From a rocky start fraught with late payments in 1948, to new laws to protect pharmacists in 2018, C+D outlines the sector's defining moments, and its role in the NHS, in an interactive timeline to celebrate the health service's 70th birthday this month.
With thanks to the British Society for the History of Pharmacy president Stuart Anderson for fact-checking.
The NHS is bornJuly 5, 1948
The National Health Service (NHS) is launched by minister for health Aneurin Bevan. For the first time, patients can access medicines for free via NHS prescriptions. As a result, dispensing figures rocket past estimates by pharmacists and Mr Bevan of 140 million – hitting 202m in the first year.
This meant community pharmacists were due to receive a substantial increase in income, but the payment system crashed under the demand – incoming payments were received up to 11 months late.
The public’s reaction to the inception of the NHS was not universally popular, as Royal Pharmaceutical Society (RPS) museum documentation assistant Matthew Johnston explains in the video.
The medicines revolution1950s – 1960s
The increase in industrial production of medicines means community pharmacists move from making bespoke pills and tablets in front of patients, to supervising medicines in the dispensary.
The diminished visibility of the community pharmacist’s role is the beginning of a crisis for the sector, which will come to a head in 1981.
First self-service pharmacy1951
Boots is among the first UK pharmacy operators to move to a system where patients could pick items from shelves and take them to a till – rather than requesting pharmacy staff hand them over from behind a counter – at a store in Edgware, London.
Prescription charges introducedJune 1, 1952
The NHS introduces prescription charges of one shilling (five pence) per item. They are temporarily abolished in 1965, but the subsequent soaring drugs bill forces the government to reinstate them three years later, with more exemptions than before.
Pharmacists require degrees1967
Pharmacists are required to achieve a Bachelor's degree for the first time, rather than a diploma, which means taking a three-year university course followed by one year’s training in a pharmacy.
POM and P medicines introducedOctober 25, 1968
The Medicines Act classes drugs into three categories – prescription-only medicines, pharmacy products, and those that can be bought without a prescription in a wide range of shops such as newsagents.
Government questions pharmacy futureSeptember, 1981
The Conservative spokesperson for health in Margaret Thatcher’s government Dr Gerard Vaughan tells the British Pharmacy Conference in Brighton he was "not quite sure" that he knew the future for the community pharmacist, but "it is for the profession to tell us how best to run its job and develop its skills".
The president of the Pharmaceutical Society of Great Britain later tells C+D this statement "sounded like a death penalty" for the sector.
First pharmacy servicesLate 1981
The first pilots of clinical services in community pharmacies begin. One of the earliest schemes – run by the West Midlands Regional Health Authority – trains pharmacists to monitor patients’ blood pressure.
NPA launches "ask your pharmacist" campaign1982
The National Pharmacy Association (NPA) announces a campaign to get patients to “ask your pharmacist” about health matters.
NHS 'blacklists' introduced1985
The government introduces a list of prescription items the NHS won’t pay for, in an attempt to save the NHS £100 million a year, which includes popular branded medicines.
To see the original blacklist in the RPS Museum, watch the video.
Report praises pharmacists' "indispensable contribution"1986
The Nuffield Foundation publishes a government-commissioned report on pharmacy, detailing how pharmacists could contribute to healthcare.
It makes 26 recommendations, and concludes: "We believe that the pharmacy profession has a distinctive and indispensable contribution to make to healthcare that is capable of still further development."
Government encourages pharmacy assistant roleNovember 28, 1987
The government publishes a primary care programme with a chapter on community pharmacy, which sets out how to develop the sector's healthcare role.
It says that “pharmacists should be able to delegate to appropriately trained assistants...the dispensing of prescriptions, while retaining overall personal responsibility”, C+D reports.
Government funds pharmacy schemes1989
Pharmacy begins playing a greater role in public health, with the government investing £250,000 into a scheme to promote healthcare in community pharmacies via leaflets.
DH and RPS create joint "way forward"March, 1992
The Department of Health and the Royal Pharmaceutical Society of Great Britain publish a joint report called “Pharmaceutical care: the future for community pharmacy”. It recommends pharmacists participate in national health promotion campaigns.
Pharmacy policies change in UK countriesSeptember, 1997
The UK begins the process of devolving power from Westminster to Northern Ireland, Wales and Scotland. This breaks up the uniform UK pharmacy policy when three new governments are later created, in 1998.
Four-year undergraduate courseSeptember, 1997
The length of the undergraduate pharmacy course in the UK increases from three to four years, in line with the rest of the European Union.
Government pushes for healthcare in communityDecember 8, 1997
In its health white paper "The New NHS - Modern, Dependable", the government says it will deliver better healthcare faster, by treating patients with services offered by community pharmacies.
Pharmacists involved with NHS Direct1999
The first pilot with community pharmacies receiving patient referrals from a nurse-led telephone helpline – which will become NHS 111 in 2014 – launches.
Government recommends pharmacy servicesSeptember, 2000
A government paper, Pharmacy in the Future – Implementing the NHS Plan, sets out how the sector can help the NHS by improving its access to services – such as medicines management and repeat dispensing – by increasing the number of community pharmacies and improving out-of-hours coverage.
MHRA formedApril 1, 2003
The Medicines and Healthcare products Regulatory Agency (MHRA) is set up, following the merger of the Medicines Control Agency (MCA) and the Medical Devices Agency (MDA).
Government focuses on pharmacy accessNovember 16, 2004
The government expands on its vision for community pharmacies, in a paper called "Choosing Health" that focuses on their ease of access. "Their location in the heart of communities provides opportunities for…supporting individuals to take control of their lives, their health and…self-management of their long-term condition," it states.
National contract published2005
Community pharmacy's national contract for England and Wales is agreed by the Pharmaceutical Services Negotiating Committee, the NHS and the Department of Health. It replaces one from 1987, which focused only on prescriptions, with a more service-oriented approach.
The new contract creates three categories of services: essential, advanced and enhanced. It expects all pharmacies to deliver essential services – such as support for healthy lifestyles and self-care – and hopes they will deliver enhanced ones as well. Advanced ones will be commissioned locally.
Scotland and Northern Ireland also receive their own contracts this year.
Community pharmacies begin MURsApril, 2005
Medicines use reviews (MURs) are introduced in England, the first advanced service for community pharmacies.
Scotland minor ailments scheme introducedJune, 2006
Community pharmacies across Scotland receive funding to treat patients for minor ailments. In 2015-16 they dispense more than two million items through the scheme.
Independent prescribing course introduced2006
Community pharmacists can prescribe medicines in pharmacies for the first time after government legislation is amended. By July 20, 2018, there are 6,732 independent and supplementary prescribers, according to the General Pharmaceutical Council.
GPhC is createdSeptember, 2010
The Royal Pharmaceutical Society of Great Britain splits in two – creating pharmacy’s regulator, the General Pharmaceutical Council, and its professional body, the Royal Pharmaceutical Society.
NMS introducedOctober 1, 2011
The new medicine service (NMS) becomes the fourth advanced service to be added to the community pharmacy contractual framework in England.
National pharmacy flu vaccination programme is rolled outSeptember 16, 2015
Pharmacies across England begin vaccinating patients as part of the NHS seasonal flu jab programme.
Pharmacy cuts hit the sector in EnglandDecember 17, 2015
The Department of Health announces it will slash funding for pharmacies in England. Ten months later it confirms this will be by 12% between December 2016 and 2017, with a further 7.4% drop the following financial year.
It triggers a backlash across the country. A petition signed by a record-breaking 1.8 million is delivered to Downing Street. The National Pharmacy Association pledges that its battle against the cuts is “far from over”, and the Royal Pharmaceutical Society expresses “dismay”, while the Pharmaceutical Services Negotiating Committee unanimously votes against them.
Pharmacy funding cuts court case dismissedMay, 2017
A High Court judge dismisses the sector’s case against the funding cuts in England brought by the Pharmaceutical Services Negotiating Committee and the National Pharmacy Association “with regret”. The two pharmacy bodies appeal the decision a year later – a decision has not been reached at the time of going to press.
Dispensing error defence becomes lawApril 4, 2018
A legal defence from criminal prosecution for inadvertent dispensing errors comes into force, following a decade-long saga.
However, the Pharmacists’ Defence Association raises concerns that the legal defence would only help in a “limited range of scenarios”, while lawyer Noel Wardle says there is still a “significant risk” that pharmacists who commit an inadvertent dispensing error will be investigated for a crime.
NHS turns 70July, 2018
In the same month as the NHS enters its 70th year, the longest-running health secretary in history, Jeremy Hunt, is replaced by Matthew Hancock, and a new page is turned in the government’s relationship with community pharmacy.