Health

Welsh pharmacies forced to sell medicines at a loss as funding model buckles

Published

2 months ago

February 12, 2026

COMMUNITY pharmacies across Wales are being forced to sell some medicines at a loss because of an outdated NHS funding system that no longer reflects real-world costs, owners have warned.

Under current rules, pharmacists must dispense prescriptions at prices set nationally, even when those prices are lower than what they paid wholesalers — leaving them out of pocket on everyday items such as aspirin.

The situation has led to mounting debts, emergency loans and, in some cases, owners remortgaging their homes simply to keep their doors open.

Figures from the National Pharmacy Association suggest four in ten Welsh pharmacies were not profitable last year, with many described as “clinging on by their fingertips”.

Selling at a loss

Unlike normal retailers, pharmacies cannot set their own prices or refuse to stock products.

They are contracted to the NHS through the Welsh Government’s Community Pharmacy Contractual Framework, which fixes reimbursement rates for prescription medicines.

But wholesalers’ prices have risen sharply due to inflation, supply shortages and higher manufacturing costs.

That means the maths often no longer adds up.

In one example shared by pharmacists, a packet of 75mg aspirin costs £3.75 to buy but is reimbursed at just £3.05 — a loss of 70p each time it is dispensed.

Multiply that across hundreds of packs a month and dozens of other medicines, and small losses quickly turn into thousands of pounds.

One west Wales pharmacy owner told The Herald: “You wouldn’t run a corner shop selling bread for less than you paid for it. But that’s effectively what we’re told to do every day.”

‘Averaging out’ no longer works

The government’s model assumes that losses on some drugs will be balanced by profits on others.

But pharmacists say that system — once workable — has broken down.

Generic medicines that previously provided modest margins are now also rising in price, while reimbursement rates lag weeks or months behind market costs.

At the same time, running costs have surged.

Energy bills, staff wages, National Insurance contributions, fuel for deliveries and regulatory costs have all increased, while core NHS funding has remained largely flat in real terms for nearly a decade.

Owners say they are now busier than ever too, as GP surgeries redirect patients to pharmacies for minor ailments, vaccinations and clinical advice — work that takes time and staff but often brings little additional income.

Debt and closures

The result is growing financial pressure.

Some pharmacists report taking out short-term loans just to cover monthly payroll, while others have dipped into pensions or personal savings.

Across the UK, hundreds of community pharmacies have closed in recent years, with rural and small-town chemists particularly vulnerable.

Health campaigners warn that if closures continue, patients could lose easy access to prescriptions, advice and walk-in care — pushing more pressure back onto already stretched GP practices and hospitals.

David Thomas, Welsh Board member for the National Pharmacy Association said: “These shocking findings should sound major alarm bells to the Welsh government and will understandably cause concern to patients who depend on their local pharmacy.

“It is simply unsustainable and unfair to expect individual pharmacy owners to remortgage their house and dip into their pension pot to subsidise the cost of prescriptions and to keep their doors open for their patients.

“Pharmacies are hanging on by their fingertips and something has to change. Without urgent action, the government risks pharmacies closing for good and their New Prescription Service going up in smoke.

“To prevent this from happening, the government should step in and offer pharmacies a stabilisation payment, similar to recently offered to GP colleagues.

“Only through stabilisation and long term investment can pharmacies deliver the expansion in services for patients and take pressure away from others in the NHS.”

Russell Goodway, Chief Executive at Community Pharmacy Wales, the organisation representing all community pharmacy owners in Wales, said:
“The findings of this poll closely mirror our own evidence and reinforce the very real financial pressures currently facing community pharmacies across Wales, regardless of size or ownership model.

“Community Pharmacy Wales has been in ongoing dialogue with the Welsh Government Cabinet Secretary for Health and Social Care since before Christmas, seeking to secure a recurring stabilisation payment. Such support is essential to prevent further deterioration and to safeguard the sustainability of the sector. We will continue to make a strong and evidence-based case for the additional resources that are urgently needed.”

Government response

The Welsh Government says it recognises pharmacies are an essential part of primary care and points to increased investment, including additional stability payments and grants for premises improvements.

A spokesperson said reimbursement prices are set using supplier data and that “while some medicines may be reimbursed below cost on occasions, this is offset by the profits pharmacies make on most of the medicines they dispense”.

But pharmacists argue that assumption no longer reflects reality.

A simple question

At the heart of the row is a basic principle.

If the NHS commissions a service, pharmacists say, it should at least cover the cost of providing it.

As one owner put it: “No business can survive by selling stock at a loss and hoping it balances out. Eventually the numbers catch up with you.”

Unless the funding formula changes, many fear more local chemists could disappear from Welsh high streets — and with them one of the most accessible parts of the health service.

Photo caption: Community pharmacies say fixed NHS prices are forcing them to dispense some medicines below cost (Pic: stock).

Health

Patients face higher costs and fewer appointments as NHS dental reforms begin

Published

5 hours ago

April 1, 2026

Tom Sinclair

PATIENTS across Wales are being warned to expect higher charges and longer waits for appointments as sweeping changes to NHS dentistry come into force today (Tuesday, Apr 1).

The reforms — described by the British Dental Association (BDA) as “untested” — are expected to reshape how dental care is delivered, but critics fear they could deepen the already serious access crisis.

Dentists say the changes will mean many patients are seen less often, while some treatments will become more expensive at a time when households are already under pressure from rising living costs.

Under the new system, routine check-ups for new patients will rise from £20 to £27.21 — an increase of more than a third — while urgent appointments will increase from £30 to £37.50.

At the same time, recall periods for patients considered to be in good oral health could stretch to 18 or even 24 months, raising concerns that problems may go undetected for longer.

The BDA has warned that the reforms could accelerate the loss of NHS dental services, with some practices already handing back their contracts. In certain areas, more than ten per cent of NHS dental capacity has reportedly been returned by practices unwilling or unable to continue under current conditions.

That loss of capacity is likely to put further strain on remaining services, making it even harder for patients to secure appointments.

Russell Gidney, Chair of the BDA’s Welsh General Dental Practice Committee, said: “From today, many patients across Wales will have to get used to more costly, less frequent dental care.

“But the risk all now face is that utterly untested reforms will push more practices out of the NHS, taking the access crisis from bad to worse.”

The changes come at a politically sensitive time, with the Senedd election scheduled for Thursday (May 7), and mounting pressure on ministers to address long-standing problems in NHS dentistry.

Access to NHS dental care has been a growing concern in recent years, with many patients across west Wales struggling to find a dentist taking on new NHS patients.

The BDA says the reforms have been introduced without sufficient consultation and has called for a pause on full implementation until 2027, alongside a wider rescue package to stabilise the service.

It is also urging the next Welsh Government to commit to increased funding, better protection for vulnerable patients, and a reset in relations with the profession.

The Herald understands that concerns are also being raised locally about whether practices in Pembrokeshire and Carmarthenshire will be able to maintain NHS provision under the new system.

With demand already outstripping supply, there are fears that more patients could be forced to turn to private care — or go without treatment altogether.

Health

Davies and Kurtz accuse Welsh Government of ‘passing the buck’ over Hywel Dda plans

Published

2 days ago

March 30, 2026

Tom Sinclair

Concerns grow over Withybush services as ministers insist decisions rest with health board

THE WELSH GOVERNMENT has been accused of “ducking responsibility” and “hiding behind an unelected health board” amid growing concern over proposed NHS service changes in west Wales.

Samuel Kurtz MS and Paul Davies MS have criticised ministers following a formal response to their joint letter raising alarm about plans linked to Hywel Dda University Health Board’s Clinical Services Plan (CSP), which was approved at an extraordinary meeting in February.

The plan outlines significant changes to how services are delivered across the region, with implementation expected to begin in the next Senedd term and continue over several years.

In a reply dated March 26, Cabinet Secretary for Health and Social Care Jeremy Miles confirmed that responsibility for planning and delivering NHS services lies with local health boards, adding that decisions on the CSP “rest with the health board.”

He also sought to reassure concerns about Withybush Hospital, stating that emergency department services were not included in the CSP decision.

However, the response has drawn sharp criticism from local politicians, who argue that the Welsh Government cannot distance itself from decisions affecting frontline care.

Paul Davies said: “This response is deeply disappointing but sadly not surprising. The Welsh Government is once again trying to pass the buck and avoid accountability by hiding behind an unelected health board.

“Let’s be absolutely clear – health boards are not independent actors. They are created, funded and directed by the Welsh Government. Ministers cannot wash their hands of decisions that will have such a profound impact on communities across west Wales.”

Samuel Kurtz echoed those concerns, warning that public confidence is being eroded.

“People in Pembrokeshire are rightly concerned about what these changes mean for local services, particularly at Withybush Hospital,” he said.

“Attempting to suggest that key services like the emergency department sit outside of these plans will do little to reassure the public, when we have seen services hollowed out and destabilised over the last decade.

“The Welsh Government must stop hiding behind process and start taking responsibility for the future of healthcare in our communities.”

The Herald understands that concerns remain widespread among residents and campaigners, particularly over the long-term future of hospital services in Pembrokeshire, with fears that centralisation could lead to longer travel times for urgent care.

Hywel Dda University Health Board has previously said the changes are designed to improve safety, sustainability and outcomes for patients, but the proposals continue to generate strong local opposition.

Health

Mental health referrals shake-up as 111 service rolled out across west Wales

Published

6 days ago

March 26, 2026

Tom Sinclair

Concerns raised over phone-based support replacing GP referrals

ADULTS seeking routine mental health support in west Wales will increasingly be directed to a telephone helpline instead of face-to-face services, following a major decision by Hywel Dda University Health Board.

The Health Board has approved a permanent change to how patients in Ceredigion access support, with plans to roll out the same system across Pembrokeshire and Carmarthenshire in phases.

Under the new pathway, patients assessed by their GP as needing non-urgent mental health support will be told to contact the NHS 111 Wales “Press 2” service, rather than being referred to community mental health teams.

The change was first introduced in Ceredigion in March 2025 as an emergency response to staff shortages.

Health chiefs now say the model has proven “safe and effective,” claiming it allows patients to receive quicker support while freeing up specialist teams to deal with more serious cases.

Liz Carroll, the Health Board’s Service Director for Mental Health and Learning Disabilities, said: “Making this change permanent will mean more adults needing non-urgent support will access help much quicker.”

She added that the move would also create capacity for those with “more complex or urgent mental health needs.”

Concerns over access and understanding

Despite the positive assessment, the decision follows a nine-week consultation in which concerns were raised by patients and professionals.

Feedback highlighted confusion about how the 111 Press 2 service works, what support it can offer, and its limitations.

There were also worries about accessibility for people who struggle with telephone-based services, as well as questions around medication and prescribing.

Andrew Carruthers, Chief Operating Officer at the Health Board, acknowledged the concerns.

He said: “People told us they wanted greater clarity and consistency… and highlighted gaps in understanding about 111 Press 2.”

He added that steps would be taken to improve awareness and build trust as the system is rolled out more widely.

Shift driven by pressure on services

Before the change, some patients in Ceredigion faced waits of up to 28 days or more for a face-to-face assessment.

However, data suggested that fewer than five per cent of those referred required that level of specialist input.

Health officials say diverting less urgent cases to the 111 service has improved access times and allowed community mental health teams to prioritise higher-risk patients.

The Health Board also confirmed there has been no increase in serious incidents or complaints linked to the temporary system.

What it means for Pembrokeshire

The phased rollout means patients in Pembrokeshire will soon see similar changes when seeking help for non-urgent mental health issues.

GPs will still be able to refer patients directly to specialist teams where cases are urgent or complex.

The NHS 111 Wales Press 2 service operates 24 hours a day and offers free access to mental health support, including Welsh-language provision.

However, the shift marks a significant move away from traditional GP-led referrals — and is likely to prompt debate over whether remote access can fully replace in-person care.