The NPA launched its ballot in September to protest against ongoing delays to NHS funding for pharmacy, which was due in March.
Now NPA members have overwhelmingly approved taking collective action to try and force the government’s hand.
Asked if they were prepared to “limit your service offering in the interests of patient safety, if adequate funding is not forthcoming”, some 93% of Welsh respondents voted yes, 99% in NI voted yes, and 99% in England voted yes.
The NPA said 63.5% of NPA members in England, Wales and Northern Ireland had voted, “representing 3,399 independent community pharmacies”.
Read more: Streeting slams NPA ‘sabre-rattling’ over collective action
The NPA had previously planned to act on any mandate before Christmas, but chief executive Paul Rees told C+D it would now make any recommendations on collective action in January, should the government fail to make a satisfactory offer.
Asked if the NPA was backtracking, Rees said the delay was “not a backtrack at all, it’s giving the government the chance to digest the results.
“We are looking at January, it’s the obvious time for us to recommend action. It’s up to each pharmacy what action they take, but the turnout was massive, and we know pharmacies are at the end of their tether. When or if we recommend action we give people plenty of notice, and December wouldn’t be a great time.”
“Off the scale”
Rees said the NPA also wants to “enable the government to digest the result of the ballot because the strength of the yes vote, and the turnout, are off the scale.
“Some 81% of multiples with ten branches or more voted, and there was a higher turnout by multiple independents than smaller ones, which shows the intensity doesn’t just exist among single-handers.
Read more: Saturday shutdown: Pharmacy protest ballot could see weekend closures
“It’s important to allow the government time. We have already written to Wes Streeting with the results, now we want to give them time to put something on the table to Community Pharmacy England (CPE) that is meaningful and substantial.”
Asked what would represent a meaningful and substantial offer, Rees said it would have to be one “felt by pharmacy owners as a real contribution”.
“We need an uplift that takes into account any clawbacks, the national living wage (NLW) and national insurance (NI) hikes, and that, at the very least, is net neutral,” he added.
End of an era
Recently, Wales and Scotland both received a 6% uplift to core pharmacy funding.
Asked if 6% would be suitable for England, Rees said the NPA would need to “analyse whatever is put on the table, but after years of real terms cuts totalling 40% over the last decade, whatever is put forward, in the round, can’t be an uplift that means a further cut.
“This has to be the era of the end of cutbacks. The budget has made the situation even worse, it puts even more pharmacies at risk. We need an urgent injection of cash, it can’t just be the writing off of clawbacks, cash needs to go straight to pharmacies now.”
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The ballot, which launched in September and ran for six weeks, got an unusually strong turnout, said Rees.
“The typical trade association ballot gets a turnout of between 7% and 15% but our ballot had a turnout of 63.5%,” said Rees. “It shows the strength of feeling among contractors and what action people are prepared to take.
“It shows the sense of anger and desperation among contractors which has been intensified by the impact of the budget.”
Reaction
Responding to the result of the ballot, Independent Pharmacies Association (IPA) chief executive Dr Leyla Hannbeck said: “As healthcare professionals, we believe that patients must not be caused suffering by any withdrawals of our members' valuable and vital professional services.
“The government must urgently raise pharmacy funding to prevent further closures of community pharmacies. We are awaiting a settlement and the results of that settlement will determine the next steps.”
Company Chemists’ Association (CCA) chief executive Malcolm Harrison said the results serve to “underline the huge pressure that pharmacy contractors face, following a decade of underfunding”.
Read more: Ian Strachan: If the IPA had been consulted, we’d have advised the NPA to call off its ballot
“It is imperative that [contract] renegotiations for 2024/25 commence without delay,” he added. “The government and NHS must uplift all elements of the contractual framework to stop further reductions in opening hours and permanent closures”.
C+D asked the NPA whether delaying its collective action could be interpreted as an indication that a funding announcement might be imminent, but Rees said “we hope there may be an offer put forward to CPE in the next few weeks, but we have no particular information that something is coming soon.”
Rees also said the mammoth delay to current negotiations between the government and CPE means the results of the ballot would apply to negotiations for the 2025/26 financial year, saying “our mandate runs throughout.”
“Not a radical bunch”
Breaking down the vote, the NPA said that in England:
- 97.8% voted to serve notice on opening hours above the minimum required by their contract – meaning fewer pharmacies will be open in the evenings and at weekends
- 93.3% voted to withdraw free home deliveries of medicines that are not funded
- 96.1% voted to withdraw from locally commissioned services, including some local addiction support services, emergency contraception and stop smoking support
- 99.2% voted to refuse to co-operate with certain data requests above those required for patient safety and contractual minimums
- 96.8% voted to withdraw from supplying free monitored dose systems (medicine packs) that the NHS does not pay them to provide, other than those covered by the Disability Discrimination Act
Read more: NPA CEO Paul Rees talks ballots and bargaining power
NPA chair Nick Kaye said that pharmacies “don’t want to reduce services but we will be left with no option but to suggest that pharmacy owners should consider acting on the clear ballot results if the government does not act to protect this vital and much-loved part of our health service.
“As a third-generation Cornish pharmacist, I deeply care about my patients, as do pharmacy teams across the country, but I have never experienced a situation as desperate as this.
“Pharmacy owners are not a radical bunch, we have never proposed action like this before, but after a decade of underfunding and record closures, something simply has got to give.”
