Community pharmacy’s growing workload is “not sustainable” and workforce capacity must be increased to support it, the Pharmacists’ Defence Association (PDA) has warned.
A new report, published by the PDA on April 28, noted that the introduction of the Pharmacy First service in 2024 has contributed to “huge increases in prescription volume” and a “wider range of clinical services and walk-in consultations being offered” by pharmacies.
It found that pharmacy’s “total system capacity has been exceeded” as a result, and the “present pace of growth in workload is not sustainable”.
Read more: Revealed: Who delivered the most Pharmacy First consultations?
The PDA said “workforce capacity must increase” - and added that and this “needs to include” a two-pharmacist model as the “present one pharmacist, one consulting room pharmacy model has reached its safe capacity limit”.
This two-pharmacist model, along with expanded consultation room capacity, would support NHS 10-year plan proposals for pharmacy and “secure the longer-term viability of community pharmacies in England”, it added.
The report also recommended that “representatives of the pharmacist workforce” are “involved in contractual negotiations, especially when new services are introduced”, and said “any increased funding must be suitably ring-fenced to achieve staffing growth”.
“Buckling under pressure”
In the report, the PDA cited NHS Business Services Authority (NHSBSA) data that showed just over 6.2 million Pharmacy First consultations were delivered in the service’s second year, a 25% increase on the year of its launch.
It also found there had been a 300% growth in the number of services delivered by pharmacies between 2021 to 2025, jumping from 7.5 million to 25 million.
But despite the “significant” growth in workload since Pharmacy First began, the report said, the total staffing numbers per pharmacy have remained the same.
Read more: NHS spent £2m on latest Pharmacy First campaign, govt reveals
According to data from the England Community Workforce Survey, there was a 6.6% decrease in the number of pharmacists and a 32.9% decrease in the number of pharmacy technicians across the country between 2021 and 2024.
Other trained support staff decreased by 6.2% over the same period, and there was a 5.5% decrease in England’s pharmacy workforce overall.
Read more: Expand Pharmacy First conditions, says health watchdog
Using the survey data, the PDA calculated that there are, on average, 1.2 pharmacists working per pharmacy in England - and said this means that for “most of the working week”, a pharmacist “will be working alone without another pharmacist or a pharmacy technician being present”.
“The net result of this static workforce, increased workload and heightened intensity is that pharmacy teams are buckling under the pressure,” it added.
“Simply untenable”
NHSBSA data cited in the report also showed a 9.8% decline in the number of brick-and-mortar pharmacies across England between 2019/20 and 2024/25.
And those pharmacies are now open for fewer hours, the report said, with opening hours dropping from 55.64 to 51.94 per week between September 2022 and December 2025.
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The PDA said “such intensity and pace of work is simply untenable” when the workforce is not growing “to match this huge increase in workload intensity”.
Future workforce
The report also highlighted that the recent change to the MPharm degree, which will see students graduate as pharmacist independent prescribers (PIPs) from this year, is “transformative”.
It noted that the percentage of PIPs on the GPhC register has already increased from 21% in 2021/22 to 38% in 2025/26, and said the number of students being accepted to study pharmacy is “rising at a rapid pace”.
Expand and enhance
But it warned that to accommodate independent prescribing and “widening provision of other clinical services”, the NHS must support the expansion and enhancement of pharmacy consultations rooms.
“If pharmacies are to remain as the front door to the NHS, then the premises they operate from must be fit for purpose,” it said.
“We recognise that there will be re-configuration costs, but the NHS supports GP practices in premises improvements,” it added. “There is no reason why the NHS cannot support pharmacy premises to enhance consulting room capacity.”
Read more: Scope of Pharmacy First conditions ‘under review’, Kinnock says
It comes after the PDA revealed that a “large multiple” in Scotland has been “celebrating” its locum rates reaching “their lowest for eight years”.
The PDA told C+D that the multiple, which it declined to name, had highlighted the low locum rates as a “positive achievement” in recent management communications.
