If strike action isn’t an option, how can contractors make government listen, asks Patrick Grice…

Community pharmacies can’t go on strike … well, that’s according to PSNC. Following calls from some contractors that pharmacies should take strike action, the negotiator has taken legal advice.

It says that although strike action can be effective for employees this is not an option for businesses as employers. In addition, the protections afforded to trade unions organising collective action such as strikes are not given to organisations representing businesses such as PSNC.

The result is that any collective action, for example, to withhold NHS or other pharmacy services, by contractors or PSNC, would fall foul of competition legislation, be a breach of contract/contractual services and more, even if limited in scope and duration.

And then there are the potentially significant adverse financial and reputational consequences. So let’s leave talk of strike action to the PDA, an organisation more than capable of rising to the challenge if required.

That PSNC should go as far as taking legal advice on the question is a measure, perhaps, of the desperation among contractors in England. Polls carried out at engagement events in December 2022 set out the state of affairs quite starkly:

• 42 per cent said they would not be able to keep their pharmacy going beyond a year
• 88 per cent said their business was losing money
• 84 per cent said they had stopped or were considering stopping certain Advanced Services.

PSNC could have been accused of crying wolf over the state of community in the past, but that isn’t the case now. But is anyone out there listening?

The national media is all over the consequences of industrial action by nurses, ambulance drivers and junior doctors, but despite some coverage, haven’t really caught up with the parlous state of the community pharmacy network and the consequences for patients … yet.

The government and NHS England? There’s not much to show that they listening to anything at the moment, even as the signs of damage to the pharmacy network mount. In a letter to ministers before Christmas PSNC warned that closures were likely and medicines supply was at risk.

Last month further evidence to support that warning emerged, with news that Lloydspharmacy, having pulled out of Sainsburys, is now being systematically dismembered. The number of branches being sold off is not known and may well depend on the offers that they attract, but it is clearly a nationwide operation. Whether Projects Sapphire, Clover and Mulberry will lead to permanent closures is also unknown.

Whatever the outcome, it is hardly a vote of confidence in the future of community pharmacy businesses. Investment company Aurelius only completed the acquisition of McKesson UK, the parent company of LloydsPharmacy and AAH Pharmaceuticals, in April 2022.

Given the time frame, you could speculate that stripping out the retail division and focussing on digital, homecare and wholesale was the plan all along. And don’t forget that Walgreen Boots Alliance put Boots up for sale last year, albeit at a price no-one was willing to pay.

So back to the question: is anyone listening? They might just be starting to. That community pharmacy is on the radar of the Health and Social Care Committee is a good thing, and so is persistent talk of a Pharmacy First service. But if these developments come to anything, this is ‘jam tomorrow’ stuff.

That the leading pharmacy bodies – AIMp, CCA, NPA and PSNC – have stepped up their joint activity with the Save Our Pharmacies campaign should make a wider audience start listening, and alert patients to the potential problems that might lie ahead for them if nothing changes. If the SOS campaign succeeds in influencing the government’s Primary Care Recovery Plan which is currently in development, that would be a result.

But the ‘here and now’ is still discouraging. Department of Health proposals on price concessions have been described as ‘sticking plaster’ and fall far short of the long-term structural reform PSNC wants. The negotiator says it is “ very disappointed by the piecemeal options on the table from NHS England for regulatory easements, going so far as to say that “they made it clear that NHS England and the Department have no intention of relieving the pressure on all contractors in any meaningful way.”

Footnote

As a footnote, this month sees the third anniversary of when the Covid pandemic really hit the UK, and nationwide lockdowns were announced in March 2020. It seems like an age ago now, and no one wants to relive the worries and concerns that we all had as the virus swept through across the country.

Covid is now more of a known quantity and, with the huge strides in vaccine development, more manageable. That Covid has been largely tamed is one of the good news stories of recent years. It deserves some small celebration!

Patrick Grice is the contributing editor of Independent Community Pharmacist.