In increasingly difficult times in the community sector, pharmacy owners are looking for new income streams to support the NHS model.

At the moment it is about survival for some pharmacies, and when you’re in that situation it can sometimes be difficult to make sense of any strategy going forward, when decisions are driven by finance.

The threat from internet pharmacies is very real, and in a world where digital and online options are available on people’s phones, why should they be loyal to the bricks-and-mortar model of pharmacy? So many patients are opting to choose the perceived convenience and ease of online sites to supply their repeat prescriptions.

As a sector, perhaps we need to ask the question: 'Why?' In your own pharmacy, ask: 'Am I under threat from online competitors?' If the answer is yes, then ask what is it that would encourage the public to have a reason to continue using your pharmacy to safely supply their repeat medication.

Across the country, we are hearing of the difficulties people face trying to see a doctor or a nurse when they are unwell. As a result, the government is actively encouraging them to speak to their pharmacist first.

This is a huge opportunity to capture the loyalty from these individuals. Although they present for advice, they could also get a health assessment from the pharmacy. This is perhaps the missing link. If you were to consider adding pharmacist care to a patient’s journey when they need this healthcare intervention, it could be a reason why they would bring or keep their repeat prescription with your pharmacy.

So what would that potentially look like? Pharmacists would need to be available and easily accessible to do the face-to-face triage required. In addition, there would need to be:

• Private consultation rooms in pharmacies for people who want to be triaged by the pharmacist, so that it feels the same as a GP practice. The triage would have to be to a high standard.
• Care added to the supply of long-term repeat medication, with regular conversations to build a trusting relationship between pharmacists and patients.
• Care with diagnostics, to support people to understand how they are managing their long-term condition, and give them the tools to help self-manage, and set health goals and targets.
• A preventive care agenda and resources put into showing the public pharmacists are a professional healthcare provider who can help prevent their disease from progressing.

In an NHS where getting easy access to a nurse or doctor is difficult, the public desperately needs pharmacists. No online provider can ever replace the face-to-face personal interaction, triage and a walk-in consultation embedded in their community that they get with their pharmacist.

Filling this huge gap in the NHS is an opportunity that could make the difference between survival or closure. It might be difficult, but we can’t afford not to ignore this option.

Hard times mean we sometimes need to rethink the business model of care we are offering. Digital disruption is already here. We cannot forget this, and so our bricks-and-mortar pharmacies have to compete with internet pharmacies’ ease and convenience, as well as showcase our excellence in triage, advice and medicines expertise. To deliver this, our teams need investment at every level.

Sally Butamol is a community pharmacy contractor in Scotland

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