The GP-to-pharmacy ratio is one of the most telling metrics in pharmacy planning. It measures whether an area has enough pharmacies to support its GP-registered population — and across England's nine regions, the variation is stark.
The Complete League Table
PharmSee's location analysis tool calculates GP:pharmacy ratios using NHSBSA pharmacy data (13,147 pharmacies) and NHS ODS GP practice records (12,858 practices). Here are all nine English regions ranked from best-served to most under-served, using a 25-mile radius from each regional centre:
| Rank | Region (City) | Pharmacies | GPs | GP:Pharmacy Ratio | Median Salary | Salary Sample |
|---|---|---|---|---|---|---|
| 1 | East Midlands (Nottingham) | 86 | 62 | 0.72 | £46,696 | 19 |
| 2 | North East (Newcastle) | 85 | 67 | 0.79 | £32,640 | 21 |
| 3 | Yorkshire & Humber (Leeds) | 90 | 76 | 0.84 | N/A | <3 |
| 4 | South West (Bristol) | 68 | 60 | 0.88 | £32,640 | 45 |
| 5 | East of England (Norwich) | 40 | 35 | 0.88 | £34,422 | 27 |
| 6 | London (Central) | 281 | 255 | 0.91 | £51,468 | 60 |
| 7 | North West (Manchester) | 108 | 100 | 0.93 | £34,422 | 35 |
| 8 | West Midlands (Birmingham) | 143 | 159 | 1.11 | £34,762 | 38 |
| 9 | South East (Brighton) | 48 | 62 | 1.29 | £42,631 | 63 |
Data: PharmSee location analysis, April 2026. 25-mile radius from city centre postcodes. Salary data from PharmSee salary tracker.
Understanding the Ratio
- Below 0.80: More pharmacies than GP practices — patients have choice, competition is high
- 0.80–1.00: Balanced — roughly one pharmacy per GP practice
- 1.00–1.20: Under-served — GP practices outnumber pharmacies
- Above 1.20: Pharmacy desert territory — significant access concerns
Region-by-Region Analysis
1. East Midlands (0.72) — Best Served
Nottingham leads the table with 86 pharmacies to just 62 GPs. This translates to excellent patient choice and competitive pressure on pharmacies. The region also boasts the second-highest median salary at £46,696 and the UK's single highest tracked pharmacy salary — a Band 8c role at Nottingham University Hospitals at £91,342–£105,337.
The paradox: high pharmacy density and high salaries. The explanation is Nottingham's concentration of teaching hospitals driving up the mean through specialist roles, while community pharmacy density keeps neighbourhood access strong.
2. North East (0.79) — Well Supplied, Lower Paid
Newcastle's 85 pharmacies comfortably outnumber its 67 GP practices. But the North East has the joint-lowest median salary at £32,640 — a £18,828 gap with London. Boots dominates hiring here (51% of regional vacancies), creating a near-monopsony effect on community pharmacy wages.
3. Yorkshire & Humber (0.84) — Balanced with Diversity
Leeds' 90 pharmacies to 76 GPs shows healthy provision. Yorkshire stands out for employer diversity: Boots (20 jobs), Cohens (18), Weldricks (6) all competing in the same market. Salary data is insufficient for a regional median, though the national figure of £42,631 applies.
4–5. South West & East of England (Both 0.88) — Rural Adequacy
Bristol (68/60) and Norwich (40/35) share the same ratio but differ in structure. The South West has a larger absolute pharmacy count spread across a wider geography. The East of England is more compact but relies heavily on NHS trusts for employment (10 NHS Jobs vs 4 Boots in the Norwich area).
Salary-wise, the South West lags at £32,640 median (joint lowest), while East of England manages £34,422.
6. London (0.91) — Adequate but Expensive
London's 281 pharmacies serving 255 GP practices delivers a 0.91 ratio — adequate on paper. But London's complexity means this average hides enormous variation by borough. Inner London boroughs like Tower Hamlets and Newham may be under-served while Kensington is over-supplied.
London compensates with the highest median salary at £51,468 — a 21% premium over the national median.
7. North West (0.93) — Borderline
Manchester's 108 pharmacies to 100 GPs puts the North West at the tipping point. A few more GP practice mergers or pharmacy closures could push this ratio above 1.0. The median salary of £34,422 offers little incentive for new pharmacists to fill gaps.
8. West Midlands (1.11) — Under-Served
Birmingham crosses the 1.0 threshold with 159 GP practices but only 143 pharmacies. This is England's second-largest city operating with a structural pharmacy deficit. The median salary of £34,762 masks a wide spread — the mean is £43,551 and the upper quartile reaches £56,062, pulled up by specialist trust roles.
9. South East (1.29) — Most Under-Served
Brighton's 62 GPs to 48 pharmacies creates England's worst GP:pharmacy ratio among major centres. The South East as a whole faces the compounding challenges of high property costs, ageing demographics, and coastal geography. Despite a median salary at the national average (£42,631), recruitment struggles persist.
The Salary-Density Paradox
There's no clear correlation between pharmacy density and salary:
| Pattern | Regions | Explanation |
|---|---|---|
| High density + High salary | East Midlands | Teaching hospitals drive specialist pay |
| High density + Low salary | North East, South West | Community pharmacy saturated; chain monopsony |
| Low density + High salary | London, South East | Cost-of-living supplements; specialist demand |
| Low density + Low salary | West Midlands | Polarised market; median dragged down |
This matters for career planning: a well-served area isn't necessarily a low-paying one.
Use This Data
Check the GP:pharmacy ratio for any English postcode on PharmSee's location analysis tool. Compare salary data across all regions on the salary tracker, or search 1,385 live pharmacy jobs to see what's available in your target area.
Data sourced from PharmSee location analysis (NHSBSA + NHS ODS) and salary analysis (384 roles), April 2026.