Community pharmacies across England are under intense financial and operational pressure, and the latest Pharmacy Pressures Survey from Community Pharmacy England (CPE) confirms how serious the situation has become.
Despite a headline funding uplift for the Community Pharmacy Contractual Framework (CPCF), many contractors are struggling to stay viable while maintaining safe, high‑quality care for patients.

Headline findings: most pharmacies are losing money

The 2026 Pharmacy Pressures Survey gathered responses from more than 2,900 pharmacy owners and around 900 pharmacy team members across England, giving a robust picture of what is happening on the ground.
According to the survey, 75% of community pharmacies are currently losing money and only 14% report being profitable, highlighting a widespread sustainability crisis in the sector.

The survey and subsequent analysis also found:

• Around 99% of respondents said NHS reimbursement prices do not cover the cost of medicines, meaning many items are dispensed at a loss.
• Rising staffing costs were reported as a key pressure by roughly 95% of respondents, reflecting real‑world inflation in wages and employment costs.
• A significant minority of owners have had to take drastic measures, with about one‑quarter (25%) reporting that they took no salary or income in the past year.

These findings are being used by CPE to brief MPs and the national media, underlining that the current funding and reimbursement arrangements are not sustainable for a large portion of the network.cpe.org+3

Operational impact: reduced hours, fewer services and staff pressure

Financial pressure is translating directly into operational changes that patients can see and feel.
Survey data and follow‑up commentary show that many pharmacies have reduced opening hours and scaled back some services in an effort to cope with cost pressures and workload.

Examples highlighted include:

• A substantial proportion of pharmacies reducing their opening hours over the past year, with more planning further reductions.
• Some pharmacies reporting they have had to stop or limit services such as vaccinations and Pharmacy First due to staffing and financial constraints.
• Reports of redundancies and difficulty replacing staff, compounding pressure on remaining team members.

For pharmacy teams, the cumulative effect is long, demanding days, worry about job security and increasing stress as they try to balance patient care with growing administrative and procurement burdens.

Daily medicine shortages: patients feeling the impact

Medicine shortages are no longer an occasional inconvenience; they have become a daily reality for many pharmacies and their patients.
The survey findings show that medicine supply problems are now one of the most significant drivers of pressure in community pharmacy.

Key points from the survey and commentary include:

• 86–88% of pharmacies report spending more time sourcing medicines than in previous years, with teams routinely contacting multiple suppliers and searching for alternatives.
• Many pharmacy team members say patients are making repeat visits to multiple pharmacies to obtain medicines or seek advice, increasing frustration and anxiety.
• A large majority of respondents report direct impacts on patient care, including longer waits, delays to treatment and reduced responsiveness due to time diverted to procurement.

Pharmacists and their teams are often left in the difficult position of spending extra time trying to source medicines, then dispensing at a loss once stock is found, which is clearly unsustainable in the long term.

Funding uplift: 10.3% rise, but is it enough?

Against this backdrop, Government and NHS England have agreed a funding uplift for the Community Pharmacy Contractual Framework (CPCF) for 2026/27.
The settlement will see the community pharmacy funding budget increased by 10.3% for this financial year, taking total CPCF funding to £3.636 billion, an increase of £340 million compared to 2025/26.

This new deal is linked to an expanded role for community pharmacy, including greater involvement in clinical services and independent prescribing under a £340m NHS agreement.
While the uplift is welcome and higher than the overall NHS increase, CPE’s analysis and sector commentary suggest it may still fall short of what is needed to fully address years of under‑funding, inflationary costs and structural reimbursement issues.

For contractors, the key question is whether this settlement will be enough to stabilise finances once growing workloads, Pharmacy First activity, clinical services and prescribing are fully factored in.cpe.

What this means for community pharmacy owners

Taken together, the survey results and funding changes send a clear message: community pharmacies are being asked to do more for patients and the NHS, while still operating under significant financial and operational strain.
CPE has described the findings as a “clear warning to Government” about the risk of further pharmacy closures, particularly in areas with high health need, where loss of a local pharmacy can worsen health inequalities.

For pharmacy owners and superintendents, some of the practical implications include:

• A need for close monitoring of cash flow, wholesaler bills and reimbursement trends to avoid sudden financial shocks.pharmaceutical-journal+1
• Careful decisions about opening hours and service mix that balance sustainability with access for patients and contractual obligations.
• Recognition that team wellbeing and mental health are under pressure, requiring conscious support and realistic workload planning.cpe.

At the same time, there are opportunities to strengthen the business by optimising the mix of NHS and private services, investing in team skills, and tightening governance to make inspections and audits smoother.cpe.org+2

Practical steps: governance, services and staff training

While systemic change on funding and reimbursement will depend on national negotiations, there are practical steps individual pharmacies can take to improve resilience.

1. Strengthen governance and inspection readiness

Robust governance and clear SOPs make it easier to manage pressures safely and demonstrate to the GPhC and NHS that your team is in control.
Ensuring staff understand key principles of GPhC inspection, incident reporting, risk management and documentation can reduce the stress of inspections and support safer day‑to‑day practice.

Linking this back to training, structured courses on GPhC inspection & governance, clinical governance and patient safety can help your team standardise processes even when workload is high.

2. Optimise your services and “Pharmacy First” offer

With Pharmacy First, hypertension case‑finding, flu vaccination and other national services now embedded in the CPCF, pharmacies that actively plan their service mix may be better placed to generate sustainable income.
Focusing on services that match local demand, are operationally achievable with your current staffing and can be delivered efficiently is key to making the most of the new funding environment.cpe.

Training staff in consultation skills, clinical assessment for common conditions and service‑specific protocols (e.g. hypertension case‑finding, antimicrobial stewardship) can build confidence and consistency across the team.

3. Invest in staff skills and role clarity

In a pressured environment, well‑trained teams with clear roles and responsibilities can work more efficiently and handle complexity better.cpe.org+2
Ensuring pharmacy technicians, dispensers and pharmacists have access to structured learning on governance, services and clinical topics helps spread expertise and reduce dependency on a small number of individuals.

Platforms like academy.pharmacys.org, which focus on UK‑specific GPhC inspection readiness, NHS & clinical services and medicines safety, can support pharmacies in building an audit‑ready training plan without having to design all content from scratch.

Using the survey as a conversation starter with stakeholders

CPE is actively encouraging pharmacy owners to use the survey findings in conversations with MPs, local health leaders and the media to raise awareness of the pressures on community pharmacy.
Sharing your local experience, backed up by national data showing that most pharmacies are loss‑making and facing daily medicine shortages, can help reinforce the case for a sustainable future for the sector.

Locally, you can also use the findings as a framework for discussions within your team and with other contractors, focusing on:

• Where your pharmacy’s experience matches or differs from the national picture.
• Which pressures are within your control and which require system‑level change.
• Joint opportunities for collaboration, such as shared service promotion or training initiatives.