Delivering Healthier Communities across Scotland

Manifesto

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Introduction

Community Pharmacy Scotland (CPS) is a member organisation that represents community pharmacy owners throughout Scotland. Our expert teams deliver NHS care services to the people of Scotland from over 1,200 accessible premises, usually without the need for an appointment. CPS negotiates with the Scottish Government to agree on the terms, remuneration and reimbursement of these NHS services.

Ahead of the 2026 Scottish Parliamentary elections, CPS has identified four key areas that it believes political parties must prioritise with respect to community pharmacy services. Only by investing in these areas can our network of pharmacies support NHS transformation and the delivery of a healthier Scotland. In this manifesto, we highlight how pharmacy teams are ideally placed to prevent, detect and treat ill health, helping to address some of the most pressing challenges facing Scotland today. From diabetes and cardiovascular disease to weight-related health issues and the unacceptable toll of drug-related deaths, we know that our teams can make a meaningful contribution with the right investment. To take on these extended roles effectively and efficiently, our infrastructure and funding must also be prioritised.

Early intervention, trusted relationships and accessible care are key to improving outcomes, and community pharmacy is uniquely placed to deliver on all three.

This manifesto reflects our commitment to the people of Scotland and our willingness to lead and deliver real change. We urge policymakers to recognise and invest in the power of community pharmacy as part of the foundation for a healthier, fairer Scotland.

Our priority policy ambitions for the 2026 Scottish Parliament election:

1) The community pharmacy network should be commissioned to deliver a national NHS weight loss service, focussing on the direct use of medicines.

2) CPS calls for the establishment of a national substance use service and centralised funding, ensuring that our teams are uniformly commissioned to focus on the care and interventions that best protect our most vulnerable people.

3) 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.

4) CPS would like to see further investment in NHS Pharmacy First Scotland to include more treatment protocols and expand the prescribing element further.

5) The community pharmacy network should be commissioned to undertake cardiovascular screening in target populations.

6) The community pharmacy network should be commissioned to deliver a suite of women’s health services, with the aim of improving choice and access to NHS medications and advice.

7) CPS believes that better digital infrastructure and information sharing is essential in achieving a shift from secondary to primary care interventions. These digital requirements must be defined and delivered as a priority.

Our priority policy ambitions for Prevent:

  • The Weight of The Nation:

    In 2023, 32% of all adults in Scotland were living with obesity. It is well understood that the impact of chronic obesity on health outcomes is devastating not just for the individual, but also for the health services battling against a rising tide of type 2 diabetes, cardiovascular disease and cancers. Supporting people to achieve and maintain a healthy weight is a critical and urgent priority.

    Community pharmacy teams already excel as weight management providers through their private offerings by supporting behaviour change, in person, alongside the appropriate use of medications. Deploying these new medicines as recommended by the National Institute for Health and Care Excellence (NICE) through the community pharmacy network on behalf of the NHS would ensure safety and effectiveness through a trusted supply chain and the ability to deliver face-to-face consultations.

  • Tackling Drug Deaths:

    Community pharmacies play a significant role in supporting people who use drugs through locally commissioned services for harm reduction and advice.

    In 2023, a national service which guarantees that every pharmacy in Scotland holds a supply of Naloxone for use in emergency overdoses. We are determined that this is developed further to train and make supplies to those most at risk.

    CPS also fully supports Healthcare Improvement Scotland’s ‘24 report on MAT standards implementation, which highlighted areas for improvement and standardisation.

Our priority policy ambitions for Detect:

  • Targeted Diabetes Screening:

    NHS Scotland spends ~ £875 million (4.5% of the total budget) annually on diabetes care for almost 340,000 people. Over half of this is spent managing avoidable complications.

    Preventative measures are crucial to addressing this challenge but can only be deployed effectively if those most at risk can be identified accurately and engaged with. This can be challenging 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. A recent study using community pharmacy teams in NHS Tayside to identify at-risk individuals has not only been proven feasible, but more effective than traditional services in terms of use of resources and patient acceptability.

  • Cardiovascular Disease:

    Despite significant improvement, an estimated 700,000 people in Scotland are living with a cardiovascular disease today and this collection of conditions still cause 29% of all deaths annually.

    The main predictive factors for heart attack and stroke are well established and easily measured: atrial fibrillation, high blood pressure and high cholesterol. As these predictive factors can go completely unnoticed in terms of symptoms, many people in Scotland have no idea of their risk of developing or already having cardiovascular disease.

    Crucially, this means that they often have no reason to be routinely engaged with NHS services, so are never screened despite other risk factors such as age and weight suggesting that they should be.

Our priority policy ambitions for Treat:

  • NHS Pharmacy First Scotland:

    In 2020, this service was launched to build on the Minor Ailments Service which preceded it, to offer an NHS consultation service for common health conditions to all members if the public resident in Scotland. Since the service launch, pharmacists were also enabled via clinical protocols to supply certain prescription-only medications under specific circumstances where appropriate – for example to treat urinary tract infections in women and treatment for impetigo and shingles among other conditions. The service has continued to grow, and latest figures show that almost 1.9m people accessed the service in the year to September 2024 – diverting demand from other areas of the health service.

    Pharmacists with an independent prescribing qualification and additional clinical skills training can consult on and treat more complex cases. At the time of writing, this additional capability was available in over a third of community pharmacies across the country – but the service needs additional funding if this expansion is to be sustainable.

  • Women’s Health Offering:

    Expanding the options available to women at community pharmacy has previously been identified as an ambition of the Scottish Government’s. Community pharmacy has for many years been the leading provider of free NHS emergency contraception, and more recently the launch of a ‘bridging contraception’ service has provided women with improved access to effective, regular oral contraception for up to six months. However, more could be done to extend NHS services delivered via local community pharmacies - from period delay, contraception and preconception right through to menopause and beyond.

Infrastructure and Integration

Community pharmacy teams deliver NHS services every day yet often feel disconnected from the wider health system. Despite being contractors to the NHS, they face barriers such as poor access to clinical data and outdated IT systems, which make day-to-day tasks more difficult and reduce the overall value of service delivery.

Pharmacy owners want to deliver more for patients but are held back by systems and settings that have not kept pace with modern practice. Investment in premises, technology and system integration is essential to support efficient, high-quality NHS service delivery.

  • Paperless Dispensing:

    The Digital Prescribing and Dispensing Pathways (DPDP) programme will phase out paper prescriptions but does not yet support paperless dispensing in pharmacies. Current dispensing processes rely heavily on paper, and each pharmacy business is built around this.

    A move to paperless dispensing will require investment in new hardware, systems and connectivity at all 1,200 + pharmacy sites – and done well this would free up pharmacy team time to deliver the clinical services described above.

  • IT Systems and Connectivity:

    While digital service claiming has progressed in some areas, existing IT infrastructure often limits how services are delivered, recorded and evaluated. Current systems are built around outdated architecture that cannot easily adapt to new service models.

    As more and more clinical services are delivered there is also a need for seamless connectivity to, and information sharing with, other NHS services. Having the right information is critical to ensuring that patients are seen by the right professional, in the right setting, at the right time – particularly during the out of hours period. Improving visibility of community pharmacy interventions for the rest of the NHS is also necessary if we are to deliver the most efficient, effective and safest patient journeys as a whole system.