Key findings

• There were 11,800 active community pharmacies and 112 active appliance contractors during 2019/20. 239 new pharmacies opened during 2019/20, while 405 closed. This is the lowest number of active contractors since 2015/16.

• 1,046 million prescription items were dispensed by community pharmacies and appliance contractors in 2019/20. This is the highest level of dispensing in the previous 5 years, an 4.22% increase in items dispensed since 2015/16.

• 808 million prescription items were dispensed via the Electronic Prescription Service (EPS) in 2019/20, 77.3% of all items dispensed in the year by community pharmacies and appliance contractors. This is an increase of 41.9 percentage points from 2015/16.

• The cost of drugs and appliances reimbursed to community pharmacies and appliance contractors totalled £8,649 million in 2019/20. This was an increase of 5.10% from £8,229 million in 2018/19 following four consecutive years of decreases from the five year high of £8,664 million in 2015/16.

• 1.72 million seasonal influenza vaccines were administered by community pharmacies in 2019/20. This was 2.89 times more than the 595 thousand vaccines in 2015/16.

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1. Introduction

Community pharmacies and appliance contractors are responsible for dispensing medications, appliances, and medical devices to NHS patients. They are not a direct part of the NHS but provide essential services on behalf of the NHS to the general public.

This publication aims to describe the essential and advanced services that community pharmacies and appliance contractors provide, along with some of their associated costs.

These statistics cover the financial years between April 2015 and March 2020. Due to this, the effects of the novel coronavirus (COVID-19) on dispensing contractor activity has not been explored. The end point of this release is too close to the start of the pandemic and the implementation of lockdown restrictions being announced by the UK government on 23 March 2020 to make sound conclusions on their impact.

Throughout this publication the term ‘item’, short for ‘prescription item’, refers to a single instance of a drug that is listed as a separate entry on a prescription form. For example, Paracetamol 500mg tablets x28 would be listed as one item, as would Ibuprofen 200mg tablets x56.

There are many costs incurred when a dispensing contractor fulfils a prescription. The term cost refers to the basic price of the item and quantity prescribed that is reimbursed back to the contractor. This is sometimes called the ‘Net Ingredient Cost’ (NIC).

Fees are also payable to dispensing contractors for providing essential and advanced services to NHS patients. Many, but not all fees are described in these summary statistics alongside their accompanying summary tables. Details of what fees are payable to community pharmacies and appliance contractors can be found in the Drug Tariff for England and Wales.

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2. Results and commentary

The charts in these statistics are interactive and allow you to isolate the topics that you are interested in by selecting or deselecting a series from the legend of the chart. For example, if you only want to view data for community pharmacies, you can click the other categories in the legend of the chart to deselect them. If you wish to include them again just click on their legend entry once more.

Source: Summary Tables - General Pharmaceutical Services - Table 1

The number of community pharmacies and appliance contractors in England has remained fairly consistent for the past five years. However, the number of active community pharmacies in 2019/20 is the lowest it has been in the previous five years. This follows two consecutive years of decreases, with the number of community pharmacies decreasing by 1.22% between 2017/18 and 2019/20.

The number of appliance contractors in England changed in 2019/20 for the first time since 2016/17, increasing by one.

Source: Summary Tables - General Pharmaceutical Services - Table 1

The number of items dispensed by community pharmacies in England has increased by 4.07% since 2015/16. This follows a period between 2016/17 and 2018/19 where the number of items dispensed by pharmacies remained stable, between 1,013 million and 1,016 million items a year.

The number of items dispensed by appliance contractors has increased each year since 2015/16, from 7.91 million to 9.79 million items. This is an increase of 23.7%.

Source: Summary Tables - General Pharmaceutical Services - Table 1

The yearly average number of items dispensed per contractor has been calculated by dividing the total number of items dispensed by the total number of contractors. This average is a mean.

Due to the lowest number of community pharmacies and highest number of items dispensed since 2015/16, the average number of items dispensed per pharmacy for 2019/20 is the highest of the previous five years at 87,600. This is a 5.15% increase from 2015/16.

The average yearly items dispensed for appliance contractors has increased each year since 2015/16, and now nearly matches the average items dispensed for community pharmacies, at 87,400 in 2019/20. This is a 28.1% increase from 2015/16.

Source: Summary Tables - General Pharmaceutical Services - Table 1

An NHS prescription can be fulfilled by either a paper form presented to a contractor by a patient, or by the Electronic Prescription Service (EPS). Since 2015/16 the proportion of prescription items that have been dispensed via EPS by community pharmacies and appliance contractors has increased dramatically, and EPS is now the primary mechanism that prescriptions are issued and dispensed by.

In 2015/16, 355 million prescription items were dispensed via EPS, which was just 35.4% of all items in the year. In 2019/20, 808 million prescription items were dispensed via EPS by community pharmacies and appliance contractors, which was 77.3% of all items in the year. This is an increase of 41.9 percentage points between 2015/16 and 2019/20.

Additionally in 2019/20, 99.4% of all contractors dispensed at least one prescription item via EPS, an increase from 97.5% in 2015/16.

Source: Summary Tables - General Pharmaceutical Services - Table 1

Contractors can receive many payments for fulfilling a prescription. These include being reimbursed for the basic price of the drug or appliance they have dispensed and receiving fees that relate to the dispensing of that item. There are many fees that can be claimed by a contractor depending on the item that is dispensed, details of what fees are payable to community pharmacies and appliance contractors can be found in the Drug Tariff for England and Wales.

The ‘single activity fee’ (SAF) is a fixed fee that applies to every prescription item that is dispensed. The SAF was introduced in December 2016 by the Department of Health and Social Care (DHSC) to consolidate a range of payments into one single fee. These payments were:

• The professional fee (also known as dispensing fee)
• Practice payment
• Repeat dispensing payment
• EPS monthly allowance

The value of the SAF is set by DHSC and can fluctuate throughout the year. It is based upon the forecast of the total number of items dispensed to ensure that the fee delivery remains within the agreed funding envelope for the year. Table 1 displays the value of the SAF and the dates that it has changed.

Table 1: Dispensing fees, their value, and when they came into effect

Source: The Drug Tariff for England and Wales

Figure 5 shows the total value of costs for drugs and appliances reimbursed to contractors, along with the value of all SAFs that have been claimed. This is not the total amount paid to contractors for dispensing an item as many fees are not included in these figures, such as additional fees that apply to controlled drugs. NHSBSA plans to include figures on all fees and payments that a contractor receives in future releases of this publication.

Costs reimbursed to contractors increased in 2019/20 after four consecutive years of reductions from 2015/16 to 2018/19. Costs increased by 5.10% between 2018/19 and 2019/20 from £8,229 million to £8,649 million. This is still lower than the five year high of £8,664 million in 2015/16.

The value of SAFs received by contractors has increased each year since 2015/16 from £920 million to £1,345 million, an increase of 46.1%. This has been driven by increases in the amount received for each SAF, from 90p in April 2015 to 127p in March 2020. Please note, prior to December 2016 the figures reported are for professional fees only, and do not include the three additional payments that the SAF consists of.

3. About these statistics

The General Pharmaceutical Services publication (GPhS) is a National Statistic release. National Statistics Status means that GPhS meets the highest standards of trustworthiness, quality, public value, and complies with all aspects of the Code of Practice for Statistics.

The designation of this publication as a National Statistic was confirmed in January 2012 following an assessment by the Office for Statistics Regulation (OSR). This release is currently subject to a further assessment by OSR which will begin in Spring 2021.

This publication is the first in a series by NHSBSA following a public consultation by NHS Digital.

Previous versions of this publication are, and will remain, available on the NHS Digital website. Users should always use the statistics in the latest publication to make sure they are the most up to date figures available.

Further information on the methodology used in this publication and more background information is available in the Background Information and Methodology supporting document that accompanies this release.

4. Statistical Disclosure Control

Statistical disclosure control has been applied to these statistics. Item and net ingredient cost have been redacted in the supporting summary tables if they are below five, or a patient count of less than five can be inferred from them. Further information about our statistical disclosure control protocol can be found on our website.

The high-level figures in this statistical summary have been rounded where appropriate for clarity, in most cases to three significant figures. This is to make this narrative as accessible as possible to all readers. The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.

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5. Accessibility

6. Revisions to this document

7. Feedback and contact us

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Responsible statistician: Matthew Wilson