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NHS70

NHS70: major moments in pharmacy 1948–2018

The lives of pharmacists and the medicines they manage have changed dramatically since the NHS was created. Here, we chart the milestones that shaped the profession.

To view the full infographic, click here.

The big numbers: 1948 versus 2018

The big numbers

1948 versus 2018

1948: Health secretary, Aneurin Bevan (pictured), launches the National Health Service (NHS) entitling people to free prescriptions and therefore drastically increasing dispensing volumes within community pharmacies

Health secretary, Aneurin Bevan

Source: PA Images

1953: A wider role for hospital pharmacists is recognised in the Linstead Report, including greater involvement on the wards, in medical education in teaching hospitals and in making medical decisions alongside prescribers

1958: Pharmacists become responsible for the safe and secure handling of medicines within a whole hospital, not just the pharmacy department, following a government inquiry and the subsequent publication of the Aitken Report

Hospital ward

Source: Alamy Stock Photo

1963: A committee on safety of drugs is set up to try to avoid another disaster like that of thalidomide (pictured), which was withdrawn in 1961 after suspicions it caused birth defects. The committee creates a system of reporting adverse drug reactions that becomes known as the ‘Yellow Card Scheme’

Thalidomide capsules in blister pack

Source: Science Photo Library

1968: The Medicines Act 1968 brings together existing medicines legislation and establishes a licensing system for medicines. It also introduces the concept of pharmacy (P) medicines

1971: The hospital pharmacy service is reorganised on the back of a report from Sir Noel Hall, which suggests restructuring the service to increase career prospects and making better use of resources and expertise

1981: The Conservative Party’s Minister for Health, Gerard Vaughan, admits to the 1981 British Pharmaceutical Conference that he cannot see a future for community pharmacists. This leads to the Nuffield inquiry report of 1986, which, for the first time, recognises a wider role for community pharmacists

1983: First switches from prescription-only medicines to P medicines occur, including ibuprofen, loperamide and terfenadine, widening pharmacists’ role and increasing access for patients

Pharmacist explaining medicine to customer

Source: Science Photo Library

1985: The number of medicines prescribable on the NHS is reduced to exclude many cough remedies, digestives, laxatives and analgesics, creating a renewed demand for over-the-counter medicines

OTC medicines

Source: Alamy Stock Photo

1986: A pharmacy on-call system is introduced in hospitals after the Nuffield Report describes hospital pharmacy as a “clinical pharmacy service” and recommends 24-hour cover

1987: Regulations restricting the opening of new pharmacies are introduced in the UK, with new pharmacies having to prove that their NHS service is “necessary and desirable”

1991: Nicotine gum becomes the first form of nicotine replacement therapy to be made available from pharmacies, paving the way for NHS pharmacy-based smoking cessation services

Nicotine gum and tablets

Source: Science Photo Library

1992: Pharmacies in Scotland start to offer supervised methadone consumption services; English pharmacies follow from 1996

Methadone in pharmacy

Source: Alamy Stock Photo

1997: The Yellow Card Scheme is extended to hospital pharmacists, and to community pharmacists two years later. A four-year Master of Pharmacy course is introduced to prepare pharmacists for their extended NHS roles

1999: The National Institute for Clinical Excellence is established, with the aim of creating consistent guidelines and ending the ‘treatment postcode lottery’. The Scottish Medicines Consortium follows in 2001, and the All Wales Medicines Strategy Group in 2002

2001: Schering launches Levonelle, the first emergency hormonal contraception available as a P medicine, widening pharmacists’ role in women’s health

Levonelle morning after pill launched by Schering

Source: Science Photo Library

2003: Supplementary prescribing for pharmacists is introduced following publication of the NHS Plan 2000, which set out a policy on non-medical prescribing to improve patient care

2005: A new community pharmacy contract is introduced in England and Wales, which rewards provision of high-quality NHS services as well as dispensing volume. Exemptions to the “necessary and desirable” test for market entry are introduced in England, including supermarket, 100-hour, primary care centre and distance-selling pharmacies. The electronic prescription service is launched in England, although implementation is slow

Pharmacy supermarket

Source: Alamy Stock Photo

2006: Pharmacist independent prescribing is introduced. A new community pharmacy contract is launched in Scotland that moves away from payment by prescription volume for the first time and includes a national minor ailment scheme

NHS prescription

Source: Alamy Stock Photo

2009: The Royal Pharmaceutical Society introduces mandatory continuing professional development for pharmacists

2011: New market entry arrangements come into force in Scotland. Regulations in England follow in 2012, implementing market entry tests based on pharmaceutical needs assessments and removing existing exemptions for 100-hour, primary care centre and supermarket pharmacies. Regulations are amended in Wales in 2015

2013: Primary care trusts in England are abolished and replaced by clinical commissioning groups as commissioners of NHS pharmacy services. Local authorities become commissioners of NHS public health services from community pharmacies. A national minor ailment scheme is launched in Wales

2014: Primary care clusters are established in Wales, expanding the role of pharmacists in general practice

2015: Community pharmacists in England are granted access to a summary of patient records and a pilot of pharmacists in GP practices is funded by the government. An NHS seasonal influenza vaccination service is introduced in England

Flu vaccine

Source: Science Photo Library

2016: An overhaul of community pharmacy funding in England is announced by the government, including cutting the total budget by 4% for 2016/2017 and a further 3.4% for 2017/2018, scrapping establishment payments and introducing a new quality payment scheme

2017: NHS England publishes national guidance on a range of medicines that should no longer be routinely prescribed in primary care, with the aim of saving £140m a year

2018: Revalidation for pharmacists and registered pharmacy technicians is introduced. Inadvertent dispensing errors are decriminalised, ending a ten-year battle to remove the threat of criminal prosecution for community pharmacists

Statue of the Old Bailey in London

Source: Shutterstock.com

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205049

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  • The big numbers: 1948 versus 2018

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