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Cost pressures continue to threaten the provision of community pharmacy services in Wales, according to a survey revealing the financial position of two-thirds of owners who responded has worsened in the last 12 months.

The Community Pharmacy Pressure Survey 2026, which attracted 154 responses and is designed to gather evidence to support Community Pharmacy Wales’ funding talks with the Welsh Government, made for gloomy reading.

During the survey, run over four weeks, 63 per cent said their financial position had deteriorated, 28 per cent said it stayed the same and nine per cent said it improved.

Almost three in 10 said they had difficulty paying wholesaler bills, while 86 per cent said medicine purchase costs above reimbursement heavily impacted their pharmacy.

Other cost pressures cited by respondents were locum costs (36 per cent), utilities (38 per cent) and rent/rates (34 per cent).

“Contributing factors reported were reimbursement not matching medicine purchase costs, erratic fluctuations in NHS payments, reliance on overdrafts or savings, delayed payments to suppliers, and medicines being purchased above Drug Tariff prices,” said a report laying out the survey’s findings.

Forced to reduce staff to keep the business open

The report also starkly highlighted the impact rising costs were having on pharmacies. Nearly half of owners said they were forced to reduce staff to keep the business open and 38 per cent reduced or stopped taking a salary.

“This suggests many pharmacies are relying on personal and operational sacrifices to remain open,” the report said, revealing owners are reducing staffing and services, using personal savings, borrowing money and delaying supplier payments to stay viable.

Some owners also stopped nationally and locally commissioned services and free prescription deliveries. Thirty-one per cent said they introduced charges for deliveries and 29 per cent did so for monitored dosage systems. Just over half of respondents increased their private services in the last year.

The report said “many businesses have relied on borrowing or grants” to make improvements to their pharmacies or invest in “services, facilities, or processes” to create more capacity.

Thirty per cent said they relied on grant funding to do this and 26 per cent took out loans or used external financing. “Much of the extra capacity created rests on funding that is time-limited or must be repaid,” the report noted. 

The 55 respondents who said they were experiencing staffing shortages cited increased staff sickness, recruitment difficulties and the loss of staff to other sectors as the main causes.

Workforce shortages directly affecting patient access

The report warned workforce shortages were “directly affecting patient access, increasing waiting times and limiting service delivery”.

Ninety-three per cent of affected pharmacies reported longer waiting times, 71 per cent a “reduced ability to offer services” and 32 per cent saw “more errors or near misses”.

Nearly 90 per cent of respondents reported an increase in verbal abuse, aggression or “challenging behaviour” from patients reacting to reduced service delivery.

Just 10 per cent of respondents said they were “coping well” with those situations, 30 per cent were “barely coping”, eight per cent were “not coping” and 52 per cent were “managing”.

When asked if they regularly work unpaid hours outside contracted hours each week, 29 per cent said they worked 20-plus hours, 23 per cent worked one to five hours and 19 per cent worked six to 10 hours.

Nearly half – 49 per cent – said they were not confident their pharmacy will be financially viable in the next 12 months. Only eight per cent were very confident. 

Ninety-per cent said they did not believe the current funding model in Wales “reflects the true cost of delivering services” and only three per cent thought it did.

Eighty-eight per cent wanted improved reimbursement, 60 per cent called for reduced administrative burden and 40 per cent said there was not enough support for staff training and development. Forty-per cent called for more funding to improve premises.

Four per cent said they were considering closing permanently in the next year because of “sustainability challenges”.

“Confidence in financial viability is low, with very few respondents expressing strong confidence in the future,” the report said.