The 10-Year Plan update: community pharmacy recognised, but capacity and funding concerns persist

With the NHS 10-Year Plan due for publication imminently, senior government officials and NHS figures have reiterated the importance of shifting care closer to home.  Community pharmacy has been highlighted as a “key clinical service provider” within this transition, but sector leaders warn that current capacity and funding limitations may obstruct delivery without meaningful action. 

 

Hospital to Community: A Central Shift 

 

Health Secretary, Wes Streeting told the NHS Confed Expo in Manchester that the reforms outlined in the upcoming plan aim to drive significant change.  

“As we deliver the transformational shifts in our 10-year plan—from hospital to community, analogue to digital, sickness to prevention—it will have radical implications for services.” 

 

He added that “much of what’s done in a hospital today will be done on the high street, over the phone or through the app in a decade’s time,” suggesting community pharmacy is a key player in his vision for the future. Streeting also confirmed that the government is “open to” acute trusts delivering primary and community services where appropriate to improve efficiency and integration. 

However, community pharmacy was not directly mentioned in his speech, despite its increasing relevance in the delivery of neighbourhood health services. 

These comments echoed those previously made by Chief Pharmaceutical Officer David Webb and Pharmacy Minister Stephen Kinnock, who have stated that pharmacy will be “critical” to the success of the 10-year plan. 

Meanwhile, Sally Warren, Director General for the 10-Year Health Plan, said that the radical aspect of the plan lies not in the ideas themselves, but in their implementation.  

“The flagship three shifts – hospital to community, analogue to digital and sickness to prevention – are not radical,” she said. “It is delivering the shifts that will be radical.” 

Warren also emphasised the plan’s focus on giving patients more control over their care.  

“That sense of patient power – patients being in the driving seat – is a really, really important North Star for our work in the 10-year plan,” she said. 

 

Community Pharmacy Must ‘Grow’ 

 

Meanwhile, NHS England’s National Director for Primary Care and Community Services, Dr Amanda Doyle, stated that while the 10-Year Plan will be “very, very GP-centric,” it is “not all about general practice.” Speaking at the same conference, she emphasised that “community pharmacy is increasingly emerging as a key clinical service provider in primary care and we need that to grow.” 

She acknowledged the sector is “underwater currently,” citing challenges around sustainability and workforce pressures. However, she urged that these difficulties “must drive reform,” highlighting the need to “take advantage of the opportunities around automation of dispensing and around skill mix use” to enable pharmacists to focus on clinical care. 

Dr Doyle also noted that legislative changes – such as the introduction of hub-and-spoke dispensing and the expanded role of pharmacy technicians under patient group directions – should support service transformation. 

 

How is the sector feeling while awaiting the plan’s publication?  

 

In a joint statement released on 16 June, Community Pharmacy England (CPE) and other primary care negotiators warned there is “little capacity to deliver” the proposed reforms without “further details and meaningful actions” from government. The statement welcomed the recent pledge of a £29 billion annual NHS funding uplift until 2028/29 but called this “the single opportunity in this parliamentary cycle” to enable the shift to community care. 

The letter, signed by CPE Chief Executive Janet Morrison, said that “pressures all parts of primary care are facing” stem from “a historic focus on specialist settings, bureaucracy and poor workforce planning by NHS England.” 

“Years of underfunding and real-terms cuts have left community pharmacies struggling to survive – and it will take more than automation to fix the issue,” she said. 

She added that the government must “deliver on its commitment to build the sustainable funding and operational model that community pharmacy so desperately needs.” 

Likewise, Gareth Jones of the National Pharmacy Association said Dr Doyle’s public endorsement of pharmacy’s clinical role was welcome, but warned that a lack of funding would impede any future plans: 

“Without sufficient funding, the current dire situation cannot be transformed into a position where pharmacies are playing a full clinical role within the NHS.” 

Malcolm Harrison, Chief Executive of the Company Chemists’ Association, echoed this view: 

“Reform and new opportunities, like automation, require investment which has been lacking. If we get the necessary investment, and ambitious commissioning of new clinical care services, community pharmacy will continue to grow as a clinical service provider in primary care.” 

Sir Jim Mackey, Chief Executive of NHS England, acknowledged that “everyone’s worried” about the feasibility of the shift to community-based care, noting that “we’ve talked about neighbourhood care and the shift for years and years… [but] we’ve never managed to do it on any scale or for any period.” 

 

A Wait for Detail 

 

The final version of the 10-Year Plan has not yet been published. 

As pharmacists and other healthcare professionals await further details, sector leaders are united in the message that ambition must now be matched with action – and funding – if community pharmacy is to fulfil the role many in government are increasingly asking it to play.