A balanced approach to locating pharmacies offers a blueprint for Wes Streeting’s NHS vision, argues Hemant Patel

As the NHS faces unprecedented pressures, health secretary Wes Streeting has launched a public consultation to shape a new 10 Year Health Plan for England. Streeting has outlined three strategic shifts for the NHS: moving care from hospital to community; shifting from analogue to digital; and focusing on prevention over treatment. 

These priorities align well with the rational location of community pharmacies, which are vital for public health and now poised to take on a more advanced role as part of a clinical hub-and-spoke model.

The scale of the crisis

Over the past decade, more than 1,500 community pharmacies have closed across England, particularly in rural and deprived areas. These closures have left gaps in care, forcing vulnerable populations to struggle with timely access to services and placing strain on GPs and hospitals.

To address this, a rational location strategy is needed to ensure pharmacies are placed where they are most effective and affordable. This strategy should involve public consultation, the Royal Pharmaceutical Society (RPS), which holds a Royal Charter and public interest duty, and the government. The RPS, having shaped pharmacy distribution historically, can guide criteria for future pharmacy locations that support the NHS’s strategic goals and the ambitions of the pharmacy profession.

Wes Streeting’s 10 Year Health Plan envisions shifting healthcare services into communities. Community pharmacies, integrated into a newly defined clinical hub-and-spoke model, will have an enhanced role.

A rational location strategy, supported by digital integration, ensures pharmacies fulfil this role. This model not only delivers Streeting’s vision but also fosters a collaborative culture for managing long-term conditions.

Moving care from hospital to community: One of Streeting’s priorities is moving care closer to where people live, and pharmacies should be integral to this. As part of the hub-and-spoke model, pharmacies in underserved areas can manage minor ailments, prescribe, offer medication reviews, and support long-term conditions, helping to relieve pressure on GPs and hospitals.

Strategically located pharmacies in high-need areas offer convenient care, enabling patients to manage chronic diseases like diabetes and hypertension without frequent hospital visits. This improves treatment adherence and reduces hospital admissions.

Shifting from analogue to digital: Digital transformation is key to making the hub-and-spoke model work. Pharmacies integrated into a digital network can offer e-prescriptions, remote consultations, and telehealth services, making healthcare more convenient and efficient, especially in rural areas where travel to GPs is challenging.

Pharmacies will serve as digital health hubs, allowing patients to access telemedicine services. They can also enhance digital health literacy, helping patients use apps to manage their health and reducing unnecessary hospital visits.

Focusing on prevention over treatment: In the clinical hub-and-spoke model, pharmacies are ideally placed to deliver preventive care. They can prevent long-term conditions through weight management programmes, smoking cessation support, vaccinations, and health screenings. Placing pharmacies in areas with high rates of preventable diseases helps the NHS reduce hospital admissions, and shifts care toward prevention.

Role of the RPS

The criteria for pharmacy placement should be determined through public consultation, with input from the RPS and the Government. The RPS can ensure that decisions reflect local needs while aligning with national healthcare priorities.

Involving the public and professional bodies like the RPS ensures transparency and supports the NHS’s shift to community-based care, digital health, and prevention.

Wes Streeting’s consultation offers a chance to redefine the role of community pharmacies. By embedding pharmacies into the clinical hub-and-spoke model, the NHS can better serve local populations, reduce inequalities, and foster a sustainable healthcare system.

Pharmacies in the clinical hub-and-spoke model can also support public health initiatives, offering early interventions and managing and reversing chronic conditions before they require costly hospital care.

Finally, pharmacies integrated into the NHS’s digital infrastructure can offer remote consultations and digital prescriptions. By acting as digital health hubs, they can bridge the gap for patients lacking digital literacy or access, ensuring everyone benefits from digital healthcare.

The rational location of community pharmacies is key to achieving Wes Streeting’s strategic shifts. Integrating pharmacies into a clinical hub-and-spoke model ensures a more cost-effective, patient-friendly, and collaborative approach to healthcare, especially for multi-morbidity.

Strategically placing pharmacies where they can have the greatest impact ensures they remain essential pillars of healthcare, supporting a sustainable NHS for the future.

Hemant Patel is former secretary of North East London LPC