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Policy makers, commissioners and system leaders needed to “match ambition with action”, said Hatul Shah managing director at Sigma speaking at the Sigma and Avicenna conference in Leicester this month. 

“If the DHSC, NHS England, ICBs and national negotiators want community pharmacy to carry more clinical responsibility, then they must deliver a funding model that is predictable, fair and investable.

“They must reduce reimbursement friction, improve shortage flexibilities, accelerate digital interoperability and commission services in a way that reflects what pharmacy can genuinely deliver. You cannot build a neighborhood health service on top of businesses that are fighting every month to preserve cash flow,” he said.

Community pharmacy in England was “no longer talking about potential, it was proving delivery,” as there had already been more than 5.4 million pharmacy first consultations.

However, he said, while the 2025/2026 contract settlement brought a “significant uplift”, and was “important and necessary”, it was not the finish line, as many owners were “still effectively subsidising NHS care from their own balance sheet,” which was not sustainable.

“Staffing shortages, recruitment difficulties and rising employment costs are reducing opening hours and narrowing the space many teams have to grow services. And yet, this is the important point; the opportunity in front of us has never been greater,” he said.

The NHS 10-year health plan was explicit about “moving care from hospital to community, from analogue to digital, and from sickness to prevention.” Community was “written into the future”.

“The question is no longer whether the pharmacy belongs in the centre of NHS reform, it is whether the system will actually strongly back us and quickly enough so that reform succeeds.”