However you like to define ‘independent pharmacies’ – some chains comprising several hundred branches describe themselves as such, while others reserve the term for smaller operators – they are now the dominant force in the market. 2023 was the year that LloydsPharmacy became extinct after years of struggle, while other corporates announced plans to downsize. Although independents face the same dire straits, all this churn has strengthened them collectively in market share terms.

That much can probably be agreed upon. But this being pharmacy, there is ample room for thorny debate about what it means. In particular, there is growing discontent in some quarters about how the 24 seats on the Community Pharmacy England committee are carved up among the separate operator groups. The rules state that half the seats must go to multiples, and Company Chemists’ Association (CCA) reps currently fill nine of them. 

But with the composition of the sector itself changing so rapidly, should these mandated seat allocations be reviewed? Is it fair that a shrinking segment should retain its veto? At present, it appears there will be no meaningful review before the next committee election in 2025 – but will that be too late?

These questions have been asked for some time, and tensions were inflamed in December by the news that the superintendent at distance selling behemoth Pharmacy2U has been nominated to the committee as a CCA representative. Pharmacy2U certainly has the reach of a CCA member in terms of scripts – and will be even more dominant with its acquisition of its closest competitor LloydsDirect – but it does look peculiar for a non-multiple to take this place on the negotiating committee.

Many have expressed reservations about having a DSP there in the first place; a recent AIMp survey of almost 400 contractors pointed to widespread discontent with the news – 90 per cent disagreed strongly. One argued that with its lower overheads, the DSP business model threatens the wider network’s dispensing fees.

The principle of holding regular reviews of the committee’s composition was voted through by a majority of contractors in the Wright Review Steering Group (RSG) exercise back in June 2022. And last September, the CPE committee voted overwhelmingly in favour of having these reviews at four-year intervals. (The original RSG proposals weren’t clear on this, but suggested a review might take place after one or two years).

These votes were conducted fairly and according to the rules, and the results should be respected. But I can’t help suspecting that CPE is reluctant to have this debate at all. It says that having to “continuously amend” the committee composition between election cycles “would be detrimental to both continuity and stability in governance, which are vital to cohesive leadership and accountability”.

However, CPE must acknowledge that the case for such a review is growing in strength. At the very least, we need clarity over whether it is prepared to have this conversation before the election or if it is planning to tie it into the 2025 vote – in which case, it might get to kick the can down the road for another four years.