The National Pharmacy Association has advised its 6,000 member pharmacies in England to work to rule, reducing opening hours and services from 1 April, if sufficient funding is not delivered by the government.

The NPA said the move – the first in its 104-year history – is to protect patients in the absence of a financial settlement that covers a swathe of new costs affecting pharmacies from the start of next month.

It said increases to employers’ national insurance contributions, the national living wage and business rates, on top of a decade of real-terms cuts, could jeopardise patient safety if a resolution is not found.

The government said the move would create “unnecessary disruption for patients” and that it is working on a settlement with pharmacies. A spokesperson for the Department for Health and Social Care urged the NPA to reconsider.

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Around 90% of pharmacies’ work is funded by the NHS, but they are yet to receive any confirmation of funding for 2024-25 or 2025-26 financial years that might allow them to avoid service reductions.

The NPA said pharmacies have seen around a 40% real-terms cut to funding since 2017, causing many to close, with around 1,300 pharmacies shutting since 2017.

NPA chair Nick Kaye said: “We are advising our members to reduce their pharmacy opening hours or take other steps to limit costs in the short term, in order to safeguard patient services for the long term.

“This is not a step any one of us wants to take, but we have been left with little choice because in just two weeks’ time new business costs will be hitting local NHS pharmacies across the country.

“It is better that we temporarily reduce access in the short term than to let pharmacies collapse altogether under the weight of unsustainable operating costs.”

The NPA has recommended its members give notice of reducing opening hours or other services, which could involve fewer pharmacies opening during the evening and at weekends, limiting home deliveries, and withdrawing from locally commissioned schemes like addiction support.

Safety is the top priority for every pharmacy so it is for each pharmacy to determine what action they can safely take and give patients and local NHS boards notice of any changes to ensure continuity of care. Pharmacies need to give the NHS five weeks’ notice of a change in hours.

Kaye added: “Pharmacies have shut in record numbers and those that are left are hanging on by their fingernails waiting for the delivery of a financial settlement that protects services on which millions of people rely.

“We hope that an offer from the government emerges by 1 April to cover the additional costs which pharmacies will face and start to plug the huge gap in funding created by 10 years of real-terms cuts.

“If pharmacies do not get adequate funding, then patients risk losing access to their local pharmacy altogether, threatening their access to vital medicines and health services.”

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