Rural communities in England are currently facing significant challenges due to the closures of community pharmacies, a vital resource for healthcare access in less densely populated areas. The recent peak in these closures prompts a critical evaluation of their impact on the health and welfare of rural populations.

In a session in the House of Lords last week, The Lord Bishop of St Albans inquired about the extent of these closures:

Question:

"To ask His Majesty's Government how many community pharmacies in rural areas closed in (1) 2019, (2) 2020, (3) 2021, (4) 2022, and (5) 2023."

Lord Markham provided a detailed response illustrating the trend of closures over the past five years:

Answer:

"The below table shows the total number of community pharmacies that have closed and opened in rural areas in England, as defined by the Department for Environment, Food and Rural Affairs’ Guide to applying the Rural Urban Classification to data, each year from 2019 to 2023:

Year	Number of rural pharmacies closed	Number of rural pharmacies opened
2019	13	3
2020	6	1
2021	8	8
2022	8	3
2023	13	8

Community pharmacies are private businesses, contracted to provide National Health Service pharmaceutical services. My Rt hon. Friend, the Secretary of State for Health and Social Care is responsible for ensuring that patients can access medicines, and the Department is monitoring changes to the market closely. In areas where there are fewer pharmacies, the Pharmacy Access Scheme provides financial support to the pharmacies that are present.

Every three years, local authorities in England undertake pharmaceutical needs assessments for their areas, to ensure provision continues to meet their population’s needs. Integrated care boards have regard to those assessments when commissioning services, and where a pharmacy closure impacts access to services, a new contractor can apply to open a pharmacy in the area.

When a local pharmacy closes, patients can choose to access pharmaceutical services through any alternative pharmacy, including any of the over 400 distance selling pharmacies that are required to deliver medicines to patients free of charge. In some rural areas, doctors are permitted to dispense medicines.”

These figures highlight a distressing trend, particularly with the closures peaking again in 2023, impacting rural residents' access to essential pharmaceutical services.

The closure of a local pharmacy impacts rural communities significantly, where distances are greater and access to alternative healthcare services can be limited. In addressing these closures, Lord Markham acknowledges the importance of the Pharmacy Access Scheme and local authorities' role in health service assessment and provision. Additionally, the importance of community pharmacies in rural healthcare ecosystems cannot be understated. They serve not just as points for dispensing medication but also as crucial hubs for health advice and preventative care.

The Lord Bishop of St Albans further questioned the government's assessment of the impact of these closures on access to primary care, highlighting the necessity of understanding and mitigating the broader health implications of these closures:

Question:

"To ask His Majesty's Government whether they have made an assessment of the impact of rural pharmacy closures on access to primary care."

Answer:

It is the statutory duty of every local authority in England to undertake pharmaceutical needs assessments for their areas including those that are rural in nature, every three years, to ensure provision continues to meet their population’s needs. Integrated care boards have regard to those assessments when commissioning services and where a pharmacy closure impacts on the access to services, a new contractor can apply to open a pharmacy in the area.

Patients who struggle to access pharmacy premises can access pharmacy services remotely through any of the over 400 online pharmacies that are contractually required to deliver medicines free of charge. Alternatively, in some rural areas, doctors are permitted to dispense medication to patients.

The Pharmacy Access scheme provides additional funding to pharmacies in the areas where there are fewer pharmacies.

The closures of rural pharmacies are a symptom of broader challenges in healthcare provisioning in rural areas. The direct impact of these closures on health access necessitates immediate and proactive policy interventions.

The Rural Services Network's campaign "Winning the Rural Vote" advocates for tailored solutions to address the healthcare disparities faced by rural communities. Enhancing accessibility, increasing the availability of health services through multi-disciplinary health hubs, and addressing workforce shortages in rural healthcare are pivotal. These measures are crucial to ensure that rural residents receive the same standard of care as those in urban areas.