For decades, community pharmacies in the UK have been a familiar part of the high street. A quieter shift is redefining the pharmacist’s role. Through Pharmacy First and a new contractual framework, pharmacists are taking on minor illness management and some urgent medicine supply, redirecting cases from GP surgeries to community pharmacies. The change promises quicker access for patients and reduced workloads for GPs.
Pharmacy First in Action: Expanding Access Amid Mounting Sector Pressures
Launched in January 2024, Pharmacy First enables pharmacists to complete episodes of care for a set of common conditions using agreed clinical pathways, building on earlier consultation services. At the same time, the 2024–26 Community Pharmacy Contractual Framework boosts sector funding and revises margins to support service expansion, creating a rare alignment between increased responsibility and additional investment.
Independent one-year evaluations show that pharmacies now offer quicker, more convenient care for common conditions such as sore throats and earache, with most consultations successfully managed on-site without the need for GP referral. That matters when the service goal is to free up millions of GP appointments and reduce avoidable pressure on primary care.
However, the promise comes with caveats. The ability to deliver these services relies on a stable pharmacy network, yet the sector has come under significant pressure. Since 2017, nearly 1,000 pharmacies in England have closed, with closures concentrated in deprived areas, raising concerns about equitable access to expanded services nationwide. Many independent and small-chain pharmacies face severe staffing and financial pressures, with national surveys consistently highlighting low morale, recruitment difficulties and uncertainty about long-term viability. Without addressing these workforce and funding challenges, policy ambitions risk falling short in practice.
Making Reform Work: Integration, Investment and the Future of Community Pharmacy
For these reforms to work in practice, the system must strengthen digital integration, referral routes and collaboration with local GPs. Weak IT systems or unclear pathways often drive patients back to their GP after visiting a pharmacy, increasing workload instead of reducing it. To achieve real system benefits, Integrated Care Boards (ICBs), GP practices and pharmacies must establish clear protocols, shared records and aligned incentives.
Pharmacy reform offers one of the NHS’s most promising opportunities for impact, delivering faster treatment for minor conditions, easier access for patients, and meaningful relief for GP practices; provided investment and integration match ambition. If implemented superficially, it risks fading as a temporary policy gesture; but with genuine commitment, community pharmacies could stand at the forefront of a stronger, more responsive primary care system.
