PARLIAMENTARY DEBATE
Pharmacy First - 31 January 2024 (Commons/Commons Chamber)

With permission, I shall make a statement on the launch of our Pharmacy First service.

Pharmacies are at the centre of our communities. They are an accessible front door to our NHS for millions of people. Alongside general practice, optometry and dentistry, pharmacy is one of the four pillars of primary care in England. Four in five people in England live within a 20-minute walk of a community pharmacy. Pharmacies provide fast, fair and simple access to care and advice for the kinds of illnesses from which people suffer every day. Our constituents can now walk in off the high street whenever it suits them—whether they are at home, at work, or visiting somewhere.

Our pharmacists are not only conveniently located, but highly skilled professionals with years of training under their belts. The number of registered pharmacists in England has grown considerably under this Conservative Government—up 61% compared with 2010. None the less, these skilled healthcare professionals still represent a rather untapped resource in our NHS, so this Government are bringing forward reforms that will make the most of their expertise: giving people up and down the country a variety of quality care and wise advice, quickly and easily, saving them a trip to the GP; freeing up appointments for patients who need GPs the most; and driving our plan to cut waiting lists. The benefits are clear. That is why this Government have consistently taken the decisions that allow community pharmacists to deliver more clinical services and supply more treatments— whether that be other parts of the NHS referring patients suffering from minor illnesses to community pharmacists for advice and the sale of over-the-counter medicines, offering lifesaving blood pressure checks in pharmacies, or making it easier for women to access oral contraception in pharmacies. I am proud of everything that we have accomplished so far.

To unlock the full potential of our pharmacists, we need to go further and faster. That is why I am delighted to inform the House today that we are launching the Pharmacy First service—a personal priority of the Prime Minister, who is himself the son of a pharmacist. This will give pharmacists the power to supply prescription-only medications, including antibiotics and antivirals for seven common conditions: sore throats, ear aches, infected insect bites, impetigo, shingles, and minor urinary tract infections in women. More than 10,000 community pharmacies have signed up—over 95% of pharmacies in England—which is a brilliant sign of their approval.

The next time that anyone is suffering from any of those seven conditions, for most people their first port of call will be a quick trip or a call to their pharmacist. They will not need to see their GP first. They will not need to spend time making an appointment, and they can turn to their pharmacist whenever it suits them. That benefits everyone involved: people get the care they need faster; GPs can focus on more complicated cases; and pharmacists can make better use of their knowledge and skills. This is a common-sense reform. Pharmacists see and advise people with these sorts of conditions every day, but we have now enabled them to provide prescription-only medicines where clinically appropriate, so that they can help people more easily.

All this will deliver results. Pharmacy First will make it easier for millions of people to get the care they need on the high street and, together with the expanded blood pressure and contraception service, it will free up as many as 10 million GP appointments, in turn reducing unnecessary trips to A&E, reducing the pressure on GPs, and driving forward our plan to cut waiting lists for patients.

The investment that we are putting into Pharmacy First will also level up digital infrastructure in community pharmacies up and down the country, streamlining referrals to and from GPs, giving pharmacists better access to relevant information from patients’ GP records, and allowing them to share relevant information quickly in return.

Pharmacy First is not just about delivering care faster, but about making care fairer by driving down health inequalities. That is because there is double the number of pharmacies in the most deprived communities in our country. Getting the right care, the right contraception and the right test will now be faster and simpler for all those people in our more deprived communities than it ever has been before. Thanks to Pharmacy First, they will be able to take full advantage of their pharmacists’ expertise and use them to complement the care they receive from their GPs and throughout the NHS.

Pharmacy First was made possible only through close collaboration with Community Pharmacy England, which I thank for all the work it has done and will continue to do to support community pharmacies to gear up and deliver this new service for our NHS.

We on the Conservative Benches have a clear plan for the NHS: getting patients the care they need faster; making the system simpler for staff; and making it fairer for everyone. That is our plan and I look forward to working with pharmacists up and down the country to deliver today’s announcements as we build a brighter future for families right across the country. I commend this statement to the House.

I call the shadow Minister.

I thank the Minister for advance sight of her statement.

Let me start by paying tribute to the many organisations that have been involved in preparing for this launch and the thousands of pharmacies across the country that have embraced this initiative. Labour has long been arguing that pharmacists should play a greater role in the NHS, so we support this move.

As the Minister has said, pharmacies already do far more than just dispense repeat prescriptions and sell shampoo: they are medicine experts within the NHS; they are highly trained; they are easily accessible right across the country; and, as we saw during the pandemic, they are a highly trusted part of their communities. But their skills and knowledge are often under-utilised. Therefore, bringing more services to British high streets for patients to get treated more quickly and conveniently is absolutely right. It is why, as we announced last week, we want to bring NHS out-patient appointments closer to people through high street opticians too.

The Minister is right to say that pharmacists can take pressure off GPs. However, let us be clear: this announcement will not make up for the 1,000 pharmacies which have been closed under the Conservatives, or the 2,000 GPs that have been cut since 2015. Patients today are waiting over a month to see a GP, if they can get an appointment at all. When Labour was last in office, people could get an appointment within 48 hours.

That is the thing with this Government: they give with one hand and take with the other. Will the Minister explain what has happened to the Government’s pledge to deliver 6,000 more GPs this year and what she is doing to support community pharmacies, which are already facing a perfect storm of inflationary pressures for running costs, recruitment challenges and an unstable medicines market?

The Government press release issued today claims that patients in England will be able to get treatment for seven common conditions at their high street pharmacy from today. I would like to dig down into whether that is actually the case. Healthwatch England has warned that it will take time for pharmacists to be trained in order to provide the services that Ministers have announced, so can the Minister tell us when she will be able to guarantee that the services advertised will actually be available?

Let me also ask about IT integration. To facilitate this roll-out, pharmacists were supposed to have access to GP Connect, so that details of patient consultations would automatically be sent to general practice through the clinical IT systems. The Government have had 12 months to get that ready, but from what I am hearing this morning it is still not live. Pharmacists are telling me that they can access only a summary of GP records, that they have to use another system to input what they have prescribed, and that they then have to download that and email it across to the GP. That is cumbersome. What estimate has the Minister made of the time that will be wasted at a local level to address that issue, and how long will it take before the system is ready?

Finally, what is the Government’s plan in the longer term to integrate the increase in independent prescribers who are being trained as part of the long-term workforce plan, and does the Minister agree with us that we should be accelerating the roll-out of independent prescribing to establish a community pharmacist prescribing service covering a broad range of common conditions? That would support patients with chronic conditions, which is the big challenge facing the NHS. Does the Minister agree that community pharmacies will have an important role to play in supporting GPs in the management of long-term conditions such as hypertension and asthma and in tackling the serious issue of over-prescribing, which is responsible for thousands of avoidable hospital admissions every year?

We agree that patients should be able to go to their local pharmacy to receive some services that they currently get at GP surgeries, such as vaccinations free of charge on the NHS, allowing patients to be seen faster and freeing up GPs to see more complex cases. By bringing healthcare into the community, patients will have greater control. The NHS should be as much a neighbourhood health service as a national health service, with healthcare on the doorstep, there when it is needed—and with Labour, it will be.

Well, the very first appointment under Pharmacy First happened at 8.30 this morning.

It was 8.31!

Oh, was it 8.31? I thank the Secretary of State. When will the services be available? I should think that many more are taking place already.

I am afraid that, while welcoming this, the hon. Lady is being a little pusillanimous with her praise. A lot of her suggestions, as she will know, are simply not true: already, well over 2,000 new GPs and tens of thousands of nurses are working in our NHS. Many thousands of additional practice staff are working in GP practices, and, as she will know, our brilliant GPs have made 50 million more appointments available each year ahead of the target in our manifesto. Good on them. They are doing an amazing job, and Pharmacy First will ease the ever-increasing burden on them.

The hon. Lady talks about technology. I am pleased to tell her that ensuring that the technology was in place was key in deciding when we could go live. There is a very short window in which some systems will have elements of manual intervention, but only for a few weeks. The whole system will be fully automated and will provide the ability to inquire into GP records and to swap advice, which is important for pharmacists to deliver the excellent service that they are already delivering.

Finally, the hon. Lady will know that community pharmacists have for some time now been delivering blood pressure checks, which in some cases are truly lifesaving. This is amazing patient access and patient convenience. The Labour party should, for once, simply praise it and be glad that the Government have stuck to our plan and got on with it.

I am so pleased to hear today’s announcement that we are delivering. It was one of the key things in our plan for patients that I wanted to ensure happened. In particular, many Members of this House, current and past, have had infections and, as a consequence of not dealing with them, have ended up in hospital. This is the sort of sensible approach that, frankly, met some resistance during my time in the Department, with worries about over-prescribing. It is about treating pharmacists like proper professionals and, most important, providing quicker access to necessary care, which patients will now properly enjoy.

May I say a huge thank you to my right hon. Friend for her contribution to kicking this project off? I feel very fortunate to be at the Dispatch Box on the day we launch it, because many others were involved in setting it up. She rightly highlights some of the problems with spotting things such as sepsis infections, which pharmacists are trained to spot. They really can be the first line of defence. Being able to walk in off the high street to see a pharmacist is incredibly valuable to us all.

As a long-standing supporter of the idea of Pharmacy First, I welcome the right hon. Lady’s statement and the specific reforms she has talked about introducing. She will be aware, however, that pharmacists in my constituency and further afield are very concerned that they are unable to do the job that they are already expected to because of lack of capacity and problems in accessing certain drugs that they need to prescribe. Can she indicate how the existing problems will be dealt with, so that they can do what is promised in Pharmacy First?

I am grateful to the right hon. Gentleman for his support for the programme. There are around 14,000 licensed medicines, the vast majority of which are in good supply. The Department works very closely with the sector on finding alternatives and sourcing supplies of medicines, and most of the time we are able to meet the demand. Occasionally there are challenges, but that does not change in any way the ability of community pharmacists to be the expert medicine suppliers that they are, and to meet the need that members of the general public have for treatment and advice.

I warmly welcome the statement. This initiative has the potential to transform primary care and access to treatment, but does the Minister agree that to realise its full potential, we need to invest in new technology—she mentioned digitalisation—to make sure that community pharmacies are set up to take advantage of these new opportunities? We also need to invest in the pharmacy workforce as part of the Government’s long-term workforce plan, so that those in alternative roles within pharmacies, such as pharmacy technicians, have the capacity to take the opportunities she has outlined.

My hon. Friend is absolutely right. Investing in technology is vital, but so is investing in the workforce. We have seen a 61% increase in the number of registered community pharmacists since 2010, and we aim in our long-term NHS workforce plan to increase that by a further 50%. We have already increased the number of training places for both pharmacists and pharmacy technicians.

I, too, welcome Pharmacy First, which I think is a very good initiative. In recent weeks we have seen the closure of two pharmacies in my area, on Beverley Road and Chanterlands Avenue. I am also told by leaders in the Humber pharmacy community that our area has one of the largest numbers of temporary closures because of problems accessing pharmacists. Will the Minister look favourably, therefore, on my idea to attach a school of pharmacy to Hull York Medical School? We need a school of dentistry, too. If we could have a centre of excellence in the Humber area, it might solve some of our specific workforce problems.

I am always happy to speak to colleagues on both sides of the House about their ideas for new dental and pharmacy schools. It is an ongoing interest.

England is, in fact, blessed with huge numbers of community pharmacies—well over 10,000—and four in five of us are able to walk to a community pharmacy within 20 minutes. The number of pharmacies in more deprived areas is double the number in more well-off areas. We are very well served by our brilliant pharmacies, and I hope the Pharmacy First programme will improve their footfall and their value in each of our communities.

I very much welcome this initiative to encourage our pharmacies to provide more frontline healthcare. People need to know about this, because they often do not think of going to the pharmacy. What work are the Government doing in larger population centres such as Harwich and Dovercourt, which has over 20,000 people but no out-of-hours pharmacy cover? People have to make a round trip of more than 40 miles to collect a prescription on a Sunday, for example. Are the Government doing any work on 24/7 pharmacy coverage for larger population areas?

My hon. Friend raises an important point. Pharmacists will keep their community pharmacy open for up to 72 hours a week in most cases, and up to 100 hours in some cases, which means there is weekend accessibility. We keep this under review, but the availability is very good.

The Liberal Democrats have long supported calls for Pharmacy First, and the National Pharmacy Association, based in my St Albans constituency, has been calling for it since at least 2017. This is a welcome move, but it is long overdue. The Minister will be aware that there have been almost 700 permanent pharmacy closures since 2015, and the Company Chemists Association now estimates that eight pharmacies a week are closing, including one in my constituency. What steps is she taking to make sure there are no more closures this week, next week and every other week this year?

The hon. Lady might remember that the Liberal Democrats were in government for a good part of that period. She talks about pharmacy closures, and we see pharmacies opening and closing. There has been a small number of net closures, but we are very well served across England and we keep a close eye on that. Pharmacy First is a new boost to community pharmacies across England.

I congratulate my right hon. Friend on bringing in this initiative. I have fantastic community pharmacies in South Derbyshire—although, sadly, when the boundary changes come, I will lose Hatton to Derbyshire Dales. They are leaders in their field and they are trusted in their communities. This is a brilliant initiative, and I cannot thank my right hon. Friend enough.

I thank my hon. Friend.

Order. That was a perfect answer. I have to tell the House that we have a lot of business to get through today, and I will therefore need short questions and admirably short answers, because otherwise not everyone who is standing will have a chance to ask a question.

I do not agree with most of what the Minister has said today. We are all in favour of pharmacies, but I think this statement is a distraction from the real problems in our health service, our GP service and much else.

Order. Will the hon. Gentleman please ask a question?

Has the Minister looked at the number of pharmacies that have closed in the poorest areas of our country? Lastly, what is she going to do about companies like Boots? It has even closed its local branch in Westminster—

Order. Because of his seniority, I have allowed the hon. Gentleman a little leeway. One question, one answer.

The more deprived parts of England are much better served by community pharmacies than better-off areas are.

We have amazing pharmacists in Watford, and I have championed community pharmacies such as Sigma, which is a fantastic local business. Can the Minister provide an assurance that the general public will be made massively aware of this fantastic new service?

Yes, there will be a significant communications package, beginning today.

The Minister does not appear to be concerned about the record number of community pharmacy closures under this Conservative Government. Why does she think it is happening?

There has been a 61% increase in registered pharmacists since 2010, with plans to increase that number by 50% in the next few years.

The Government currently contribute £2.6 billion to community pharmacy, quite apart from the £645 million addition for Pharmacy First. We are about to start negotiations for the 2024-25 period.

The three pharmacies in Shirley, in my constituency, have been there for decades. They are very well known and very trusted, but they are all on the edge of having to close. To stay open, one pharmacist is using their own savings and not paying themselves a wage. I welcome your announcement, but would you read a letter from them—

Order. There may have been lax obeying of the rules at other times, but would the hon. Lady please refer to the Minister as “she”, not “you”?

Forgive me, Madam Deputy Speaker. That was an error.

Would the Minister read that letter, consider these issues and perhaps meet us to talk about it? They are good people, and we want to keep their pharmacies open.

I am of course happy to read the letter, but I would say that Pharmacy First offers a significant new boost to community pharmacies.

My right hon. Friend will be pleased to hear that, across Cheshire and Merseyside, including my Eddisbury constituency, 535 community pharmacies will be starting the Pharmacy First initiative today. Particularly in rural areas, pharmacies are a lifeline for many people. Can she reassure patients of the clinical competence of pharmacists to make prescriptions, and can she reassure pharmacists on the issue of clinical liability?

I can assure my hon. Friend that pharmacists are highly skilled and better trained than ever before in this country. They are fully equipped to meet the demands of their new prescribing role.

I welcome the Pharmacy First initiative—its roll-out is long overdue—but what expectations are we creating in the minds of patients attending pharmacies? Will pharmacists be trained in denying medication to people who turn up expecting to be given a prescription of some sort? Clearly, the initiative will encourage more people to present in order to get medication when it may not be necessary.

The hon. Gentleman raises a good point. Of course, pharmacists will be prescribing for seven common conditions. Plenty of referrals will be made to GPs, and from GPs to pharmacists, to give patients the accessibility and the appropriate level of assessment for their needs.

Pharmacies in Horsham have asked for such a scheme, so they will very much welcome it, as do I. However, as the Minister is aware from our one-on-one discussions, for which I am grateful, there are currently issues of access to pharmacies in Horsham. Will she ensure that the sector is appropriately resourced and has the right training in order to ensure that the scheme is the great success that it deserves to be?

Absolutely, and I am always happy to discuss that further with my right hon. Friend.

Northern Ireland’s minor ailments scheme, and this Pharmacy First initiative, are acknowledgments that GPs can spend up to 40% of their working day on minor ailments, but the scale in Northern Ireland is different from what has been proposed for England. Is there capacity for a UK-wide roll-out of Pharmacy First to take pressure off our GP services? If there is, that would be the right thing to do.

I seriously look forward to the re-establishment of the Stormont Assembly so that it will be possible for Northern Ireland to implement such a scheme itself.

I warmly welcome the statement. I have been a strong champion of pharmacies in my constituency. We are experiencing challenges, however, when the likes of Boots withdraw their services. It is difficult to transfer or apply for licences, despite the fact that we have a number of keen applicants who want to provide important pharmacy services. What more can the Government do to speed up and make the licensing application procedure smoother and better?

I would love to hear more about that from my right hon. and learned Friend. I will be happy to look into it.

In recent months, Boots has closed two of three pharmacies in the Hampton area of my constituency. That has left Hampton North, which is one of the most deprived wards in the London Borough of Richmond upon Thames, without a single pharmacy, so elderly residents and those with long-term conditions have to walk for a lot longer than 20 minutes to access a pharmacy. Local GPs tell me that it is just not viable to set up a community pharmacy facility. Will the Government review the pressures on community pharmacy and consider the community pharmacy contractual framework so that we can make this initiative work and take the pressure off GPs?

As I have already mentioned, there are many community pharmacies starting up all the time, as well as closing down. The hon. Lady will appreciate that the Pharmacy First initiative is a real boost to community pharmacies. I am happy to discuss it with her, but I would imagine that there will be the capability to open new community pharmacies in her area.

I congratulate my right hon. Friend and her Front-Bench colleagues on rolling out this initiative. The Isle of Portland had two pharmacies, both run by Boots, but one is now shut. Can I meet my right hon. Friend and Front-Bench colleagues to discuss how we can ensure that deprived areas such as Portland retain the pharmacies that they desperately need?

I would be very happy to meet my hon. Friend.

With so many of my constituents waiting a long time to see GPs, any boost to primary care capacity must be welcomed, so I thank the Minister for today’s announcement. The GPs and pharmacy staff I meet raise concerns about recruitment to open roles. What assurances can the Minister offer that this will not be another policy, like the childcare announcement, that lacks the workforce or sectoral strategy to really gain the full benefits?

As the hon. Gentleman will know, our NHS long-term workforce plan intends to increase by 50% the number of registered pharmacists. That work is under way and includes increasing the number of pharmacy technicians.

It is great that people will be able to go to the pharmacy for their prescriptions, as well as for the products that they need, without the need to visit a GP. Chelmsford has some great community pharmacies, but Boots is closing three branches. Will my right hon. Friend meet me to discuss how we can ensure that the people of Chelmsford will be able to get to a pharmacy, in order for the initiative to work?

I would be very happy to meet my right hon. Friend.

The community pharmacy in Wem in my constituency has struggled to find a full-time pharmacist, relying instead on locums. That means that opening times are erratic, people cannot rely on the service, and the pharmacy is loss-making because locums are so expensive. How will the Minister help pharmacies in rural areas to recruit the full-time pharmacists and reduce their reliance on locums?

The hon. Lady will be aware that, although a few are owned by GP practices, community pharmacies are usually private businesses. We are training the registered community pharmacists that we need. Obviously, it would be for that local area to put in place its own recruitment policies, but I would be happy to meet her to discuss that further.

I warmly welcome my right hon. Friend’s statement, and I put on the record my thanks to all the pharmacists who work in my constituency. The geography of my constituency can often mean that someone’s nearest pharmacy is about a mile and a half away across the water, so they end up driving 11 miles around to get to it. I believe that the mapping needs to change. Will she meet me to discuss it?

I am always happy to meet my hon. Friend. Just to let her know, 100 pharmacies in Cornwall are signed up to Pharmacy First.

This brilliant announcement has the potential to free up many thousands of GP places in areas such as Peterborough, but the initiative will be the success that we need it to be only if more people know about. My right hon. Friend touched on an awareness campaign, but what efforts will she make to ensure that it reaches difficult-to-reach communities, such as those for whom English is an additional language?

There will be a big communications plan, which I am happy to share with my hon. Friend. Well over 100 community pharmacies in his area have signed up to Pharmacy First, which is brilliant news. It is incumbent on us all—and the purpose of the statement—to ensure that our constituents know about this excellent new service.

Although my right hon. Friend and I share a common scepticism of the sclerotic state of the European Union, there are lessons to be learned from Europe. I am glad to see that, like France, we are now respecting community pharmacies. However, I have one specific question. In her statement, she said that one thing on which the pharmacy can act is female urinary tract infections. Why not male?

I wish my hon. Friend a happy Brexit day. I will have to come back to him on that issue. The point is that the service is limited to minor urinary tract infections. That might be why it does not include men, but I will certainly get back to him on that point.

I and many—if not all—of my constituents very warmly welcome the statement. On integration with other NHS access services, if an individual were to dial NHS 111 with one of the conditions mentioned in the statement, would they be diverted to a pharmacy or to a GP first?

To a pharmacy. NHS 111, GPs and urgent and emergency care can all refer to pharmacists for those particular common conditions.

I join others in welcoming the new scheme. Will my right hon. Friend ensure, as part of the communications, that the NHS website is updated to show which pharmacies have signed up to Pharmacy First, and will she continue to encourage those that have not yet signed up to do so?

What is brilliant is that over 95% of all community pharmacies have signed up, including 172 in my hon. Friend’s area.

Key to the service’s success will be pharmacies actually offering it when patients turn up. Does my right hon. Friend know how many individual pharmacists have been trained to provide the services, and is there a way of gathering and publishing data on when pharmacies will offer the service, so that patients will not have a frustrated journey and we can see where the gaps are?

As I say, more than 95% of all community pharmacies have signed up to the service, and all their pharmacists have been trained in how to deliver it.

As someone who has championed the role of community pharmacies throughout my time in this House, I warmly welcome today’s statement. I am particularly delighted that we were able to host one of the pilot schemes in Cornwall, which was hugely successful, resulting in 7,500 consultations that took 6,000 appointments away from GPs and 75 A&E appearances. Will the Minister join me in thanking all the pharmacies in Cornwall that took part in that pilot, which was so successful?

Absolutely. It is only by trying these things that we can see how successful they can be, and I do believe this service is going to radically improve patient access to care.