Invest in workforce now for benefits later

There’s no denying that community pharmacy teams are delivering amidst considerable pressure. Finding solutions to the current pharmacist shortage is our number one priority at the Company Chemists’ Association and we will leave no stone unturned in our efforts. However, it is important to look for solutions in the future, as well as the here and now, if we are to plot our path to a brighter place.

The good news is that on the horizon are several opportunities which, with the right ambition and investment, will fundamentally and positively shape how pharmacists and their teams operate in the years to come. 

The NHS’ planned move towards routine independent prescribing (IP) represents probably the single greatest change to community pharmacy practice in living memory. As more pharmacist prescribers come online, our offer to patients, the public and the NHS will fundamentally change. 

But the clock is ticking. From 2026, every newly qualified pharmacist will be able to prescribe. They will need opportunities to use those skills in community pharmacy, or they will look elsewhere for gainful employment.

That only 5 per cent of community pharmacists in England are IPs currently is illustrative of the challenge ahead. IP has already been a game-changer in community pharmacies in Scotland and Wales, where prescribing services have been pioneered through Pharmacy First and Choose Pharmacy respectively, allowing pharmacists to manage the treatment of patients across a greater scope of common clinical conditions. 

NHS England can learn much from colleagues across the Severn and the Tweed. It is within their gift to commission services at scale, to create the commissioning environment for prescribers and the case for investment to encourage further IP training. My fear is that the ambition will be limited to developing a model of prescribing for community pharmacy in England, for others to pick and run with. 

But the clock is ticking. From 2026, every newly qualified pharmacist will be able to prescribe.

There is a risk that pilots will be limited to a few sites and that the new local ‘system’ will be tasked to design a bespoke model of care around the individual pharmacist. This could be made worse still by the requirement for gigabytes of data to be captured, to allow a protracted evaluation that will confirm what we can already see to the north and to the west.

I challenge NHSE to set itself a Big Hairy Audacious Goal, to solve the essence of the problem – to improve nationwide access to primary care – and then force itself to think big and create a plan for long term success. It needs a huge goal that drives progress, defines a vision for the future and gets everyone working together towards achieving it.

Integrating IP into everyday practice will enhance the pharmacist’s role, in turn making community pharmacy more desirable, to patients and to those considering a career in the sector. It will enhance the urgent care offer and bring care for long term conditions closer to patients’ homes, particularly in deprived areas. This could have a huge impact on NHS efforts to clear the current backlog.

In addition to prescribing, we think community pharmacies have the potential to routinely administer an additional 10 million vaccinations each year, be they for flu, Covid or many of the other conditions circulating in society.   

Truly unlocking the potential of community pharmacy requires more than an IP accreditation, however. The workload of pharmacists, specifically in dispensing, must be considered. At the CCA, our position is that one pharmacist should be responsible for one pharmacy. However, if we are to maximise the opportunity of IP and other possible futures, we must address elements of the past that are holding the profession back: like supervision.

We, the profession and the industry, must work together to develop what we want the pharmacist of the future to be able to do for patients. We must take a professional and pragmatic approach to ensuring future practice has a framework of governance, and regulation that enables evolution rather than restricts it. 

We also believe that as the role of the pharmacist evolves, so should the roles of others within the pharmacy team. Adding pharmacy technicians to the list of professionals who can vaccinate under a Patient Group Direction is a key first step. This will help to make all roles in a community pharmacy more attractive, further relieving workforce shortages. 

Community pharmacy has a dedicated workforce that has been tested by Covid. The future looks bright, with several exciting initiatives on the horizon. If we are to be serious though, we need Big Hairy Audacious Goals, with a plan for delivery and investment to match.

Malcolm Harrison is chief executive of the Company Chemists’ Association