Something is happening on our high streets.
From this autumn, around 100 community pharmacies in England will begin offering free, seven-minute finger-prick cholesterol tests. People aged 40 to 84 who haven’t had a blood test in the previous year will be able to walk in, get checked and discuss the result with their pharmacist.
That may sound like a modest NHS initiative, but I like to think it points towards something more significant.
Read more: ‘Historic’: Pharmacies to offer free cholesterol checkups from autumn
For years, those of us who championed community pharmacy inside government argued that pharmacists were chronically under-used clinical professionals in the NHS. We needed to stop thinking of pharmacy simply as somewhere medicines are dispensed and start seeing it as part of primary care. Sounds rather trite now, which is a sign of how far we’ve come.
Pharmacy First, during my tenure as the minister, was born of that thinking. And it is working - more than 2.75 million Pharmacy First clinical pathway consultations were delivered between April 2025 and January of this year.
My argument today, tapping into all the experience and insight I have, is that this success should give us confidence to ask the next question: is Pharmacy First an analogue service in a digital age?
Read more: Tech training ‘immediate opportunity’ for Pharmacy First
Its great strength is its simplicity. You have a problem. You walk into a pharmacy. You speak to a professional, often without an appointment. We must not lose that and to their credit, I don’t believe the current Department of Health team have any intention of doing so.
But if we were designing Pharmacy First today, surely we would think more multi-dimensional?
We should be able to open the NHS App, describe our symptoms and be directed towards the right destination; self-care, GP, urgent care or community pharmacy. If pharmacy is appropriate, crucially we should be able to see which pharmacies nearby offer the service and which have the capacity to see me.
“Try your local pharmacy” is mere signposting. “Your local pharmacy can help you this afternoon” is a pathway. And the potential is becoming greater all the time.
Pharmacy First 2.0
From this September, of course, all newly qualified pharmacists will register as independent prescribers. A national NHS prescribing offer is also being introduced this autumn, extending Pharmacy First and the Pharmacy Contraception Service. Mix in cholesterol and blood-pressure testing and something interesting begins to emerge.
The community pharmacy of the future isn’t simply somewhere to go when you are ill. It should increasingly be somewhere that helps stop you becoming sick in the first place. That is why Jeremy Hunt and I combined pharmacy with the wider primary care - and, crucially, prevention - brief when I served in government alongside him.
Read more: Every pharmacy could have a prescriber by ‘early 2030s’
And that is what I like about the new cholesterol service. It takes prevention out of the policy document and puts it onto the high street. An apparently healthy person walks into a pharmacy and minutes later may discover a cardiovascular risk they knew nothing about - with a clinician there to advise what happens next.
So my argument isn’t that we got it wrong with Pharmacy First. Quite the opposite.
Pharmacy First 1.0 established an important principle: pharmacists should be a part of primary care.
Pharmacy First 2.0 should bring together that extraordinary physical network with the digital NHS - connecting triage, prescribing, patient records, prevention and the NHS App.
Read more: Pharmacy First uptake is highest in deprived areas, research finds
Digital-first must never mean digital-only. The ability simply to walk into a pharmacy is one of the NHS’s greatest assets.
But the high street and the smartphone shouldn’t be rival front doors to healthcare. They should increasingly be the same front door.
Steve Brine is a consultant, podcaster, trustee, former MP for Winchester & chair of the Health Select Committee