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Nnenna Odoh reflects on her new role as community pharmacy primary care network lead for HASP (Hull Association of Similar Practices) PCN…

When I was appointed to the role, one of the first things that struck me was the scale of the opportunity: seven community pharmacies, five GP practices and thousands of patients moving through the same local healthcare system.

The services already exist. The clinical skills already exist. What interests me now is how we connect them.

In my own pharmacy, clinical services are already a substantial part of daily practice. We routinely deliver Pharmacy First consultations, blood pressure case-finding, ambulatory blood pressure monitoring, New Medicine Service consultations, vaccinations and other clinical services alongside the dispensing workload.

Recent activity has included around 80 to 120 blood pressure checks each month, with approximately six to 12 patients progressing to ABPM. PharmData figures also show a recent three-month average of approximately 82 Pharmacy First consultations and 152 NMS interventions a month.

Those numbers have reinforced something I have believed for some time: community pharmacy already has meaningful clinical capacity. The challenge now is ensuring that this capacity is visible, understood and connected to the rest of primary care.

Looking beyond one pharmacy

As a pharmacy manager, much of my focus has naturally been on what we can achieve within my own team.

That has meant developing clinical service delivery, building confidence among team members, creating opportunities to identify eligible patients and making services part of the pharmacy's everyday workflow rather than treating them as an occasional addition.

But there is a limit to what one pharmacy can achieve in isolation. My new PCN role has made me think about the bigger picture.

What happens when seven pharmacies are considered collectively rather than separately? What clinical capacity already exists across those pharmacies?

Do the five GP practices in the PCN know exactly what each pharmacy can offer? Do practice teams know how to refer into those services? Do pharmacies know how best to communicate back?

And perhaps most importantly, does the patient experience those organisations as connected parts of one primary care system? That is where I think the real opportunity lies.

The pathways already exist but often informally

One of the interesting things about community pharmacy and general practice is that referrals already happen. In my own pharmacy, we occasionally receive patients referred through Accurx.

We also see patients who tell us that their GP practice has asked them to attend the pharmacy for a blood pressure check.

Likewise, community pharmacists refer patients back to general practice every day when further medical assessment is needed. The issue is that these pathways are not always consistent or formalised.

For example, if I assess a patient in the pharmacy and identify symptoms or red flags that require GP review, simply telling the patient to “see your GP” may not be enough.

I may have taken a clinical history, identified the concern and made a professional decision that further assessment is required. But once the patient arrives at the surgery, all that information can be reduced to ‘the pharmacist told me to come’.

So where appropriate, I have tried to make that handover clearer. Sometimes I communicate with the patient's GP practice using secure NHS email, explaining the presentation and why I believe further assessment is required.

At other times, I provide the patient with a short written referral note detailing the relevant concern, red flags and reason for referral. These are small interventions, but they point to a much bigger issue.

The patient should not be expected to act as the messenger between two healthcare professionals when useful clinical information has already been gathered.

Hypertension has shown me what connected care can achieve

One of the clearest examples I have seen of joined-up working is hypertension case-finding. We undertake a significant number of blood pressure checks in the pharmacy, and where appropriate, patients progress to ABPM.

The results can then be communicated to the patient's GP practice for further assessment. What makes this especially tangible is when patients come back.

We have had patients return and tell us that they have since seen their GP and started a new antihypertensive medicine. At that point, the journey has moved from pharmacy to general practice. But it often comes back again.

Some of those patients later return to the pharmacy with concerns about their new medicine. They may be unsure how to take it, worried about a possible side effect or simply need reassurance.

Where eligible, we can enrol them into the New Medicine Service rather than automatically directing them back to the GP practice.

That gives us an opportunity to explore adherence, discuss their experience of the medicine, address appropriate concerns and identify when further medical review is genuinely required.

For me, that is a much more useful way to think about the patient journey. It is not pharmacy or GP. It is pharmacy, GP and pharmacy again, depending on what the patient needs at each stage.

The next step is visibility

One of the first things I want to understand through the PCN role is how visible community pharmacy services really are to local GP teams.

It would be easy to assume that low referral numbers mean practices do not know what pharmacies provide. I do not want to make that assumption.

There may be many reasons why referrals are currently limited. Practice teams may not know which pharmacies offer a particular service.

They may know a service exists but not know whether the pharmacy has capacity that day. They may be uncertain about the referral method.

They may not know what feedback they will receive after the patient has been seen. Or perhaps there are already good informal systems in place that simply need to be shared more widely.

My first priority therefore is not to arrive with a finished solution. It is to listen. I want to understand what the seven pharmacies are currently offering, what the five GP practices currently need, what is already working and where the gaps actually are.

Mapping what we can provide

For community pharmacy to become a more reliable part of the referral pathway, I think we need to be able to describe our offer clearly.

It’s not just ‘we provide Pharmacy First’ but ‘which services are available?’ And ‘which pharmacies provide them? What is the realistic capacity? How should a patient be referred?

‘What happens once they have been seen? And what happens when the pharmacy reaches capacity?’

That is a very different conversation. A GP receptionist or care navigator should not need detailed knowledge of every community pharmacy service specification.

They need something practical. They need to know, for example, that an appropriate patient can be directed to a participating pharmacy, what information needs to accompany that referral and what they can expect afterwards.

That simplicity is what turns a service from something that technically exists into something that becomes part of everyday practice.

Capacity needs to be honest

I also think pharmacy needs to be open about capacity. Offering a clinical service does not mean a pharmacy can absorb unlimited referrals.

Community pharmacy teams are balancing dispensing, clinical checks, booked consultations, walk-in demand, vaccinations, medicines queries and increasingly complex clinical activity.

If general practice is going to refer more patients into community pharmacy, we need an honest conversation about what each pharmacy can safely and consistently manage.

One pharmacy may be able to accept a certain number of Pharmacy First referrals in a day. Another may have more or less capacity depending on staffing, workload and available clinical space.

That is not a weakness. It is useful operational information.

Seven pharmacies each contributing realistic capacity could create something much more substantial than any one pharmacy working alone.

That is one of the things I am particularly interested in exploring through the PCN role. Instead of asking ‘can this pharmacy see the patient?’ we begin asking ‘what community pharmacy capacity exists across the PCN and how can we make best use of it?’

Two-way referral has to mean two-way communication

I also want to explore how referral outcomes are communicated. If a GP practice refers a patient to pharmacy, there should ideally be a clear way of knowing that the referral has been actioned.

Did the patient attend? Was the condition managed in pharmacy? Was treatment supplied? Was self-care advice given? Was the patient escalated elsewhere?

The same applies when pharmacy refers back into general practice. If the pharmacist has already assessed the patient, identified red flags or gathered relevant clinical information, the GP practice should receive that information in a way that supports triage.

The exact system is something I want to discuss with practices and pharmacies. Could Accurx be used more consistently? What role should NHS email play? Could PharmOutcomes or other existing systems support feedback?

I am less interested in prescribing one particular digital solution than in agreeing a process that people will actually use.

Pharmacy First is part of the opportunity

Pharmacy First creates a particularly obvious opportunity for this type of working.

Our pharmacy is already delivering a significant number of consultations without a fully developed local GP referral pathway.

That makes me curious about what could happen if local practices had clearer visibility of pharmacy capacity and an agreed route for appropriate referrals.

But increasing referral numbers should not become an end in itself. The value comes from directing the right patient into the right service.

If a patient can be safely managed through Pharmacy First, that can potentially avoid them needing a general practice appointment.

If their presentation falls outside the service or requires medical assessment, pharmacy should be equally confident about sending them back with appropriate clinical information.

The aim should not simply be to move workload from general practice into community pharmacy. It should be to make better use of the clinical capacity that already exists across both.

The pharmacy team matters too

For pharmacists to spend more time providing clinical care, the wider pharmacy team has an important role.

Pharmacy technicians, accuracy checking technicians, dispensing assistants, healthcare assistants and other trained team members increasingly contribute to the safe and efficient running of the pharmacy.

Developing the whole team allows pharmacists to spend more time where their clinical skills are most valuable. That has been an important part of my own management approach.

Clinical service growth is rarely achieved by one pharmacist working harder. It comes from building a team that can identify opportunities, understand the services available and support the workflow around those consultations.

As we talk about community pharmacy taking a larger role within primary care, I think we also need to recognise the importance of developing the people around the pharmacist.

What I want the first year to achieve

I am at the beginning of this PCN role, so I think it is important not to write the success story before the work has happened.

My priorities at this stage are relatively straightforward. I want to understand what each of the seven pharmacies currently provides.

I want to understand what the five GP practices would find most useful from community pharmacy. I want to identify where referrals are already happening successfully and where they are breaking down.

I want us to explore realistic pharmacy capacity. I want to develop clearer two-way communication. And I want to make it easier for patients to move between community pharmacy and general practice without feeling that they have entered two completely separate systems.

Success for me would not simply be measured by a rise in referral numbers. I would want to see greater confidence between professionals.

I would want GP teams to know what community pharmacies can offer. I would want pharmacists to know how to escalate effectively. I would want referral outcomes to become more visible.

And ultimately, I would want patients to reach the most appropriate professional more efficiently.

Independent prescribing adds another layer

Independent prescribing expands the range of clinical care pharmacies can provide, but it has also reinforced something important.

Additional clinical capability only reaches its full value when the wider system knows it exists and has a practical way of accessing it.

Independent prescribing will allow pharmacists to do more. But integration determines whether those skills become part of the wider patient pathway.

That is why I see the development of referral relationships as something that needs to happen alongside the growth of pharmacist prescribing, not afterwards.

A before-and-after story

One of the things I find most exciting about starting this role now is that there is an opportunity to measure what happens next.

This is the ‘before’. We know what services exist. We know that referrals already happen, but often at relatively low volume or through informal routes.

We know that community pharmacy has clinical capacity. Now we can start asking what changes when those pieces become more deliberately connected.

I would like to return to this work later and look at what actually happened. Did GP referrals increase? Did pharmacies feel the pathway was manageable?

Which services were used most? Did practices find the system useful? What did not work? What had to change? And most importantly, did patients experience a more joined-up journey?

That, for me, is where the real learning will come from.

One patient pathway

Seven pharmacies and five GP practices may be separate organisations, but the patient moving between them does not necessarily see those organisational boundaries. They simply want help.

Community pharmacy already has the accessibility, the clinical services and increasingly the clinical capability to contribute much more extensively to primary care.

General practice has the diagnostic, prescribing and longitudinal care infrastructure that remains essential. The opportunity is not to make one replace the other.

It is to connect them better. That is what I hope to explore through my role as community pharmacy PCN lead for HASP PCN.

Not seven pharmacies working next to five GP practices. But one patient pathway, supported by both.