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Outsider has a few resolutions – but will they last past January?

Every new year brings the promise of change. And every time, people burden themselves with promises to make the next year different. So let’s look forward to 2026 through some resolutions—shared between community pharmacy and its paymaster – that might make everyone’s hangover a little better. 

Resolution #1 (Payer): “We’ll stop asking for more while paying for less.”

The last decade has been a case study in output inflation. Across the UK, we’re now dispensing roughly 197 million more prescription items a year than we were 10 years ago – over 15 per cent growth. At the same time, the UK has seven per cent fewer community pharmacies than it did a decade ago. 

And while we’ve been doing that, the cost of living is up roughly 39 per cent. That means every line in a contractor’s cost base – wages, utilities, rent, suppliers, compliance – has been climbing in a world where the Treasury assumes you can absorb it “because you’re resilient”. Resilient is what people call you when they don’t want to pay you properly.

If 2026 is going to be more than another year of optimism-by-press-release, the payer-side resolution needs to be brutally simple: fund activity honestly. Not just service headlines, but the capacity that makes services safe: time, staffing, training, and the operational plumbing that keeps cashflow and governance functional.

Resolution #2 (Pharmacy): “We’ll protect safety and quality while we expand.”

Community pharmacy’s own resolution has to be just as clear: don’t let expansion dilute the basics.

Dispensing at this scale isn’t a background task; it’s our raison d’être. Yes, margins have been squeezed and returns are often diminishing. But the work is still rising – and 2026 will pressure-test how well pharmacies can hold the line on accuracy, counselling, and clinical checks while also delivering more services.

Don’t assume pharmacy can do more because ‘we’re brilliant’. Networks and committees can set direction, but delivery depends on whether the system gives pharmacies the operating conditions to do the job safely as complexity rises. Pharmacies need to make choices. Don’t do everything, but when you choose to deliver, do it well. Be explicit about what good looks like, what it costs, and what has to stop if the system won’t pay for safe delivery. 

Resolution #3 (Payer): “We’ll make payment work like it’s 2026, not 2006.”

It’s hard to feel ‘transformed’ when your cashflow is held together by rules, timescales, and uncertainty about reimbursement.

Service delivery is only as scalable as the system’s ability to pay correctly and consistently. In 2026, the NHS can’t keep rolling out pharmacy-facing activity while letting payment friction become “a contractor problem.” Admin burden is real cost. Payment errors are real cost. Delays are real cost. And “we’ll fix it later” is a closure strategy.

So here’s the payer resolution: make payment fair, predictable, accurate, and timely – because that is capacity. 

Resolution #4 (Pharmacy): “We’ll redesign the team, not just stretch the pharmacist.”

If independent prescribing is to take bigger steps toward mainstream community delivery, the sector cannot pretend it will be achieved by pharmacist stamina.

Workforce and skill-mix are not optional extras. Role development, wider team deployment, and training pathways are the only credible way to create clinical headroom without burning out the very people the NHS wants to empower. Pharmacies need to build a team-based operating model that makes clinical expansion sustainable. Not heroic. Sustainable.

Resolution #5 (Everyone): “We’ll tell the truth about capacity.”

This is where the optimism gets heavy. Because the numbers are already telling the story: more items, fewer pharmacies, higher national costs. And borrowing costs are much higher than a decade ago. That makes investment harder just as the system expects pharmacies to modernise.

If 2026 is going to avoid being another year of ‘pharmacy can fix access’, both sides need to stop using ambition as a substitute for capacity planning. The government has to admit that pharmacy cannot be the answer to every access problem unless it is funded as a serious clinical provider. Pharmacy has to admit that saying ‘yes’ to everything isn’t leadership; it’s slow-motion failure.

And then there’s the resolution nobody wants to write down: leadership. In 2026, what’s missing is likely to be clear, stable political leadership – inside pharmacy and outside it. Externally, it’s lots of noise and short-term wins. Internally, pharmacy can still look split between ‘the vision’ and ‘the balance sheet’. That gap is where services go to die.

So the final resolution for 2026 – uncomfortable but necessary – is: stop mistaking goodwill for strategy. Goodwill runs out. Strategy is what you do before it does.

And if all else fails, here’s a final, very British resolution: don’t confuse a pharmacy that’s still open with a pharmacy that’s still okay—because ‘open’ isn’t the same as ‘funded’. By next New Year, the only thing we should be dispensing on goodwill is a sachet of rehydration salts—and even those need reimbursing.

Outsider is a community pharmacy commentator