Community pharmacy has shifted from a supply service to a clinical service right before our very eyes. We’ve had the Taylor Swift-style midnight launch of more details on Pharmacy First, an agreement to finally allow us greater access to GP records, and contraception is finally available for women without a prescription from their local pharmacy.

However, is it all as exciting as it seems to be? Or should we welcome such news with a hint of caution? A parliamentary debate on community pharmacy on September 14 and the Health and Social Care Committee’s (HSCC) pharmacy inquiry last month got me thinking.

Read more: ‘Enormous pressures’: MPs flag pharmacy funding, workforce and drug supply woes

I pondered the following question: are the current short-term issues (eg stock shortages) undermining the strategic development of community pharmacies? And has this led to a loss in momentum with regards to prescribing and new services, or potentially a loss of confidence in community pharmacies from the public?  

I strongly believe that the answer to both questions is no, although one does concede that there is a genuine debate to be had. Without wanting to put a dampener on these exciting times, let’s briefly summarise some of the current, and potential, issues facing community pharmacies:

 

Knowledge and confidence

 

A service such as Pharmacy First will undoubtedly bring an increased workload for community pharmacists. But will it also bring an increased cognitive load?

Read more: No plans to expand Pharmacy First conditions ‘at present’, says Leadsom

One could argue that it will not as we’ve known for a long time how to treat an uncomplicated urinary tract infection (UTI) or an infected insect bite; we are just finally being given the powers to do so. The mandate has finally caught up with our knowledge, but do we have the confidence to use it?

  

A mindset change

 

Community pharmacists have long struggled to remove themselves from the dispensary and for a service such as Pharmacy First to truly work, a pharmacist must have free time to do the work.

Read more: Launch dates announced for Pharmacy First and contraception services

Many pharmacy managers have stated that pharmacists should be spending at least three hours of their day removed from the dispensary, but how many pharmacists are of that mindset, and how many pharmacies have the staffing to allow this?

The Pharmacists’ Defence Association (PDA) has even suggested that having a second pharmacist in community pharmacies may be the best way for the Pharmacy First service to work.

 

Medicines supply issues

 

There’s also a record number of supply issues. These supply issues have led to reports of pharmacists spending increasing amount of time trying to source medicines, leading to reduced times for services and frustrated patients.

 

Rising costs

 

Oh, and then there’s the increased number of items being dispensed and rising costs, according to the NHS Business Services Authority (NHSBSA). The rising cost of items (as well as absolutely everything else becoming more expensive) has led to widespread reports of dwindling profit margins and cash flow problems.

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These cash flow problems have led to pharmacies closing. The parliamentary debate stated that in the first six months of this year, the net number of pharmacies in England reduced by 222.

Sadly, it is not rare to hear that a community pharmacy team is more concerned with paying their wholesalers at the end of the month then they are with any new services.

 

Workforce issues

 

And there’s still high vacancy rates. Last year’s community pharmacy workforce survey showed a 20% vacancy rate for pharmacy technicians, 16% for pharmacists and 9% for dispenser. Data for this year’s survey is being collected now, but anecdotal evidence seems to suggest that these vacancy rates will have continued to increase in 2023.

However, will a service such as Pharmacy First cause a reverse in the trend for 2024? And what about the public’s current perception of community pharmacy? Are they excited for the new services?

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Well, the good news is that the public have long enjoyed the human contact, and personalised services, that local community pharmacies are able to provide. However, there is growing concern that staff are too becoming busy for consultations.

A survey conducted by Ipsos at the end of last year stated that 91% of respondents felt they received good advice from their pharmacy about medicines, a health problem or injury. Despite this, only 56% of those questioned would be comfortable with a pharmacist prescribing a new medicine they had not taken before.

Data is being collected for this year’s by Ipsos for this year’s survey, with additional questions around stock of medication.

Read more: 'High' patient confidence in independent prescribers, study shows

The Proprietary Association of Great Britian’s (PAGB) recent self-care survey report highlighted that two in five adults are still using their GPs for minor health issues. Education and clear direct messaging will be needed to convince these adults to use their community pharmacies more.

Having written all these points down, I seem to have dampened my own excitement for the future of community pharmacy… hopefully it hasn’t dampened yours.

I do still feel that the answer to my original question is no, but I’m very keen to hear your views, opinions, and stories.

Shy Teli is the chief pharmaceutical officer's clinical fellow at the Centre for Pharmacy Postgraduate Education (CPPE)