Not all parts of England have equal access to pharmacy services. PharmSee's location analysis tool maps GP-to-pharmacy ratios across the country — and some areas show clear signs of strain. When GP surgeries significantly outnumber pharmacies, patients face longer waits, reduced choice, and pharmacies that are stretched thin.
The Under-Served League Table
Using PharmSee's location analysis with a 25-mile radius from each regional centre, we ranked areas by their GP-to-pharmacy ratio. A ratio above 1.0 means there are more GP practices than pharmacies — a proxy for under-supply.
| Rank | Area (Region) | GPs | Pharmacies | GP:Pharmacy Ratio | Assessment |
|---|---|---|---|---|---|
| 1 | Brighton (South East) | 62 | 48 | 1.29 | Significantly under-served |
| 2 | Birmingham (West Midlands) | 159 | 143 | 1.11 | Under-served |
| 3 | Manchester (North West) | 100 | 108 | 0.93 | Borderline |
| 4 | London | 255 | 281 | 0.91 | Adequate |
| 5 | Bristol (South West) | 60 | 68 | 0.88 | Well-served |
| 6 | Norwich (East of England) | 35 | 40 | 0.88 | Well-served |
| 7 | Leeds (Yorkshire & Humber) | 76 | 90 | 0.84 | Well-served |
| 8 | Newcastle (North East) | 67 | 85 | 0.79 | Well-served |
| 9 | Nottingham (East Midlands) | 62 | 86 | 0.72 | Very well-served |
Data: PharmSee location analysis, April 2026. 25-mile radius from city centre postcodes. Based on NHSBSA pharmacy data and NHS ODS GP practice data.
Why Brighton Tops the List
The South East's 1.29 ratio — 62 GP practices served by just 48 pharmacies — makes it the most under-served major area in England. This isn't just a numbers game. Brighton and the surrounding Sussex coast have:
- High retirement-age population generating above-average prescription volumes
- Coastal geography limiting pharmacy catchment areas (no pharmacies in the sea)
- High property costs making new pharmacy premises financially challenging
- Tourism pressure creating seasonal demand spikes
For pharmacists, this under-supply translates to opportunity. The South East's median pharmacy salary of £42,631 (matching the national median) is complemented by a wider range of available roles.
Birmingham: The Second City Squeeze
Birmingham's 1.11 ratio reflects the West Midlands' dense urban population. With 159 GP practices and only 143 pharmacies within 25 miles of the city centre, the gap is smaller per-pharmacy than Brighton but affects a much larger population.
The West Midlands salary data reinforces this story: while the median is a modest £34,762, the mean jumps to £43,551 and the upper quartile hits £56,062. The region's large teaching hospitals (UHB, Sandwell) drive specialist demand — Band 8a roles like the Specialist Clinical Pharmacist in Thrombosis at UHB (£57,528–£64,750) reflect genuine clinical need.
The Hiring Demand Signal
Under-served areas should, in theory, generate more job vacancies. The hiring data from PharmSee's job tracker broadly supports this:
| Region | GP:Pharmacy Ratio | Relative Job Density |
|---|---|---|
| South East (Brighton) | 1.29 | High — 31 jobs in Brighton area |
| West Midlands (Birmingham) | 1.11 | Moderate — 47 jobs in Birmingham area |
| North West (Manchester) | 0.93 | High — 86+ jobs in Manchester/Leeds corridor |
| East Midlands (Nottingham) | 0.72 | Lower — 24 jobs in Nottingham area |
Job counts from previous PharmSee regional analyses.
The correlation isn't perfect — London's adequate 0.91 ratio still generates the most absolute vacancies (141 in the London area) due to sheer population size. But on a per-pharmacy basis, the under-served areas show elevated hiring activity.
What Causes Under-Supply?
Several factors create pharmacy deserts:
- Contract economics — NHS pharmacy contracts generate thin margins in areas with high premises costs
- Population growth — housing developments in the South East outpace new pharmacy openings
- Consolidation — chain acquisitions can lead to branch closures where two pharmacies overlap
- GP practice mergers — when GP surgeries merge, the combined patient list still needs pharmacy services, but no new pharmacy opens
- Workforce shortages — a pharmacy can't open without a superintendent pharmacist, and Band 7+ pharmacists are in short supply nationally
What This Means for Pharmacists and Planners
For job seekers: Under-served areas offer stronger negotiating positions and less competition for roles. Brighton, Birmingham, and Manchester are worth targeting. Check live vacancies on PharmSee's job search.
For pharmacy owners: High GP:pharmacy ratios signal opportunity for new contract applications or extended service uptake. Use PharmSee's location analysis to assess specific postcodes.
For commissioners: These ratios should inform Pharmaceutical Needs Assessments. Areas consistently above 1.0 warrant review of pharmacy provision.
Data sourced from PharmSee location analysis (April 2026), NHSBSA pharmacy data, and NHS ODS GP practice directory. Ratios based on 25-mile radius from city centre postcodes.