Targeted Diabetes Screening Through Community Pharmacy

Published: 20/11/25

In line with our Manifesto, a key policy area is that of detecting illness in those who may present at the Community Pharmacy with or without symptoms.

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It appears that people are accessing the NHS in Scotland later in the course of their illness and more unwell than has been the case in the past.

The reasons for this are many and include:

• We are still feeling the impact of the COVID-19 pandemic, where most routine care had to be placed on hold for a significant period of time.

• Current waiting times for most services has increased and patients are reportedly struggling to access on-the-day primary care appointments

• The Health Foundation has highlighted that there is a link between rising costs of living and people avoiding care services due to financial stress – be that the cost of missing work or transport costs acting as a barrier.

The consequences of this emerging pattern are therefore presenting as:

• More critical health events that could be prevented with earlier intervention occurring – for example, heart attacks, strokes and diabetes-related complications.

• More advanced cancers at diagnosis, affecting survival rates.

• Complex disease at presentation (in particular at Emergency Departments)

Whilst these challenges are not brand new, they have intensified in recent years the world over and as a result the prediction and detection of ill health at the earliest possible stage has become a cornerstone of modern health policy.

We believe that NHS and Scottish Government public health experts should work with CPS to identify screening programmes that the community pharmacy network can support and add value to.

One Such Area Is Targeted Diabetes Screening

The NHS in Scotland spends around £875 million (4.5% of the total budget) annually on diabetes care for almost 340,000 people living with the disease. Over half of this is spent on managing avoidable diabetes-related complications, which are more than twice as likely to occur in people from areas of multiple deprivation. Diagnoses have more than doubled in the last 20 years.

Whilst the ideal scenario would be to prevent diabetes, we should also strive to detect cases of diabetes as early as possible. This can be a challenge as often those unknowingly living with the disease or even the risk of developing it have no reason to engage proactively with the health service.

As such, reaching out into communities with targeted and evidence-based screening programmes should form part of the efforts to reform the NHS and we believe that the community pharmacy network is ideally placed to support this shift in approach.

A recent study using community pharmacy teams in NHS Tayside to identify at-risk individuals and take them through an assessment (and if necessary a point-of-care blood test) has shown that this approach is not only feasible, but more effective than traditional services in terms of use of resources and patient acceptability.

In this study:

• 46% of those approached to undertake the risk assessment were identified as being at moderate/high risk of developing diabetes. This cohort of people, who would otherwise be unaware of their risk of developing diabetes, were then supported to access advice and care appropriate to their blood test results.

• 87% were signed up to a digital lifestyle education app

• 6.2% met the criteria to be referred to an intensive 9-month diabetes prevention programme

• 6.3% were referred to their GP under suspicion of undiagnosed disease

Whilst these results are in themselves indicative of success, there is huge potential for pharmacy teams to offer related interventions for instance weight management services, or the initiation of other evidence-based preventative therapies such as statins in the community setting.

CPS therefore believe that the community pharmacy network should be commissioned to carry out a targeted diabetes screening programme, linking with NHS services to ensure those identified as being at risk are supported to make meaningful lifestyle changes.

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