Championing community concerns to restore access to pharmacy care
At a time when the Pharmacy First Scheme is being pushed as an alternative pathway to care to relieve pressure on GP services, the closure of two Boots pharmacies in Hampton left a critical gap in care services for residents.
This case mirrors a nationwide trend. Last year, the National Pharmacy Association warned of "skyrocketing" levels of pharmacy closures. Our research found that 436 pharmacies closed permanently in England last year (2024), with 46,823 hours lost due to temporary pharmacy closures.
Championing people's voices
Community pharmacies are widely used in England, with 72% of people telling us they've used one in the past three months because they value the ease of access and speed of service they provide.
When Boots decided to close two pharmacies in Hampton, an area of relative deprivation poorly served by public transport in late 2023, over nine thousand residents were left without adequate access to a pharmacy.
Concerned by what these closures meant for their healthcare, residents in Hampton spoke to their Councillors, health and social care professionals, and their local Healthwatch, Healthwatch Richmond.
Healthwatch Richmond responded to these concerns by undertaking a rapid review of the closures' impact, visiting pharmacies in neighbouring areas, and hearing from 700 residents and patients about their experiences.
The impact of closures
One of the closed pharmacies was close to Gill's home, making it even more convenient and accessible.
"I can't walk very well, but I could always get there though as it was just across the road from my house." - Gill, Richmond resident
Gill explained that the pharmacy seemed to close without any notice to residents. This may be because while Boots informed NHS England (NHSE) they intended to close two branches in Hampton, NHSE failed to pass this information on to local NHS leaders or council.
"I find the current situation of chemist loss in Hampton quite difficult to cope with. It is totally frustrating and a most difficult situation." - Gill, Richmond resident
With residents pushed towards neighbouring pharmacies, demand at one pharmacy increased from 26% before closures to 62% after the closures.
Around a third of residents reported having to queue outside of the remaining pharmacies, often in bad weather, because these pharmacies could not cope with the increased demand:
"I had to wait over an hour outside Boots Station Road in the cold in a queue with a sick child for an urgent prescription as only two people could fit into the small customer area" – Richmond resident
The queues at the pharmacies were compounded by long and inconvenient journeys, unmanageable pressure on staff, issues with medication availability and errors in prescriptions:
"The pharmacists got something wrong when trying to find prescriptions every time someone was served - including myself. People were sent away to try other chemists as they didn't have the medication in stock or on order." – Richmond resident
Advocating for access
Alongside publishing their review, Healthwatch Richmond worked with local councillors, MP Munira Wilson, the Health and Wellbeing Board, and the Local NHS to address the closures.
However progress in securing a new pharmacy in Hampton was slow, with the "impenetrable, bureaucratic processes surrounding new pharmacy license applications" presenting several significant challenges.
Based on evidence Healthwatch Richmond collected from residents and assurances they received from NHS England that no applications had been submitted, the Health and Wellbeing Board issued a notice stating that a new pharmacy was needed in the area..
While an application to open a new pharmacy had already been submitted by a provider, London's Market Entry Team rejected it some eight months later.
Healthwatch Richmond formally requested information from the Market Entry Team about how the application was handled and why it was rejected. The findings were shared with Munira Wilson, MP for Twickenham, and led her to describe, in Parliament, the process of applying for new pharmacy licenses as "perverse". She went on to say:
"It is also utterly unreasonable that timely applications to open pharmacies in response to multiple closures should be inherently prevented in this way. The delays in sharing information with the local health and wellbeing board and the delays in decision-making are unforgivable." - Munira Wilson, MP for Twickenham
Returning pharmacy care to Hampton
Finally, after a year of campaigning and feedback from over 700 residents, an application to open a new pharmacy in Hampton has been approved, and work is underway to open it in February 2025.
Approving a new pharmacy in Hampton is a significant victory for the local community and a powerful reminder of the importance of listening to people voices. It also highlights local Healthwatch's invaluable role in supporting their communities and advocating for everyone to have better access to healthcare services.
"It's brilliant news that this application has been approved, which is a key step towards opening new pharmacy services for Hampton residents. We fully support the need for local pharmacy services and understand the frustrations with the process so far - we are working in partnership with NHS colleagues across London to make improvements." - Denise Madden, Deputy Executive Lead for Richmond at NHS South West London.
Healthwatch Richmond's work to secure a new pharmacy has highlighted that a complicated bureaucratic process and poor communication across services can leave communities without access to basic healthcare.
What happens next:
Healthwatch Richmond wants the issue of pharmacy commissioning addressed at a national level. We have called on the government and NHS England to look at the funding of fully integrated primary care, which includes pharmacy services.
As the new pharmacy is established, Healthwatch Richmond remains dedicated to improving access to healthcare and working with local partners to prevent similar delays in care.
"Our work does not stop here. The system for deciding pharmacy applications is unnecessarily bureaucratic and led to perverse decisions and ultimately avoidable and extensive delays for our residents." - Mike Derry, Chief Officer, Healthwatch Richmond
