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The old flu jab turf wars have reared their ugly head – but the pharmacy and general practice sectors are more aligned than they realise, writes Shilpa Shah

As we head into the winter season, it feels like déjà vu. I’m seeing the same complaints arise regarding flu vaccinations, as I have for so many years. This year the flu vaccination service started on 1 October 2025 (except for pregnant women). As pharmacies were trying to plan their October diaries, patients were telling us that their general practice had already told them that they must have their flu vaccination in the surgery, as the surgery had already ordered the stock.  

We even had some reports of surgeries vaccinating patients early, however, there was no evidence of this when the integrated care board checked with the surgery. In the constant battle between community pharmacy and general practice, we also need to consider the patient.  

As a people pleaser myself, it’s easy for patients to say what they think the healthcare professional in front of them wants to hear. While patients are tied to their pharmacies with respect to prescription nomination, the relationship with their general practice is different. Patients simply do not want to upset their doctor. 

Complementary services

Community pharmacy and general practice complement each other well within the primary care arena in terms of patient care in the local community. Dentists and opticians also form an important part of primary care, but they are specialists in what they do. Community pharmacy and general practice are generalists. What needs to change for us to start working together and complementing each others services rather than feeling as though we’re in competition? 

The government, Department of Health and Social Care and NHS England have a role to play in reducing these tensions. Both sectors’ contracts are set up to help patients within the local community in different ways; however, there is too much overlap, causing confusion for both patients and for us. Initially, the reason community pharmacy was given the flu vaccination service was so we could capture those patients who don’t regularly visit their general practice and help those who just want to pop in during their lunch break etc.  

However, over time people realised how convenient the service was and started popping in to have their jab. As there are payments associated with this service, we soon started seeing some pushback from GPs claiming that by pharmacy doing these vaccinations it would affect their business.  

The importance of that word - ‘business’ - is something a lot of the public don’t realise. GP surgeries are businesses, just as pharmacies are. What is lost in this argument between professions is the fact that between us, more people than ever are getting vaccinated.  

We hear all the time about the pressures in general practice. We also share the same challenges and the funding constraints in community pharmacy. There are workforce issues in both sectors and premises are not fit for purpose. The difference is the funding that surgeries get towards staffing, IT and property.  

I think that there are some simple solutions that would help both sectors. For example, we have services such as vaccinations that are carried out successfully in community pharmacy, patients have built their trust in us so why not move all vaccinations to community pharmacy (including children’s vaccinations)? This would allow GPs to use that time to focus on childhood illnesses or mental health in young people.  

Another solution would be to align the community pharmacy and general practice contracts so that they complement each other rather than compete against each other. The GP contract could request that 90 per cent of patients presenting with for minor illness or one of the seven Pharmacy First clinical conditions must be seen by the local community pharmacy. Ideally, this should be a walk-in service, but we all know that is unlikely to happen.  

There are always going to be some patients that may have complicated conditions or may really want to see a member of surgery staff, but if the messaging is correct I’m convinced a majority would be happy to go to a community pharmacy. This will also educate patients ongoing about using the right services. 

With the increase in pharmacists who are qualifying as prescribers, we need to be ahead of the game and have a clear plan of how they will be utilised - not to do the same work that doctors do but to take on the low acuity conditions such as uncomplicated hypertension, management of cholesterol etc. We should be able to initiate and continue treatment and refer to general practice if necessary.  

We need general practice to understand exactly what these services are for and why community pharmacies are doing them. In our sector, we need to level up and deliver these services to a high standard every hour we are open and ensure we send back appropriate notes to general practice. 

We also need much better integrated IT but until we have that, let’s use the IT we have to the best of our ability. 

We need everyone in general practice to understand the payment structure (as opposed to learning this from social media where the figures are incorrect and often taken out of context. 

I appreciate that for this to work we need appropriate funding, that goes without saying. But if we work together and understand each other better then that can only be beneficial to the public.

Shilpa Shah is chief executive of Community Pharmacy North East London