The 2026 Budget makes artificial intelligence central to the government's plans for NHS productivity. It contains no pharmacy-specific programme. But the decisions it sets in motion will shape how medicines are managed across the health service, and community pharmacy has a short window to influence them.
What the Budget announced
The Chancellor and the Health and Social Care Secretary have asked Mark Bailie to lead an independent review of NHS productivity and AI. It reports in early 2027 and will inform the next spending review. Alongside it, a £15 million AI Challenge Prize will target frontline public-service problems. The first competition focuses on the NHS, with a top award of up to £2.5 million.
Much of the substance has been deferred to that review. That is the opening. The question is not whether AI will reach pharmacy, but whether pharmacists help decide what it does when it arrives.
The productivity trap
The Budget ties AI to productivity throughout. For pharmacy, that word needs handling with care. There is scope to strip out repetitive work: documentation, stock forecasting, claims and reimbursement, routine patient communications. Done well, that would free up pharmacists and pharmacy technicians for consultations, prescribing and complex cases.
But productivity must not become a euphemism for expecting fewer people to dispense ever more prescriptions. A tool that raises throughput while cutting the time pharmacists spend with patients is not progress. It's about whether care becomes safer and more accessible, not how many transactions are automated.
Where AI could help now
Pharmacy already has the services AI could strengthen, and it does not need new ones invented.
The Discharge Medicines Service was designed to catch problems when patients leave hospital. In practice, discharge information often arrives late, incomplete or not at all, and pharmacies have little to help them prioritise referrals.
Once the information exists, AI could compare pre-admission and discharge medicines, flag high-risk changes and prepare a structured summary for review. The pharmacist then resolves discrepancies, explains the changes to the patient and contacts the prescriber where needed. That would help DMS deliver what it was meant to.
Pharmacy First and the move to independent prescribing make the case stronger. Newly qualified pharmacists now join the register as prescribers, and community pharmacy takes on more clinical decisions each year. Decision support that surfaces interactions, unusual doses, missed monitoring or a recent admission becomes more valuable, and its design more consequential, once pharmacists prescribe at scale.
The same tools could identify patients at risk of poor adherence or a medicine-related admission. They could help teams spend their time on the prescriptions and people that most need it.
Governance is not optional
None of this works without the right foundations.
Data. AI is only as good as the information it can see, and community pharmacists still lack consistent, timely access to the full clinical record. Investment in AI without investment in interoperability will disappoint.
Clinical safety. Health IT used in the NHS is already subject to clinical risk management standards: DCB0129 for manufacturers and DCB0160 for the organisations deploying it. Few community pharmacies realise DCB0160 applies to them. In my own work developing AI governance policy and a DCB0160 template for community pharmacy, the gap between what the standard requires and what independent contractors have capacity to do has been the most consistent finding.
Accountability. Responsibility cannot be handed to an algorithm. Pharmacists must be able to see why an alert fired, challenge it and record a different judgement. Tools must be tested for performance across patient groups, and owners need clear answers on where data is processed and whether it trains commercial models.
Cost. If safe adoption depends on technical resources only large multiples have, independents will be left behind and existing inequalities will widen. Funding and training must be part of the plan.
What the sector should do
Unless pharmacy moves now, the Bailie review will report before the profession has finished debating it.
In my view, Community Pharmacy England, the National Pharmacy Association and the Royal College of Pharmacy should commit publicly to a joint pharmacy submission, drawing in hospital pharmacy, pharmacy technicians and patients. It should arrive with specific proposals: AI-supported DMS, prescribing decision support, adherence risk identification and less administration for commissioned services.
Each proposal should be judged against the same principles: demonstrable patient benefit, professional oversight, transparency, secure and interoperable data, equitable access and evaluation in real pharmacy settings.
Designed with pharmacy, or around it
If pharmacy engages early, AI could speed its shift towards prevention, prescribing and medicines optimisation. If it stays on the margins, systems will be built around the profession, designed mainly to increase volume or cut cost.
AI is not a substitute for pharmacists or the relationships they hold with patients. Its best use is to point their expertise at the people and decisions where it matters most. The government wants AI to transform NHS productivity. It will only do so safely if medicines, and the pharmacists who manage them, sit at the centre of the conversation.
