The future

Published on: 15th February 2022 | Updated on: 15th March 2022

Whilst dispensing medicines safely will always remain the central role of pharmacies, there is likely to be a shift to offering services that help people to stay healthy and take pressure off other NHS services, such as urgent care. This will include prevention and treating minor illnesses, with pharmacies working closely with GPs and other providers in Primary Care Networks.

The Government has made clear through the NHS Long Term Plan that it wants to better utilise the skills and reach of community pharmacy. However, this will require the sector to embrace a series of changes. The following animation describes the transformation that community pharmacies will need to undertake over the coming months and years.

Future of Pharmacy Animation

Vision for the future

Community pharmacies are a critical part of the NHS and they have much more to offer to benefit patients, local communities and local healthcare systems. With proper financial support pharmacies could make real progress on:

  • Prevention: Healthy Living Pharmacies can do much to help;
  • Levelling up health inequalities, particularly after the pandemic;
  • Tackling obesity and other health factors that have contributed to the UK COVID-19 deaths;
  • Provision of enhanced community and public health care;
  • Ongoing provision of COVID-19 booster vaccinations; and
  • Providing first port of call help to support GPs to return to pre-COVID activity.

In October 2019, a five-year deal for community pharmacies came into effect. This set out a pathway of clinical service development for the sector. As part of the deal, funding was fixed and the Government committed to exploring ways to make dispensing more efficient and to free up pharmacist and pharmacy teams time and capacity. Revised pharmacy terms of service would also be introduced to reflect the different ways in which people use and access online services and the way these services are provided.

Funding and operational barriers

When the five-year deal was agreed, community pharmacy funding was set at £2.592bn per year. Government also committed to working with PSNC on measures that would help to release capacity in the sector. Delivering all the services within that constrained funding envelope was always recognised to be a challenge for the sector, and with COVID-19 pressures and the lack of progress on capacity-releasing work for pharmacies, the situation is now even more challenging than had been anticipated.

PSNC has been arguing strongly for an uplift in core pharmacy funding to take into account the chronic underfunding that the sector is experiencing, and in recognition of the significant financial and capacity challenges that all pharmacies are currently dealing with. Unfortunately, the Government has rejected any uplift to the funding for the Community Pharmacy Contractual Framework (CPCF) for 2021/22. This will pose considerable challenges for many pharmacy businesses as they try to embrace the positive service changes this year, while also managing cashflow as they pay back COVID-19 loans.

PSNC Briefing: Community Pharmacy Funding and Capacity
This PSNC Briefing describes the current situation regarding community pharmacy funding and capacity, including information that was used in recent negotiations with HM Government.

Changes for 2021/22

From September 2021: New Medicine Service

The NMS, which supports patients who have been newly prescribed a medicine to get the maximum benefit from it, has been extended with a range of new patient and carer cohorts now eligible for the service. This will benefit people prescribed a new medicine for hypercholesterolaemia; osteoporosis; gout; heart failure; glaucoma; Parkinson’s disease; epilepsy and urinary incontinence or retention.

The service can also now be offered to support parents / guardians / carers of children and adults newly prescribed eligible medicines who could benefit from the service, but where the patient is not able to provide informed consent.

From October 2021: Hypertension case-finding service

Supporting the NHS Long Term Plan ambitions for prevention of cardiovascular disease, from October pharmacies will be able to offer blood pressure testing. This service will have 2 stages. The first is identifying people at risk of hypertension and offering to measure their blood pressure. The second stage, where clinically indicated, is offering ambulatory blood pressure monitoring (ABPM) over a 24-hour period. The blood pressure test results will then be shared with the patient’s GP to inform a potential diagnosis of hypertension. This is an important service, but given the current capacity pressures it is expected that pharmacies may take some time to implement it.

From March 2022: Smoking cessation service

Smoking remains a leading cause of illness in England, and a factor in COVID-19 outcomes. From March, NHS Trusts will begin to be able to refer patients discharged from hospital to pharmacy to continue their smoking cessation care pathway. Pharmacies will offer medication and behavioural support, in line with the NHS Long Term Plan care model for tobacco addiction.

Regulatory and other CPCF changes

Various regulatory and associated changes will also be made or are planned over the course of 2021/22. These will mostly impact pharmacies, but they may change working practices, and some might ultimately lead to changes and improvements in the ways that patients receive pharmaceutical services. In particular:

  • Changes will be made to the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 to include a pandemic provision: this relates to the protection of staff and patients in a pandemic.
  • There is also agreement to continue conversations with DHSC on regulation of the dispensing and supply of medicines, taking into account novel ways of undertaking these services.
  • Discussions will be progressed on a suitable process to investigate allegations of prescription direction: this helps to ensure that patients retain free choice of which pharmacy to use.
  • DHSC has also confirmed its intention to progress legislation on original pack dispensing of medicines, and the wider use of hub and spoke technology.

In addition, a revised Pharmacy Access Scheme (PhAS) commenced from January 2022. The scheme seeks to ensure that all patients have access to a pharmacy, even in remote areas.

PSNC negotiates with the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I) on behalf of all NHS community pharmacies in England. Learn more about PSNC.