Pharmacy in the United Kingdom has been an integral part of the National Health Service since it was established in 1948. Unlike the rest of the NHS pharmacies are largely privately provided apart from those in hospitals, and even these are now often privately run.
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History
The Pharmacy Act 1868 limited the sale of poisons and dangerous drugs to qualified pharmacists and druggists.
The advent of the NHS had an immediate beneficial effect on the pharmaceutical industry. In 1960 there were proposals that the private patients of general practitioners should be enabled to receive their drugs free on the health service, but they were not implemented.
The supply of drugs in the hospital service represented about one-tenth by value of the supply through the retail pharmaceutical service in 1965.
There was a reduction of more than a quarter in the number of pharmacies in the community between 1963 and 1979. According to the Pharmaceutical Services Negotiating Committee at that time over 4,000 pharmacies in England and Wales dispensing less than 24,000 prescriptions per annum were losing money on NHS services.
Contract
NHS pharmacies are governed and paid for their NHS work under a standard contract, which was modified in 2005. This modification enabled pharmacy contractors to be paid for Medicines Use Reviews conducted by pharmacists for people with multiple long term prescriptions. There are also New Medicine Services, which are intended for patients who have started on long term medication, such as asthma treatment.
In 2016 the government announced that the budget for pharmacy would be reduced by £170 million nationally from 2017 (£113 million in England) - its “share” of the £22 billion in savings required across the NHS. Under the new contract there will be a payment of £1.33 per prescribed item dispensed, but the flat rate establishment payment (around £25,000 per pharmacy) set up in 2005 will be reduced by 40% and is to be abolished. There will be an access scheme with monthly payments for the 1340 pharmacies more than a mile away from the next pharmacy. There will be additional quality incentives for:
Dispensing Doctors
In rural areas GPs are permitted to dispense medication if there is not a pharmacy within a mile of the surgery. There are 1,290 dispensing practices across the UK serving 8.8 million patients in 2015.
Pharmacists in GP practices
NHS England is supporting initiatives to place pharmacists in GP practices in order to improve the management of medication for patients with long term conditions. About 420 million repeat prescriptions are generated in the UK each year — about 200 for each general practitioner each week. In the practice pharmacists can do more Medicine use reviews.
Regulation
Retail pharmacies and pharmacists are regulated by the NHS, under the provisions of the Pharmacy Act 1954 and The National Health Service (Pharmaceutical Services) Regulations, which prevent new pharmacies being opened without permission. This was done by the Family Health Services Authority and then by Primary Care Trusts. Now regulation is by NHS England and its Pharmaceutical Services Regulations Committees. Retail as well as hospital pharmacies in England, Scotland and Wales are regulated by the General Pharmaceutical Council, In Northern Ireland by the PSNI.
Local Pharmaceutical Committee
Local Pharmaceutical Committees were established in every area in 1948. Each is a representative committee of persons providing pharmaceutical services as defined in Section 44 of the National Health Service Act 1977. Each committee has about 12 members. There are now about 80 in England.
Retail Pharmacies
89% of the UK population live within a 20-minute walk of their local pharmacy. A majority of the population visit a pharmacy at least once every 28 days. In 2014 more than 1.1 billion prescription items were dispensed in England. This was 34.5 million more than in the previous 12 months and 378.4 million more than in 2004. The total net ingredient cost of prescribed items was £8.9 billion. 89.9% of all items dispensed in England were free of charge. In Scotland the total number of items dispensed in the community in 2014–2015 was 101.1 million with a net cost of £1.2bn.
Since at least 1979 there have been proposals that pharmacists should develop their role of giving advice to the public. NHS England announced a pilot scheme in July 2015 for GP practices in England to employ around 300 pharmacists to provide clinical care and relieve pressure on GPs. They will monitor patients with long-term conditions, create medicine plans and provide advice and expertise on day-to-day medicines issues.
In London pharmacies are used to deliver Flu vaccination. In 2013/4 108,700 vaccinations were delivered by 1,089 pharmacies in the capital. Medicines Use Reviews in patients homes are delivered by pharmacists in Croydon.
In August 2015 it was announced that retail pharmacies would be given access to NHS patients Summary Care Records after a pilot of 140 pharmacies in Somerset, Northampton, North Derbyshire, Sheffield and West Yorkshire, demonstrated “significant benefits.” Pharmacists have to ask for a patient’s permission to view their record.