To ask the Minister of Health to outline any assessment he has made on the long-term impact on the sustainability of community pharmacy services of maintaining the clawback mechanism as a means of managing wider financial pressures across the health system.

My Department has invested to support community pharmacy in recent years, with funding increasing by almost £60m (57%) since April 2018. This is the highest level of funding to date and is comparable with the rest of the UK.

I recently met with Community Pharmacy Northern Ireland (CPNI) who raised concerns about medicines reimbursement and funding arrangements. CPNI’s request is to adjust or remove established discount clawback arrangements to allow over £20m to be retained by community pharmacies with no additional service provision or benefit for patients or the HSC. This is unrealistic when my Department is experiencing a significant funding gap to meet existing services.

Discount clawback is a mechanism designed not to manage HSC financial pressures but to modulate margin or retained purchase profit as part of medicines reimbursement arrangements. The medicines margin system and annual margin survey ensures that, on average, community pharmacy reimbursement arrangements cover the cost of purchasing medicines plus a level of margin meaning that HSC dispensing should be a profitable activity overall. This system incentivises efficient procurement by pharmacies, yielding value for money for the HSC, while ensuring pharmacies are rewarded for this service.

In 2025/26 the guaranteed level of margin for community pharmacy is £34m, increased from £31.5m in 2024/25. In recent years, the actual margin achieved by pharmacies has significantly exceeded the guaranteed level. Unlike other UK regions, any excess margin is not recouped, providing additional income for pharmacies above the agreed financial envelope.

My Department’s most recent review of access and delivery of HSC pharmacy services found that Northern Ireland is well provided in respect of access to community pharmacy services and that services are being delivered in line with an agreed commissioning plan.