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Labour’s new 10-year plan for the NHS sets out bold ambitions to shift care into the community, digitise services, and prioritise prevention. With community pharmacy firmly in the spotlight, could the sector be in a very different place in a decade’s time? By Saša Janković

In July Labour published its long-awaited 10-year plan for making the NHS ‘Fit for the Future’, setting out its intentions – already heavily trailed by Health Secretary Wes Streeting – to reinvent the NHS through three radical shifts: from hospital to community, analogue to digital, and sickness to prevention.

These, said the government, would be the “core components” of its new care model, which also includes clear roles for – and shifts towards – community pharmacies, such as:

• Making pharmacies high street health hubs to manage long-term conditions, obesity, high blood pressure and high cholesterol
• Offering minor ailment support, vaccine delivery and screening for cardiovascular disease and diabetes
• Delivering free emergency hormonal contraception by the end of 2025
• Administering HPV vaccinations to women and young people who missed them in school from 2026
• Being securely linked to the Single Patient Record
• Modernising dispensing using robots and hub-and-spoke models
• And enabling patient access to weight loss services and treatments, including GLP-1 medications like tirzepatide.

Sector reactions

Despite what felt like a drawn-out wait for the publication of the plan, reactions across the sector have been broadly welcoming its contents.  Company Chemists’ Association (CCA) chief executive Malcolm Harrison said the CCA is “delighted that community pharmacy will clearly play an integral role in realising the ‘Neighbourhood Health Service’, bringing care closer to peoples’ homes”, and fully support the ambition to rebalance the focus within the NHS between primary and secondary care.

Healthcare consultant and pharmacy strategist Michael Lennox is also “delighted that the plan recognises the potential of pharmacy” and says: “The challenge has been laid. What we must do is come up with detailed solutions that allow government to grasp our thinking and make the plan implementable.”

And community pharmacist Mark Burdon, from Burdon Pharmacy Group in Newcastle-upon-Tyne, says that there are no surprises. “But the two standouts for me are increasing the role of community pharmacy in long term conditions and giving us access to patient records, and these are absolutely brilliant,” he believes.

Cost implications

Nonetheless, the announcement comes at a time of significant cuts to integrated care boards, and with the government’s delivery plan still some way off, it remains to be seen how all these changes will be achieved. 

For example, the plan includes the creation of 250–300 Neighbourhood Health Centres by 2035 – which will act as multidisciplinary ‘one-stop shops ‘offering services like diagnostics, mental health support and pharmacy-led care. Between 40 and 50 are to be delivered during this Parliament. But how much will it cost to set these up and where will they recruit the pharmacy staff from? 

“With the right investment and integration of pharmacy teams into neighbourhood health services under the plan, pharmacy teams can play a transformative role in improving population health, support prevention and enable better care across the NHS, but delivering it depends on a supported and skilled workforce”, says Tase Oputu, Royal Pharmaceutical Society England board chair. 

Oputu also warns that: “Investing in pharmacists across all sectors is vital to ensure safe, equitable, and accessible care for patients, and whilst we support the focus on community and neighbourhood care, this must not come at the expense of investment in hospital pharmacy services. We are concerned that any disinvestment within secondary care may cause unintended consequences and have a negative impact on patient care.”

Numark chairman Harry McQuillan agrees that if an “under one roof” approach is taken, the workforce will be the critical issue. “Recruitment must be underpinned by a funded, strategic plan across all professions. The recent pharmacy funding agreement in England is a positive first step,” he says, “It shows that the government recognises pharmacy’s role in patient care, particularly around prevention and managing long-term conditions. We will, however, need to see sustained investment in training, support, and retention if these centres are to succeed.” 

Jay Badenhorst, director of pharmacy at the Pharmacists’ Defence Assocation (PDA), says that while the total investment backing the plan is £29–30 billion “the specific cost breakdown for neighbourhood centres hasn’t been published yet”. 

Badenhorst raises concerns around what he describes a lack of clarity: “There is a mention of possible private investment in infrastructure, but this is currently vague, so the PDA would likely question whether the £30 billion overall NHS investment is sufficient when spread across all sectors, especially given inflationary pressures and existing deficits.”

As for staffing, a new NHS workforce plan is expected in autumn 2025, which will include revised projections and strategies for recruitment, including pharmacy roles.

But with many pharmacists already reporting unsafe staffing levels, Badenhorst says: “Where will the pharmacists come from? There’s no clear strategy to prevent a drain from community pharmacies into these new centres, which could destabilise existing services and contribute to workforce pressures. 

“There’s also a risk that in these new centres, pharmacists could be subsumed by medical hierarchies, limiting their ability to lead on medicines optimisation and long-term condition management.”

Digital transformation

Another focus is to digitally transform the NHS, with a strong focus on integrating artificial intelligence (AI), robotics and genomics into the care delivery process.

A key goal is to create a single patient record that is accessible across all services including community pharmacies, but this would entail the NHS getting better at tech procurement and putting an end to the delays pharmacy has experienced so far with patient record access.

“Digitising the NHS is no mean feat, but as the 10-year plan clearly states, technology is pivotal to its future,” says Tracey Robertson, managing director of Cegedim Rx – the first community pharmacy IT supplier to switch on functionality for GP Connect. 

“I believe the plan provides the mandate needed for greater agility and innovation, but wrapped around that there must be a robust central IT infrastructure that’s continually evolving to meet the challenges those working on the NHS frontline face.” 

McQuillan says with the right leadership and clear prioritisation he is confident the NHS can overcome historic tech procurement challenges. 

“Access to patient records is not a luxury; it’s a clinical necessity,” he says. “If community pharmacy is to take on more clinical responsibility, we need proper, real-time read and write access to records. There has been progress but what’s needed is a mindset shift, seeing pharmacy not as an afterthought but as a core clinical service that requires the same digital tools as other providers.”

Noting how the PDA has repeatedly highlighted how community pharmacists have been excluded from digital integration efforts, despite their frontline role in patient care, Badenhorst says the slow rollout of shared care records and the piecemeal access to Summary Care Records (SCR)” have long been sources of frustration. 

“Ultimately, the PDA would argue that tech transformation must be co-designed with pharmacy professionals, not imposed upon them,” he concludes.

Funding shifts

Another question is whether pharmacy will get a big enough benefit from the hospital-to-primary funding shift to have the capacity it needs to do all this?

“That’s the challenge, and the opportunity,” says McQuillan. “If we’re serious about shifting care closer to home, then community pharmacy has to be a major beneficiary of that funding shift. Again, the new contractual agreement is a move in the right direction, but delivering long-term condition management, prescribing, and public health services at scale will need further resourcing.”

Badenhorst says the question of whether pharmacists will benefit meaningfully from the hospital-to-primary care funding shift remains unclear: “While Labour’s plan rightly acknowledges the expanding clinical role of pharmacists, the PDA would argue that pharmacists themselves have not yet been guaranteed the investment, support, or recognition needed to deliver on these ambitions safely and sustainably.”

Moreover, he says, the PDA would challenge any assumption that simply shifting funding from hospitals to primary care will automatically benefit pharmacists. “We would argue that unless pharmacists are explicitly included in workforce planning and funding allocations, there’s a real danger that the money will be absorbed by larger providers or diverted to other professions.”

Next moves

While it sounds like they are talking the talk, has Labour bitten off more than it can chew? Or should it be down to the community pharmacy sector to take a more proactive stance and develop its own detailed proposals for meeting the ambitions set out in Streeting’s plan?

From the PDA’s perspective, Badenhorst says Labour’s failure to meet with his organisation, despite multiple formal requests and its role as the voice of over 40,000 pharmacists, is more than just a missed opportunity.

He says: “It’s a serious oversight that raises questions about the credibility of the plan - one of the most glaring omissions is the lack of a clear strategy for how independent prescribers in community pharmacy will be fully and safely utilised. The fact that we still lack a national framework for deploying these skills, despite significant investment in training and many pharmacists taking on these opportunities, is a damning indictment of successive governments’ failure to plan for the future.” 

One organisation that was involved in the Plan is Community Pharmacy England (CPE), with chief executive Janet Morrison saying “it is encouraging to see that the government has listened to our messages about the value and potential of community pharmacy”. 

However, despite submitting detailed proposals during the consultation phase, and continuing to influence the Plan as a member of the Partners Council, during recent negotiations (through collaboration with the other primary care professions and engagement with policy influencers) Morrison stresses that the negotiator’s role is not over: “The development of each new service needs to be carefully managed given the sector’s current capacity and tight finances.

"We are keen to begin negotiations with government for the 2026/27 Community Pharmacy Contractual Framework as early as possible to ensure that these proposals will be implemented in a way that works best for our sector, underpinned by appropriate funding and seeking to avoid adding any unnecessary workload.”

Morrison says CPE is keen to work closely with the Department of Health and Social Care to ensure that community pharmacies are enabled and have the capacity to fully contribute to neighbourhood health services, and is also supporting local pharmaceutical commitees to work with the NHS and local authorities, making sure they are aware of the value of pharmacy teams while also being mindful of the need for investment.

Henry Gregg, chief executive of the National Pharmacy Association (NPA), says his organisation is also ready to “work closely with the government on the rollout of physical neighbourhood health centres so they integrate closely and do not duplicate the services that pharmacies already offer in people’s neighbourhoods”. 

Noting that “there’s still much to be established about how neighbourhood health centres will work in practice”, Gregg adds: “The NPA has no intention of sitting back and waiting for opportunities to drop into the laps of pharmacy contractors.”

Some contractors are already well-practiced at getting services up and running in their area, like Reena Barai – from SG Barai Pharmacy, in Sutton – who offers her own tips for how to get ahead of the clinical services curve.

“Over the 20+ years I’ve been running my pharmacy I’ve shown up at every meeting which involved my local NHS, I’ve not waited for an invite to speak, and I’ve always been the one in the room saying ‘community pharmacy’ does/can do this,” she says. 

“Speak up, and learn to speak ‘NHS’. No one wants to hear the whinging contractor sob story, so we need to show and be the solution to the NHS’s problems. Listen to the local issues and think about how you can help. Think who in your team can support this? How can you collaborate with other local pharmacies to be a ‘bigger’ solution?

“And finally, don’t let this perceived NHS hierarchy of doctor, nurse then pharmacist get to you. With neighbourhood health in particular the hierarchy is flipped, so have belief in yourself and the value you bring to the system. This is how we implement the 168 pages of a future NHS plan.”