03.9.2026 Shelley Gibbins
Earlier this week the Department of Health published its Neighbourhood Health Framework. It aims to deliver a vision where services collaborate at a neighbourhood level and move care from hospital to the community and from sickness to prevention. Our Head of Marketing, Shelley Gibbins, looks at what this means for community pharmacy.
The Neighbourhood Health Framework will be central to regaining public confidence in the NHS and the aim is to accelerate improvements in delivery in the short term while creating new, sustainable ways of working for the future. Integrated Care Boards have been asked to implement a series of minimum interventions in every community over the next three years. Part of that includes building on the progress made to strengthen pharmacists’ role in delivering care and recognising that pharmacies are one of the most accessible parts of primary care.
Pharmacy: The NHS’s Most Accessible Front Door
The framework states that pharmacies’ convenience for patients means they are “optimally placed” to offer services such as contraception, blood pressure checking and support on smoking cessation, as well as the Pharmacy First service.
“As pharmacies become increasingly established in supporting prevention and treating minor illness our ambition is for pharmacies to become a first point of contact for more patients to support demand on general practice.”
It continues to say that, with all newly qualified pharmacists able to independently prescribe from 2026, there is an enormous opportunity.
“As the number of prescribing-trained pharmacists grows, the ability to manage demand in primary care will rely on pharmacy teams, including prescribers, managing a greater volume of patient need.”
The framework asked ICBs to start to roll out local prescribing-based services which it says will be supported through a national digital infrastructure.
“Not only will these developments support a greater range of patients within existing patient group direction (PGD) led services, but they will unlock opportunities to improve management of everyday prescriptions, support medicines value and overprescribing opportunities and reduce pressure on general practice.”
The Gap Between Policy and Reality
The ambition is clearly for pharmacy to become a first point of contact for many patients. But it will take more than ambition to make this a reality. Despite repeated recognition of pharmacy’s potential, the sector continues to face many barriers including, unsustainable funding models, capacity constraints and workforce shortages. Without investment in infrastructure and workforce, pharmacy’s role in neighbourhood health risks remaining unrealised. Quite simply this framework reinforces what we already know - pharmacy is being expected to do more while still being funded and structured to do less.
Why Hub and Spoke Is No Longer Optional
If pharmacy is to act as the NHS front door, it cannot remain anchored to a dispensing-heavy, branch-based model. Dispensing still dominates the workload and limits pharmacies from delivering clinical consultations and preventative services.
By shifting the administrative, high-volume task of dispensing into centralised hubs, pharmacy branches can release workforce time, reconfigure physical space for clinical care and focus on patient-facing services. In a neighbourhood health model built on multidisciplinary teams and rapid access, hub and spoke is not a “nice to have”, it is an essential. Without hub and spoke, pharmacy cannot scale.
The Question of Funding
But hub and spoke alone isn’t enough. Perhaps the most critical issue here is the one of funding. It is no secret that the current pharmacy funding contract is not sustainable and a serious injection of cash is needed to support pharmacies to survive as their role in frontline healthcare grows.
Current pharmacy funding models remain largely tied to dispensing volumes, an approach fundamentally misaligned with neighbourhood health ambitions. Without fair, activity-based and clinically focused funding, the model breaks down. Pharmacies cannot invest in their workforce, adopt hub and spoke at scale or participate fully in neighbourhood teams. Without a sustainable funding model, not only are pharmacies unable to transform, many more face closure.
From Policy to Practice: What Must Change
If the Neighbourhood Health Framework is to succeed, three shifts are essential for pharmacy:
1. Structural reform to enable Hub and Spoke at scale
Dispensing must be removed from the branch wherever possible to unlock clinical capacity.
2. Contractual reform to pay for care, not supply
A fair and sustainable funding model must reward clinical services, prevention, and outcomes, not just volume.
3. System integration that places pharmacy at the core rather than the periphery
Pharmacy must be embedded in neighbourhood teams as a clinical partner, not an optional add-on.
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