Manchester and Birmingham are England's two largest cities outside London. Both are major centres for pharmacy employment and healthcare delivery. But PharmSee's analysis of dispensing data, GP practice registers, and vacancy listings reveals two markets that operate in strikingly different ways.
The headline numbers
| Metric | Manchester (M1, 3mi) | Birmingham (B1, 3mi) |
|---|---|---|
| Registered pharmacies | 108 | 142 |
| Active pharmacies (with dispensing revenue) | 91 | 129 |
| GP practices | 100 | 156 |
| GP-to-pharmacy ratio | 0.93:1 | 1.10:1 |
| Average dispensing revenue (active) | £108,550 | £77,966 |
| Median dispensing revenue | £100,242 | £64,637 |
| Vacancies (25mi radius) | 106 | 47 |
Birmingham has 31% more registered pharmacies and 56% more GP practices than Manchester within the same 3-mile radius. Yet Manchester's pharmacies earn substantially more — a median of £100,242 compared to Birmingham's £64,637, a gap of more than £35,000 per branch.
More pharmacies, less revenue
The revenue differential is the most striking feature of this comparison. According to NHSBSA dispensing data analysed by PharmSee, the average active pharmacy in Manchester earns £108,550 in NHS dispensing revenue, compared to £77,966 in Birmingham — a 39% gap.
Several factors may contribute. Birmingham's higher pharmacy density relative to its GP base (1.10:1 versus Manchester's 0.93:1) means more pharmacies competing for a similar volume of prescriptions. In areas where pharmacy supply exceeds GP-generated demand, individual branch revenues tend to compress.
The NHSBSA data captures prescription dispensing revenue only and does not include retail sales, private services, or Pharmacy First consultation fees. However, dispensing revenue remains the single largest income stream for most community pharmacies and provides a reasonable proxy for relative market conditions.
The vacancy paradox
Perhaps the most revealing difference is in hiring activity. Manchester lists 106 pharmacy vacancies within 25 miles, more than double Birmingham's 47. The employer mix tells part of the story:
Manchester (106 vacancies):
| Employer | Vacancies |
|---|---|
| NHS Jobs | 26 |
| Well Pharmacy | 22 |
| Cohens Chemist | 20 |
| Boots | 14 |
| Tesco | 14 |
| Rowlands | 4 |
| Asda | 4 |
| Superdrug | 2 |
Birmingham (47 vacancies):
| Employer | Vacancies |
|---|---|
| NHS Jobs | 30 |
| Boots | 10 |
| Superdrug | 2 |
| Well Pharmacy | 2 |
| Cohens Chemist | 2 |
| Tesco | 1 |
Manchester benefits from employer diversity: six sources list more than two vacancies each, with Cohens Chemist providing a strong regional presence (20 roles). Birmingham's vacancy market is dominated by NHS Jobs, which accounts for 64% of all listed positions — a pattern previously identified in PharmSee's Birmingham vacancy analysis.
The low community pharmacy vacancy count in Birmingham (just 17 non-NHS roles for 142 registered pharmacies) suggests that community pharmacy turnover in the city may be lower, or that independent operators — who make up the majority of branches in both cities — recruit through channels not captured by the 11 sources PharmSee tracks.
What the GP ratio reveals
Birmingham's 1.10:1 GP-to-pharmacy ratio places it among the higher-demand English cities measured by PharmSee, alongside Liverpool (1.42:1) and Leicester (1.22:1). Manchester's 0.93:1 is below parity, meaning the city has more pharmacies than GP practices — a configuration typically associated with higher competition between branches.
Yet Manchester's pharmacies earn more despite this apparently less favourable ratio. Population density, prescription volumes per GP, and the mix of urban versus suburban branches within the 3-mile ring all play roles that a simple ratio cannot capture.
What this means for pharmacists and employers
For job seekers, Manchester offers more than twice the vacancy volume and a wider range of employers. Birmingham's opportunities are concentrated in NHS settings, which may suit pharmacists seeking hospital or primary care roles but leaves community pharmacy positions harder to find through public listings.
For pharmacy owners evaluating market entry, Birmingham's lower revenue per branch and higher pharmacy density suggest a more competitive dispensing environment. Manchester's higher revenues and diverse employer base may indicate a market with stronger demand relative to supply.
Explore pharmacy data for both cities using PharmSee's pharmacy search and job listings. Compare specific branches with the pharmacy comparison tool.
Data sources: PharmSee analysis of NHSBSA dispensing data (latest available quarter), NHS Digital pharmacy register, and 11 pharmacy employer vacancy sources as of 13 April 2026. GP-to-pharmacy ratios calculated within a 3-mile radius of city centre postcodes (M1 1AD and B1 1BB). Vacancy counts use a 25-mile radius to capture the wider employment catchment. Revenue figures represent NHS dispensing revenue only and do not include retail, private, or service income.