The National Pharmacy Association chief executive Paul Rees has said its pharmacist members across England who continue to struggle with a “broken margins system” that is based on a process “no-one understands” believe their plight is similar to what the sub-postmasters went through during the Post Office scandal.

In an exclusive interview with Independent Community Pharmacist, to be published in April’s edition, Rees (pictured) said he has spent time during his four months in the role talking to members about the concerns they have keeping their pharmacies open against the backdrop of an “antiquated” pharmacy contract and ineffective medicines purchase margin system as pharmacists consistently dispense medicines at a loss.

“If you look at what’s happening in community pharmacy, with a thousand closures in the last 10 years, eight closures a week, 72 per cent of pharmacies are in deficit and our frontline community pharmacists have to do battle with the broken margins system,” he said.

“They are (dispensing) many medicines at a loss and then they’re getting money clawed back several months later, or even a year later, through an averaging system no-one seems to understand. You’ll find community pharmacists feel under massive pressure.

“I would argue they’re under more pressure than other clinicians because not only are they having to provide frontline services with diminishing resource, they’re also having to do battle with a system that doesn’t work, that no-one has any confidence in.”

Last month, Community Pharmacy England called for a “full review” of the medicines purchase margin system which it said could bring “developments such as benefit-sharing and relief mechanisms.”

At present, about 30 per cent of pharmacies’ NHS funding is delivered through the margin they are allowed to make on medicines purchases. Of the £2.592 billion a year community pharmacy receives, £800 million is delivered as retained buying margin or Category M, which determines the profit pharmacies can earn on dispensing drugs through purchasing.

The mechanism has long been criticised by pharmacy bodies for being complicated and outdated and Rees said pharmacists who are forced to adhere to a system “nobody trusts” are being treated like “second-class citizens by the NHS.”

“When I go and see members up and down the country, they do see themselves as being akin to the Post Office sub-postmasters, that they are the victim of a system that doesn’t work, that nobody trusts,” he said.

“For the Post Office sub-postmasters, you had Horizon. For the community pharmacy sector, you’ve got the margins system which no-one understands, so actually, community pharmacists are under massive pressure and they need more support.

“They don’t get their estate paid for unlike GPs, they don’t get paid for time off to learn about new developments for continued professional development and they’re not supported in terms of mental health. That is particularly crucial at this time of massive pressure.

“New services (are) being rolled out at a pace against a backlog of a system that doesn’t work and a funding model that is broken and a contract that is antiquated and out of date.”

The NPA has called on the government to implement a range of measures, including giving community pharmacy 2.5 per cent of the NHS budget, introducing a moratorium on clawbacks until a new contract and funding model is delivered, year-on-year inflation-linked increases and a new contract based on payments for dispensing, clinical services, de-prescribing, prevention and social prescribing.