Scores of local pharmacies closing across England
The number of pharmacies in England has fallen by 160 over the last two years, BBC analysis shows.
There are now 11,026 community chemists, according to data from NHS Business Services Authority - the lowest number since 2015.
Rising operational costs, staff shortages and reduced government financial support have been blamed.
This is despite rising patient demand, and plans for pharmacists to provide more services to ease pressure on GPs.
Pharmacists are warning that many more local businesses could close, without help.
Online services are available, but many rely on a local chemist for advice and to pick up prescriptions.
On Tuesday, the government will publish a primary care access plan designed to improve and extend availability of consultations by GPs. Ministers have also announced £240m ($303m) for practices to replace old phones with more modern call systems and online tools to make it easier for patients to get in contact.
Part of the primary care plan is expected to include an expanded role for pharmacists, but there are concerns about their feasibility.
Many pharmacists feel they have been taken for granted and expected to offer more services, even though their real-terms funding has fallen. They estimate there has been a 30% cut in government funding over the last seven years, after taking account of inflation.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, said there was a shortfall of £1.1bn in funding for independent pharmacies every year.
"This has led to many pharmacies severely struggling with cashflow problems," she told BBC Radio 4's Today programme, adding that because most of their work is NHS-funded, the pharmacies cannot pass on rising costs to customers.
"On top of that, we've got the workforce challenges that we have been struggling with for so many years," she said, warning "many more" pharmacies could close this year unless increased support was given.
"We are urgently needing the government to step in and provide that funding," she said.
Sanjeev Panesar owns Pan Pharmacy in Birmingham. The business was set up by his parents, and has just celebrated its 40th anniversary, but he fears services might have to be cut back, and staff numbers may also have to be reviewed.
"Things are in serious jeopardy. It's our worst year ever, where we've made a loss. We have to make some really tough calls and decisions now," he said.
Mr Panesar says he would love to support the government by helping the NHS and GP services, but said it is not possible with current financial constraints.
The workload has grown steadily, with more patients, some frustrated over lack of GP access, coming in for consultations and advice. That comes on top of the core function of dispensing medicines and treatments, while there is increasing demand for home delivery of medication.
Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee, hopes the new plan will address long-standing problems in the sector.
"What everyone learnt during the pandemic was one of the two places that will stay open was the pharmacy - lots more people come in for advice and support that we're not paid to provide. What we've been saying to ministers is we're part of the solution because we can provide access."
Scotland scheme 'more patient-focused'
Pharmacists in England look to Scotland, where a scheme called Pharmacy First includes a contract between the sector and the Scottish government setting out what services are expected, with payment for every consultation.
These cover minor ailments and illnesses, some of which might once have been dealt with at GP practices. In England there is a less formal arrangement, with some consultations by pharmacists not remunerated. There is also more prescribing of medicines by pharmacists in Scotland.
George Romanes, who owns a chain of local pharmacies in the Scottish borders, believes the new structure works better than the arrangements south of the border.
"I used to have an English pharmacy but I sold it, and all the outlets we have now are in Scotland. I think the Scottish contract is much more patient-focused," he said.
"The fact you can come in and see a pharmacist there and then as it were, rather than needing an appointment, is very beneficial for patients, they like to get a problem sorted as quick as they can."
A Department of Health and Social Care spokesperson said an extra £100m was invested in the sector last September.
"We are supporting pharmacies to provide a range of clinical services and we are increasing the services pharmacists - who are degree-qualified medical health professionals - can provide to their community, including managing oral contraception," they said.
Mr Panesar called for political leaders, including Prime Minister Rishi Sunak, whose mother ran a pharmacy, to visit local pharmacies to see first-hand the pressures they face.
"I'd love him to come and see what we do, how patients feel about what we offer and actually, that this is serious, and that the sector is crumbling, and is going to fall down like a stack of dominoes, if there's not intervention urgently."
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