What pharmacies do

The daily life of a community pharmacist is hugely varied, drawing on a wide range of clinical and non-clinical competencies and skills. Every pharmacy is required to be operated under the control of a ‘Responsible Pharmacist’ – a highly trained healthcare professional overseeing the whole operation.

Daily tasks undertaken by community pharmacists include:

• oversight of safe dispensing processes to enable medicines supply;
• supporting patient safety through clinical scrutiny of prescriptions, support with managing minor illnesses and escalating care where appropriate and providing oversight of the sale of over the counter (OTC) medicines;
• providing people with counselling to understand their medicines and how to use them, particularly when it is new medication or following discharge from hospital;
• providing public health information and health interventions;
• signposting for people to other services, information or self-care organisations;
• supporting patients with self-care and treatment of minor ailments;
• through some of the clinical services like the Pharmacy First service, provide direct patient care;
• liaison with other healthcare professionals;
• clinical review services for specific groups of people in GP practices, e.g. asthma, diabetes, hypertension;
• medicines management support for GP practices, e.g. supporting practice formulary and clinical guideline implementation, repeat prescription management; and
• providing locally commissioned services such as supply of Prescription Only Medicines (POMs) under Patient Group Directions (PGDs), screening services, public health interventions and treatments.

Community pharmacies in England operate under the NHS Community Pharmacy Contractual Framework (CPCF), which consists of Essential, Advanced and National Enhanced Services. There has been a significant increase in the number of clinical services in the past few years. NHS income for a typical pharmacy accounts for 85%–95% of total pharmacy turnover.

Essential services are those which every pharmacy must provide. These are:

• Dispensing (of medicines and appliances): working to a prescription, pharmacists will provide you with your medicines labelled correctly following the directions of a GP or other healthcare provider who can write prescriptions (e.g. nurses, dentists or pharmacists).
• Repeat Dispensing: allowing you to collect your regular repeat prescription medicines direct from your local pharmacy for an agreed period of time, without having to go back to your GP. You will need to give your permission to your GP for him/her to share information with your chosen pharmacist. When you need your prescription, instead of requesting it from your GP, you will be able to get your medicines directly from your local pharmacy.
• Discharge Medicines Service: offering advice about newly prescribed medicines to people referred by NHS Trusts after discharge from hospital.
• Disposal of Unwanted Medicines: if you have any medicines that you no longer use, you can take them to your local pharmacy for safe disposal.
• Promotion of Healthy Lifestyles: providing you with advice on keeping healthy; this could be advice on healthy eating, stopping smoking and exercise. Local health promotion campaigns cover topics such as taking care in the sun and understanding the risks of long term conditions such as diabetes.
• Signposting to other Services: your pharmacy will provide you with contact details for additional help if needed from other healthcare professionals, social services or voluntary organisations.
• Support for Self-Care: helping you to look after and care for yourself and your family. Your pharmacy will provide you with advice on treating minor illnesses, e.g. coughs and colds or long term conditions such as arthritis or diabetes. This support may include medicines which you can buy over the counter from the pharmacy without a prescription.
• Healthy Living Pharmacy: provision of a broad range of health promotion interventions to meet local need, improving the health and wellbeing of the local population and helping to reduce health inequalities.
• Clinical Governance: pharmacies must have a system to support the provision of excellent care, this includes using standard operating procedures, acting on drug safety alerts, and carrying out satisfaction surveys.

Advanced services are offered by most community pharmacies, but they are optional. These are:

• Pharmacy First Service*: giving advice and, if needed, NHS medicines to treat seven common health conditions without the need for a GP appointment. GPs and NHS 111 may also refer you to the service.
• Blood Pressure Checking Service (also known as Hypertension Case-Finding): providing free NHS blood pressures checks to people aged 40 and over to help reduce their risk of heart and circulatory diseases.
• New Medicine Service: providing support for people with long-term conditions who have been newly prescribed a medicine to help improve medicines adherence.
• Contraception Service: allowing the initiation and on-going supply of oral contraception.
• Flu Vaccination Service: administering NHS flu vaccinations to people in eligible groups.
• Smoking Cessation Service: supporting people to continue treatment to stop smoking after being discharged from NHS hospitals – patients must be referred into this service by their NHS Trust.
• Lateral Flow Device Service: supplying Lateral flow device tests for those potentially eligible for COVID-19 treatments.
• Appliance Use Review: supports people to better understand and use their prescribed appliances.
• Stoma Appliance Customisation: the customisation of a quantity of more than one stoma appliance, to ensure proper use and comfortable fitting.

*Learn more about the Pharmacy First service in our animation:

Further information on Pharmacy First aimed at GPs and practice teams is available here.

National Enhanced Services may be used to address local need, and they are also optional. These include:

• COVID-19 Vaccination Service: provision of COVID-19 vaccinations to eligible patients.
• RSV and Pertussis Vaccination Service: provision of the Respiratory Syncytial Virus (RSV) vaccination and the Pertussis vaccination to eligible patients.

Some pharmacies also offer others services to meet the needs of their local communities. These services are commissioned by local NHS England teams, Local Authorities and Integrated Care Boards (ICBs). The local services on offer can vary around the country, but examples include services for minor ailments, sexual health, substance misuse, falls reduction, care homes, and weight management.

For local services available in your area, please speak to the Local Pharmaceutical Committees (LPCs). Find their contact details via the LPC websites portal.

Pharmacy owners may also decide to supplement their income and offer additional services their communities want through the provision of private services (such as travel vaccinations, weight management, ear wax removal, etc.), as well as pharmacy medicines and health and beauty retail.

However, only around 10% of community pharmacies’ income is derived from retail and private services.

In addition to these services, most pharmacies will take part in the Pharmacy Quality Scheme (PQS) which supports the delivery of the NHS Long Term Plan by rewarding community pharmacies for achieving set quality criteria in three dimensions: clinical effectiveness, patient safety and patient experience.