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The system for pharmacy contract applications is bogged down in procedural inertia – but does Stephen Kinnock need to get involved in individual cases? Outsider muses

Pharmacy minister Stephen Kinnock has suggested he might look into the decision to decline, and then uphold on appeal, the rejection of an application for a new community pharmacy contract in Lee-on-Solent. It is, on the surface, very much a First World Problem, and certainly a small local matter. 

Yet the minister’s intimations of intervention raise questions about the boundaries between political oversight and independent regulatory processes, and those processes themselves.

The NHS is navigating multiple pressures. Supply chains are tight, and the buying power of the service appears stretched; even commonplace medicines like aspirin now appear to be a precious commodity. Meanwhile, community pharmacy sits in a quiet inertia, observing but rarely shaping the broader landscape.  

Integrated care boards (ICBs) are facing headcount reductions and the existentialisms associated with such, and the wider primary care environment teeters under competing demands. Against this backdrop, is the scrutiny of one contract appeal truly where ministerial attention is best spent? Or is it a symbolic signalling gesture as opposed to meaningful leadership?

Lee-on-Solent could be an instructive case. Though small, the town has over 3,000 residents aged 65 and over, markedly above the average number of older adults per pharmacy across England. 

By conventional measures, this is a population deserving closer attention. Yet the regulations guiding pharmacy market entry remain intricate, often opaque, and sometimes slow-moving. They can turn straightforward, demographic arguments into drawn-out debates, and in doing so, delay responsiveness to local needs.

The situation invites a broader reflection on what the current framework accomplishes. Community pharmacies have evolved into service hubs as dispensing margins shrink. The market entry regulations were designed in a different era and now often seems to protect process over practicality. 

If a pharmacy’s economic model is increasingly service-driven, and if demand is clear and pressing, should local populations have a more direct voice in determining access? Should the procedural layers be simplified, allowing real-world need to take precedence over papered arguments?

The issue also touches on the character of local health systems. ICBs, facing resource constraints and internal restructuring, are unlikely to prioritise lobbying for additional community pharmacies unless regulation facilitates it. 

National guidance and ministerial signals can be interpreted as gestures toward local empowerment, but they cannot replace structural clarity. What is required is a recalibration: rules that respond to population needs rather than procedural inertia.

I don’t know enough about this particular appeal to take a side. But I have been on one side or the other of similar decisions over the years. What is clear is that the factors that determined such decisions 10, 20 or 30 years ago seem less relevant with every passing year. With no establishment payments, dispensing at a loss, and a fundamental shift in the profit (or not) of any pharmacy’s operational platforms – something needs to give.

It may not be axiomatic that want of a pharmacy equates a need under the regulations, but what is an axiom in 2026 that was not present in 2005 is that the world has been up rooted, whilst the regulations have not. Market entry needs practical reform rather than ministerial interventions. The Lee-on-Solent application demonstrates that communities with significant needs can be underserved by the current system. 

If the town’s population justifies consideration for expanded pharmacy services, waiting for procedural exceptions or ministerial attention is neither sustainable nor equitable. A forward-looking approach would empower local commissioners, enable adaptive responses to population trends, and place service provision at the heart of decision-making. It might even encourage a more participatory model, where communities contribute to shaping their pharmacy services based on clear local need and usage patterns.

As for the minister, perhaps his time might be better directed toward the wider economic impediments? Strengthening closer ties with Europe to streamline supply chains and regulatory alignment? Providing more incentives for UK market approval of new medicines and services? Any of these could significantly enhance patient care without needing ad hoc ministerial involvement in specific contract disputes.

Resolving the Lee-on-Solent question is less about the politics of a single contract and more about the politics of community pharmacy.  No incumbent will want their place challenged. No system will want to feel exposed to more cost. However, the sector must serve - and can only survive and thrive if it does so.

There can be no hiding behind regulatory limbo. The future of community pharmacy lies not in interventionist gestures but in a coherent, responsive, and thoughtfully designed system that keeps patient access and local needs at its core.

Outsider is a community pharmacy commentator