A manifesto for community pharmacy

1. Fill the funding gap

Fill the funding gap, and commit to long-term sustainable funding, so pharmacies can deliver more of the NHS care patients need.

There has been no increase in core funding for community pharmacy since 2014. In fact, it was cut by £200m in 2016 and the lack of any increase since has meant a real terms cut of 30% over the past 10 years. Over the same time the amount of work being asked of pharmacies by the NHS has increased by 10%, making matters even worse. The recently announced Pharmacy First funding is welcome but only represents new money for new work.

At the same time, the cost and complexity of running a pharmacy business is increasing and inflation is putting extra pressure on costs.

The sector’s core funding needs an urgent uplift if further pharmacy closures are to be averted.

Long-term sustainable investment will help the pharmacy network to deliver more of the NHS care that patients and the public need, free up GP capacity and reduce the backlog.

2. Support the community pharmacy workforce

Support and enhance the community pharmacy workforce to ensure that pharmacists and their teams can continue to meet the needs of patients now and in the future.

The NHS workforce plan recognises the need for more pharmacists, to meet rising patient demand and the development of clinical services. However, the sector urgently needs further details on how the plan will be implemented.

Sustainable workforce planning by the Government, NHS and Integrated Care Systems, backed by investment in education and training, must ensure we have the pharmacy teams we need, where we need them.

With continued pressures on services, it is more important than ever to support the pharmacy workforce so that the staff needed to deliver patient care can be recruited, trained and retained.

3. Protect access to medicines

Ensure that patients can access the medicines they need, including an end-to-end review of the medicines supply chain.

Pharmacies in England dispense over 1 billion NHS prescription items each year.

Unfortunately, pharmacists and their teams have to spend too much of their valuable time sourcing medicines that are in short supply. They should be enabled to make simple, appropriate changes to medicines where this is safe and could help alleviate access issues. Volatile pricing means that pharmacy businesses are often dispensing NHS medicines at a loss. This is unsustainable.

Value for money in medicines supply is predicated on ever decreasing prices, but this cannot continue indefinitely. Moreover, this approach weakens the UK’s standing in a fragile global medicines market, and is directly leading to shortages.

Some current initiatives are merely sticking plasters that do not address the underlying problem. An end-to-end review of the medicines supply chain is required to ensure that it is fit for the future.

The safe supply of medicines should continue to be the cornerstone upon which other pharmacy-based support for patients and the public is built. Building on our supply function, and the regular contact with patients that this affords, additional clinical services will both add value to our offering to patients and the NHS and deliver a more sustainable pharmacy business model.

4. Build on the Pharmacy First service

The NHS must rollout an enhanced Pharmacy First service for England, mirroring the highly successful approaches taken in Scotland and Wales.

We welcome the Pharmacy First Service which will allow pharmacists to supply prescription-only medicines to treat seven common health conditions.

We are working to ensure the Pharmacy First service is rolled out across England at pace, but we also want to see the service expanded, mirroring highly successful approaches taken in Scotland and Wales, allowing pharmacists to supply over-the-counter medicines too.

A fully-fledged Pharmacy First service would free up tens of millions of GP appointments, building greater capacity in primary care.

5. Empower community pharmacists to do more

The NHS should empower community pharmacists to do more, with an ambitious roadmap for Independent Prescribing.

From 2026, all newly qualified pharmacists will be independent prescribers which will allow them to prescribe autonomously for any condition within their clinical competence. Independent Prescribing will also ensure community pharmacists can play a greater role in the management of long-term medical conditions, providing better integrated care with general practice.

However, very few current community pharmacists have independent prescribing qualifications or the opportunity to use their skills within the NHS.

We want to see the NHS accelerate its training plans for pharmacist independent prescribing and in upskilling the existing workforce to become independent prescribers. Ambitious and effective commissioning is also required to ensure community pharmacists can use their prescribing qualifications to support patient care.

The moves for more and more pharmacists to become Independent Prescribers is a once-in-a-generation opportunity and greater ambition is required to fully harness its potential.

6. Make pharmacies centres for public health, prevention and reducing health inequalities

Greater investment and ambitious commissioning are required to build on the integral role pharmacies play in public health and prevention – to reduce ill-health and health inequalities.

Pharmacies provide a range of preventive and public health services. However, years of underinvestment and patchy local commissioning has led to unfortunate postcode lotteries in access to services.

We want to see a greater role in testing and screening and long-term conditions management. This approach of ‘Making Every Contact Count’ will ensure the community pharmacy network can protect health, reduce premature mortality and alleviate health inequalities.

We also want to see pharmacies commissioned to provide further vaccination programmes, building on their excellent track record of administering the flu and Covid-19 vaccines.