then dropped. At the time, the Department of Health and Social Care (DHSC) said this was because, once an application was received by an ICB:

“The ICB then has to take up and check references from these referees, and compliance with this requirement often causes delays to processing applications, so removing this requirement was identified as a measure that will help expedite approval process without undermining the importance of scrutiny of the applicants’ fitness.”

Just because one pharmacy business appeared to have run into difficulties, is that a reason to go back on what DHSC was saying little more than a year ago and change the rules for all pharmacies?

Should prospective pharmacy owners have to demonstrate their financial viability? I can see a number of reasons why this probably wouldn’t work:

•       ICBs are unlikely to have the expertise to evaluate financial viability.
•      This additional step in application processes would cause delay and involve cost both to ICBs and prospective pharmacy owners, just as taking up references used to do.
•      A prospective owner may be financially viable at the time of applying for a contract but run into financial difficulties at a later date.
•      No one takes over a pharmacy with the expectation that they will occasionally have to close because of the unavailability of pharmacists and/or financial reasons.

I have read that pharmacy staff have not been paid. To me, that is indefensible, both legally and morally. However, staff do have legal remedies available to them and I cannot see any reason for the government to step in.

We all agree that patients should not be let down. But if pharmacies fail to open, it would be better to examine the causes before trying to tighten regulation for a profession that is already highly regulated.

We all know that the problem may be, at least in part, the result of underfunding. Indeed, DHSC recognised when introducing swingeing cuts to pharmacy funding in 2016 that 3,000 pharmacies might close permanently.

Instead of looking for ways to tighten pharmacy regulation to deal with pharmacies that fail to open, it would be better to get NHS funding right, to reduce the risk of unplanned pharmacy closures.

David Reissner is chair of the Pharmacy Law & Ethics Association. These are his personal views.