By Conor Price, Chief Executive – Community Pharmacy London
Primary Care is the backbone of the NHS. It’s where most people’s health journeys begin and, if we get it right, where most should end too. But right now, the sector that should be the most joined-up is the one most divided.
Across General Practice, Community Pharmacy, Dentistry and Optometry, we have nearly 40,000 community assets; buildings, skilled professionals, data systems, and deep-rooted trust.
On paper, it’s an unbeatable network. In practice, it’s a system that’s been designed to compete with itself.
For years, the model of commissioning and contracting has pitted Primary Care providers against one another, each fighting for their own sustainability rather than being rewarded for collaboration.
Community Pharmacies are under relentless financial pressure. General Practice is straining to maintain access. Dentists and optometrists were left on the periphery of system design. It’s inefficient, disjointed, and bad for patients.
If the NHS is serious about prevention, continuity, and community-based care, the future depends on the Primary Care uniting as one sector.
And Community Pharmacy can be the sector that leads that change.
Community Pharmacy’s Strength Is Its Proximity and Its People
Community Pharmacy already does what the system needs more of: accessibility, immediacy, and continuity. Pharmacists are the most approachable health professionals most people will ever meet. The public doesn’t need a referral, an appointment, or a digital form, they simply walk in.
That immediacy is a huge strategic advantage, especially when we talk about prevention and early intervention. The Pharmacy First service is proof of concept: a national framework showing how pharmacy can manage demand safely, locally and efficiently.
But we can’t stop there.
If we want to reshape the NHS, Community Pharmacy must lean fully into its strengths, prevention, medicines optimisation, long-term condition support, and population-level health coaching. It’s about using the profession’s unique reach not just to treat illness, but to keep people well.
And crucially, Community Pharmacy has to do it in partnership, not in isolation.
The Power of Relationships
In every part of the NHS I’ve worked in, one truth holds: relationships determine results.
You can have the best contract, the smartest technology, or the most polished governance but if the relationships between sectors are weak, collaboration fails.
It’s easy to underestimate the time and energy it takes to build genuine relationships across organisations. It’s not “soft stuff”; it’s the foundation for everything else.
When a GP and a Pharmacist trust each other, information flows, patient care improves, and work becomeslighter rather than harder. When local leaders talk regularly and transparently, problems are solved before they become systemic issues.
We talk about integration as if it’s an IT function, but integration is a human activity. It happens through consistency, honesty and time spent listening.
The best neighbourhoods I’ve seen are the ones really changing access and outcomes and are the ones where local leaders have invested time in each other.
Community Pharmacy has to see relationship-building not as a distraction from delivery, but as part of delivery. It’s an investment that pays back in trust, referrals, data-sharing and joint problem-solving.
Breaking Down the Barriers
The barriers to collaboration are well known: data silos, incompatible systems, rigid contracts, and a lack of shared accountability.
Community Pharmacies want to manage more acute conditions and long-term monitoring, but without shared care records or referral loops, it becomes operationally risky.
Pharmacies detect high blood pressure, but too often that information vanishes into the ether. There’s willingness everywhere but the plumbing of the system doesn’t support the flow.
That’s why we have to re-engineer collaboration from the ground up. The building blocks are already there:
· Shared Care Records that allow bidirectional updates.
· NHS Login and digital booking systems that can connect patients to the right part of Primary Care, not just the GP practice.
· Population health analytics that can identify unmet needs across neighbourhoods and direct preventive interventions through whichever Primary Care provider is best placed.
Community Pharmacy must demand and help design interoperability. Not as a tech project, but as a patient-safety and access priority.
Playing to community pharmacies' strengths
Community pharmacy’s future won’t be secured through volume dispensing. That model is under strain, and everyone knows it. The opportunity lies in redefining community pharmacy’s role as the clinical, preventative and accessible arm of primary care. That means focusing on four key areas:
1. Prevention and Early Detection Pharmacies should be central to cardiovascular prevention, offering BP, cholesterol and diabetes checks, embedding risk-assessment tools, and referring into PCN-led prevention hubs. Patients don’t care where their risk is spotted; they care that it is.
2. Long-Term Condition Support: With their expertise, pharmacists are ideally placed to help people manage chronic diseases. Structured medication reviews, inhaler optimisation, and adherence support, all should sit within a shared neighbourhood approach.
3. Social Prescribing and Health Coaching Pharmacies see patients frequently and informally. That’s a perfect gateway to social prescribing, lifestyle advice and behaviour change. A conversation at the counter can be the moment someone chooses to take control of their health.
4. Neighbourhood Collaboration Community Pharmacy should be part of every neighbourhood’s access plan, every prevention strategy, and every urgent-care model. By aligning with Optometry, Dentistry and General Practice around shared populations, not separate lists, we create a system that genuinely wraps around people.
This is where community pharmacy can lead, by showing how collaboration works in practice, not waiting for permission or pilots.
Unity within community pharmacy: setting the tone
Before community pharmacy can lead outwardly, it has to look inward.
If we want other sectors to see community pharmacy as a reliable, strategic partner, we must show unity within our own ranks.
Too often, our energy is spent competing internally between multiples and independents, between local and national networks, between contract types and delivery models.
That fragmentation weakens our collective voice and confuses the system about what community pharmacy wants to be.
It’s time to stop looking sideways at each other and start looking forward together. We need a shared national narrative that says clearly:
- We are part of primary care.
- We are ready to collaborate.
- We are indispensable to prevention, access, and continuity.
- That unity sets the tone for how others engage with us.
- When Community Pharmacy speaks with one voice, confident, outward-facing, and focused on patient outcomes, system partners listen differently.
- Leadership beyond logos
Let’s be honest: too much system energy is still wasted on egos and politics.
Endless meetings about governance, branding, or who “owns” what, while patients wait longer and staff burn out.
We need leadership that’s about outcomes, relationships and delivery, not job titles or organ logos.
The measure of success shouldn’t be who chairs the meeting, but whether the people in that community are healthier, accessing care earlier, and staying well for longer.
Community pharmacy leaders, both local and national, can model this by showing system maturity by focusing on what’s best for patients and the profession, not just what fits a particular organisation’s agenda.
Building a unified primary care
The potential for primary care to reform itself is enormous.
Imagine a patient journey that starts in a local pharmacy with a blood-pressure check, moves seamlessly to a GP follow-up, and is supported by a health coach between reviews.
Imagine shared messaging between pharmacy and dental teams about smoking cessation, or between optometrists and GPs about diabetes risk.
That’s what a unified primary care system looks like professionals with distinct skills, working as one network, powered by trust and shared data.
Community pharmacy can be the glue that holds that system together.
A movement, not a meeting
If we wait for top-down reform, we’ll still be waiting in five years. This change has to come from within.
Every ICB and every place now has the opportunity to shape primary care integration locally.
Community pharmacy leaders should be at those tables not as invitees, but as equal partners.
That’s where the culture of a Unified Primary Care begins.
It starts with relationships. It grows through collaboration. And it succeeds when the system finally stops seeing four separate sectors and starts seeing one Primary Care, one purpose, one direction.
The call to community pharmacy
Community pharmacy has always been close to its patients. Now it must get closer to its partners.
If we want to deliver the NHS’s ambition of care closer to home, community pharmacy must stand shoulder-to-shoulder with the rest of primary care, proactive, connected, and confident.
We have the infrastructure. We have the talent. What we need now is unity, relationships, and leadership that look beyond contracts and toward outcomes.
Because the future of primary care and the sustainability of the NHS, will be built not on competition, but on collaboration.
And community pharmacy can be the one to lead it.
Conor Price is Chief Executive of Community Pharmacy London and Director of CoreHealth Partners, working nationally to bring General Practice, Community Pharmacy and wider Primary Care closer together. With a background spanning frontline delivery and system leadership, he focuses on relationships, data and digital innovation that enable collaboration and practical reform across the NHS.
