The long-awaited NHS ten-year plan was published on 3 July 2025 to a slew of cautious reactions: quietly optimistic, all underscored with healthy scepticism.
Community Pharmacy England welcomed the direction of travel — a bigger role for community pharmacy in prevention and managing long-term conditions, local care and digital records — but warned that “each new service needs to be carefully managed given the sector’s current capacity and tight finances”.
The Royal Pharmaceutical Society (RPS) noted the announcement came at a time of “significant cuts” to integrated care boards — “at odds with the ambitions of the plan” — while the Independent Pharmacies Association stressed that any additional responsibilities must come with “proper funding”.
Most agreed with the government’s three big shifts in the plan — ‘hospital to community’, ‘sickness to prevention’ and ‘analogue to digital’ — but for many, what was missing was tangible detail and a reliable path for implementation. If the plan’s intention was to set the vision for the next decade, it certainly succeeds — but how useful is vision alone when the service is already battling workforce shortages, rising demand on community pharmacy and a mandate to save £1bn on medicines by 2029?
These concerns echo many of those raised in response to the ‘NHS long-term plan’, published in 2019, which recognised pharmacists as central to delivering expanded primary care services (newly introduced ‘primary care networks’ at the time) — particularly through the development of neighbourhood teams and structured medication reviews.
However, the role of community pharmacy was only loosely defined and the main sector bodies quickly flagged gaps in implementation detail. As The Pharmaceutical Journal reported on 8 January 2019: “Pharmacy leaders have warned that the community pharmacy sector will have to change significantly if recommendations for pharmacy made in the ten-year plan for the NHS in England are to be implemented successfully.”
The most critical question now is: will implementation be any different, and will pharmacy finally be given the tools and support to deliver?
Despite a £4.5bn investment into primary and community services, pharmacy leaders warned at the time that ongoing workforce shortages and underinvestment in digital infrastructure posed serious risks to progress. The mismatch between ambition and operational reality — especially around training, staffing and IT capability — meant that much of the sector’s potential remained unrealised. Sound familiar?
Six years on, the 2025 plan reaffirms many of the same priorities: increased investment in primary and community services and greater use of community pharmacists’ clinical skills. The most critical question now is: will implementation be any different, and will pharmacy finally be given the tools and support to deliver?
Once again, there are big, important questions around how pharmacy will be resourced to meet rising clinical demand — particularly in light of existing workforce shortages and escalating burnout among pharmacy staff, as well as the continual increase in community pharmacist independent prescribers.
At The PJ, this an area we’ve been focusing on closely since April 2025, when we launched our dedicated campaign focused on securing a sustainable future for the pharmacy workforce. Since then, our reporting has highlighted a steady increase in mental health-related absences among hospital pharmacists over recent years. We’ve also seen that community pharmacies are operating under serious financial pressure — a March 2025 analysis found the cost of delivering NHS pharmaceutical services (£5m) far outstrips the £2.8bn in funding, leaving a gap of more than £2m. An independent review, published on 14 July 2025, also uncovered “extreme financial pressures” on community pharmacy clinical services.
On top of that, demand for mental health support for pharmacists continues to increase. Recently, we reported that pharmacists’ self-referrals for counselling rose by roughly one-quarter in 2024 compared with the previous year.
There’s nothing wrong with ambition, but ambition without detail risks becoming little more than rhetoric
All this begs the question: how can the NHS implement a ten-year plan effectively without an up-to-date, robust workforce strategy? (The workforce plan is currently due in autumn 2025.) And how will both strategies address the growing risk of burnout and mental health challenges while expecting pharmacy teams to meet expanding clinical demands and support patient care at scale?
Noticeably, there was also little mention of how a shift from ‘hospital to community’ and ‘sickness to prevention’ will impact funding for secondary care and hospital pharmacy. As Tase Oputu, chair of the RPS English Pharmacy Board, highlighted: “Aseptic infrastructure, for example, is critical to the delivery of specialist cancer care and clinical trials and must be prioritised to meet growing demand. Similarly, delays in implementing electronic prescribing systems continue to hinder productivity and patient safety in hospitals.”
There’s nothing wrong with ambition, but ambition without detail risks becoming little more than rhetoric. There’s a valuable opportunity here for pharmacy leaders to secure a seat at the table and set out a convincing plan for how neighbourhood health teams, for instance, could look — helping make the most of available resources and finding ways to cut costs where possible. Pharmacies could also draw on their local multidisciplinary links to help shape plans and keep pharmacy teams at the centre of community healthcare. At a time when public satisfaction with community pharmacy is extremely high (according to a 2025 NHS GP satisfaction survey in July 2025), now is the time to back that vision with action — making the most of still-undefined neighbourhood health teams in a way that’s credible, sustainable and genuinely fit for the future. PJ
