In Views

Follow this topic

Bookmark

Record learning outcomes

Could a ‘holy trinity’ of transformation be key to unlocking the ‘underutilised’ pharmacy sector, asks Malcolm Harrison

For the last 30 years, governments have repeatedly said that community pharmacy is underutilised by the NHS. The next 12 months present an opportunity for transformation. 

Community pharmacy will shortly see the alignment of three key initiatives – a holy trinity, if you will — of independent prescribing, hub-and-spoke supply and changes to supervision. 

Together these changes could transform the role that pharmacists in community can play within primary care. Changes to hub and spoke and supervision laws could release the critical capacity that pharmacists will need to undertake a range of prescribing-led care.  

But transformation is not guaranteed through these changes alone. Without action and deliberate intent, this opportunity could easily be squandered, leading to another 30 years of underuse. 

We need a partnership between the government, the profession and the sector to make this change a reality.

We are at the precipice of a major culture shift, and we must not just embrace it, but do everything in our power to ride the wave of transformation

Dispensing with dispensing?

The new hub-and-spoke legislation will allow pharmacy teams to move the assembly of routine prescriptions off-site, allowing them to focus on delivering clinical care services. 

We know that the capital required to start up a hub is extremely high, and after a decade of underfunding businesses will find it difficult to secure the investment needed.

Given the slim margins currently available for supply it is also unlikely that any contractors will be able to afford to pay a third party to assemble prescriptions for them.

Even if pharmacies can get past the high price tags, a hub-and-spoke model can only offer capacity release, not cost savings.

With the abolition of NHS England, the government will have greater and more direct control over how care is commissioned.

It must be prepared to pro-actively commission additional clinical care services, to enable the sector to create the capacity needed. In addition, we need to start planning for a more service-based future. 

We need to focus on the clinical services that are available like Pharmacy First and hypertension case-finding. Showing our intent is critical for building the case for expansion. 

Embracing services and consistently providing patient-facing clinical care will show commissioners and patients exactly what community pharmacy is capable of, as well as boosting pharmacies’ bottom lines.

If the sector is to transform into a key player in the much-talked-of ‘neighbour provider networks’ of the future it will be critically important that patients know they can go to any pharmacy to get a consistent offer of care. 

Supervision update

With the coming changes to supervision, pharmacists can unlock their time as pharmacy technicians and staff are able to play a much larger and semi-autonomous role in dispensing. 

This will require a significant change to how many pharmacies operate. We need to plan for changes in how dispensaries function; how workload is distributed; and support the whole pharmacy workforce on a journey of change.

Pharmacy technicians will become an increasingly important part of a community pharmacy team, yet recruitment and training take time. 

There is a chicken-and-egg situation here. Do we train a workforce for the potential services of the future? Or wait for the services and then change?

The reality is that we need to do both. Recent Patient Group Direction changes, the introduction of emergency contraception from October and the new bundling requirements, mean consistency in service offer is important.

Changing the focus of pharmacy teams now and embracing service delivery places us in a better position to take advantage of supervision changes.

A generational opportunity

The ability for a pharmacist to independently prescribe in the community setting will be crucial for pharmacies to become the care provider settings that the NHS needs. The new education and training standards mean pharmacists registering from summer 2026 will all be independent prescribers. 

At the Company Chemists’ Association we have expressed concern that some pharmacies will be unable to secure Designated Prescribing Practitioners (DPPs) needed for the 2025 cohort to complete their independent prescriber (IP) training in 2026.

This will result in a significant reduction in the number of Foundation Pharmacist placements available. Consequently, it is possible that some graduates will unfortunately struggle to find employment in their chosen career.

A lack of commissioned IP pathways will impact more than just new registrants. Without anything to prescribe against there will be little incentive for the legacy workforce to upskill.

We could be heading to a future where pharmacists with a prescribing qualification see their skills deteriorate through lack of use, and no reason for the current professional workforce to invest in upskilling. 

Partnership

Pharmacies must make the need for change part of their everyday thinking. But the government must match the sector’s willingness to adapt and grow by investing in pharmacy and providing a sustainable funding framework. 

We must start preparing for this transformation now and the government needs to start building the foundation for success. And perhaps then, finally, policymakers will stop saying that community pharmacy is ‘underutilised’. 

Malcolm Harrison is chief executive of the Company Chemists’ Association